Validation of the Attitudes Towards Psychological Online Interventions Questionnaire Among Black Americans: Cross-cultural Confirmatory Factor Analysis (Preprint)

Abstract

BACKGROUND Acceptability of digital mental health interventions is a significant predictor of treatment-seeking behavior and engagement. However, acceptability has been conceptualized and operationalized in a variety of ways, which decreases measurement precision and leads to heterogeneous conclusions about ‘acceptability.’ Standardized self-report measures of acceptability have been developed, which have the potential to ameliorate these problems, but none have demonstrated evidence for validation among Black communities, which limits our understanding of attitudes towards these interventions among racially minoritized groups with well-documented barriers to mental health treatment. OBJECTIVE The present study aims to examine the psychometric validity and reliability of one of the first and most widely used measures of acceptability, The Attitudes Towards Psychological Online Interventions Questionnaire (APOI), among a Black American sample. METHODS Participants (N = 254) were recruited from a large southeastern university and surrounding metropolitan area and completed the self-report measure via online survey. A confirmatory factor analysis using mean and variance-adjusted weighted least squares (WLSMV) estimation was conducted to examine the validity of the underlying, hierarchical four-factor structure proposed by the scale’s original authors. An alternative, hierarchical two-factor structure model and bifactor model were examined for comparative fit. RESULTS Findings indicated that the bifactor model demonstrated superior fit (CFI = .96, TLI = .94, SRMR = .03 and RMSEA = .09) compared to both two and four-factor hierarchical structure models. CONCLUSIONS Findings suggest that within a Black American sample there may be greater utility in interpreting the APOI subscales as attitudinal constructs distinct from the global “acceptability” factor. Theoretical and practical implications for culturally responsive measurement are explored. CLINICALTRIAL Preregistered with the Open Science Framework (https://osf.io/y3r2p).

Validation of the Attitudes Towards Psychological Online Interventions Questionnaire Among Black Americans: Cross-cultural Confirmatory Factor Analysis

“…This study was conducted in compliance with The Georgia State University institutional review board protocol #H18341 and preregistered with the Open Science Framework [45].…”