Development and validation of the Soweto Coping Scale: A mixed-methods, population-based study of adults living in Soweto, South Africa.

Mental health disorders are amongst the leading contributors to the burden of disease and need to be prioritised in policy making and program implementation. In the absence of mental healthcare, people often navigate their own social support and activate individual coping mechanisms to sustain their emotional well-being. Few South African studies conceptualise and evaluate the strategies people use to manage adverse situations in non-clinical samples. We conducted two related ethnographic studies of stress and coping in Soweto (n = 107). We then used the studies to develop a novel scale to measure local forms of coping and evaluated its use in an epidemiological surveillance study (n = 933). In a split sample analysis, we first conducted exploratory factor analyses and then a comparative fit index assessment. In the exploratory factor analysis, we obtained a two-factor solution: problem-focused/emotional coping and religious coping. In the confirmatory factor analysis, both domains had good model fit above the conservative ≥ 0.95 cut-off, and both factors had adequate internal consistency (religious coping = 0.72; problem/emotion focused coping = 0.69). Both the problem-focused/emotional and the religious coping subscales were positively correlated with quality of life, except that the religious coping subscale was not correlated with social relationships. Total adverse childhood experiences were correlated with the problem-focused/emotional coping subscale but not with the religious coping subscale. We conclude that the Soweto Coping Scale provides a novel understanding of local forms of coping and can be used by mental healthcare researchers and providers who seek to develop interventions for promoting mental health and social well-being.