Other Titles
Rising Star Poster/Presentation
Abstract
Background / Problem Statement: Refugees experience disproportionately high rates of post-traumatic stress disorder, depression, and anxiety due to trauma exposure and post-migration stressors (Hynie et al., 2023). Virtual mental health services have the potential to reduce structural barriers, yet participation in virtual screening remains limited among refugee populations (Mohamud et al., 2024). Language barriers, stigma, cultural beliefs, privacy concerns, and limited digital literacy collectively influence help-seeking behaviors and restrict engagement with virtual mental health platforms (Ekeleme et al., 2024; MacPherson, 2023). Structural factors such as internet access and affordability continue to constrain utilization (Matlin et al., 2024). Despite these barriers, theory-based tools assessing refugees’ behavioral intentions toward virtual mental health screening remain lacking.
Objectives: Develop and validate a culturally and theoretically grounded instrument (TPB-RIVMHS Scale) to measure attitudes, subjective norms, perceived behavioral control, and intention related to refugees’ participation in virtual mental health screening.
Methods: An instrument development and validation study was conducted to develop the TPB-RIVMHS Scale.A 21-item self-administered questionnaire measured attitudes (6 items), subjective norms (5 items), perceived behavioral control (7 items), and behavioral intention (3 items) using 7-point scales (Ajzen, 1991). Item generation followed established scale development procedures (DeVellis, 2016).
Content validity was assessed using the Content Validity Index (CVI) by a seven-member expert panel (Polit & Beck, 2006). Four open-ended questions explored perceived advantages, disadvantages, facilitators, and barriers to participation.
Conclusion: The TPB-RIVMHS Scale demonstrates strong content validity as a culturally grounded, theory-based instrument for assessing refugees’ intentions to participate in virtual mental health screening. This instrument addresses a critical measurement gap and provides a foundation for future studies to evaluate reliability and predictive validity in larger refugee populations.
Results: All items demonstrated acceptable relevance, with item-level CVI values ≥ .78. The scale-level CVI indicated strong overall content validity. Experts confirmed that items were clear, culturally appropriate, and theoretically aligned with TPB constructs. No items were removed, and only minor wording refinements were recommended.
Notes
References:
Ajzen, I. (1991). The theory of planned behavior. Organizational Behavior and Human Decision Processes, 50(2), 179–211. https://doi.org/10.1016/0749-5978(91)90020-t
DeVellis, R.F. (2016). Scale Development: Theory and Applications. Vol. 26, Sage, Thousand Oaks.
Ekeleme, N., Yusuf, A., Kastner, M., Waite, K., Montesanti, S., Atherton, H., & O’Neill, B. (2024). Guidelines and recommendations about virtual mental health services from high-income countries: A rapid review. BMJ Open, 14(e079244). https://doi.org/10.1136/bmjopen-2023-079244
Hynie, M., Jaimes, A., Oda, A., Rivest-Beauregard, M., Perez Gonzalez, L., Ives, N., & McKenzie, K. (2023). Access to virtual mental healthcare and support for refugee and immigrant groups: A scoping review. Journal of Immigrant and Minority Health, 25, 1171–1195. https://doi.org/10.1007/s10903-023-01521-1
MacPherson, M. (2023). Immigrant, refugee, and Indigenous Canadians’ experiences with virtual health care services: A rapid review. JMIR Human Factors, 10, e47288. https://doi.org/10.2196/47288
Matlin, S. A., Hanefeld, J., Corte-Real, A., Da Cunha, P. R., De Gruchy, T., Manji, K. N., Netto, G., Nunes, T., Sanlier, I., Takian, A., Zaman, M. H., & Saso, L. (2024b). Digital solutions for migrant and refugee health: a framework for analysis and action. The Lancet Regional Health - Europe, 50, 101190. https://doi.org/10.1016/j.lanepe.2024.101190
Mohamud, H., Toulany, A., Grandi, S. M., Altaf, A., Fu, L., Strauss, R., & Saunders, N. R. (2024). Language ability and virtual mental healthcare utilization among immigrant and refugee youth: A population-based cohort study. Archives of Disease in Childhood, 0, 1-6. https://doi.org/10.1136/archdischild-2023-326507
Polit, D. F., & Beck, C. T. (2006). The content validity index: are you sure you know what's being reported? Critique and recommendations. Research in nursing & health, 29(5), 489–497. https://doi.org/10.1002/nur.20147
Sigma Membership
Delta Xi
Lead Author Affiliation
Kent State University, Kent, Ohio, USA
Type
Poster
Format Type
Text-based Document
Study Design/Type
Other
Research Approach
Other
Keywords:
Measuring Instruments, Immigrants, Anxiety Disorders, Mental Health, Mental Depression, Mental Health Screening, Health Behavior, Help-Seeking Behavior
Recommended Citation
Elshalabi, Rami S. and Hansen, Dana, "TPB-RIVMHS: Theory-Based Scale of Refugees’ Intentions for Virtual Mental Health Screening" (2026). International Nursing Research Congress (INRC). 115.
https://www.sigmarepository.org/inrc/2026/posters_2026/115
Conference Name
37th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Toronto, Ontario, Canada
Conference Year
2026
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Review Type
Invited Presentation
Acquisition
Proxy-submission
Date of Issue
2026-09-24
TPB-RIVMHS: Theory-Based Scale of Refugees’ Intentions for Virtual Mental Health Screening
Toronto, Ontario, Canada
Background / Problem Statement: Refugees experience disproportionately high rates of post-traumatic stress disorder, depression, and anxiety due to trauma exposure and post-migration stressors (Hynie et al., 2023). Virtual mental health services have the potential to reduce structural barriers, yet participation in virtual screening remains limited among refugee populations (Mohamud et al., 2024). Language barriers, stigma, cultural beliefs, privacy concerns, and limited digital literacy collectively influence help-seeking behaviors and restrict engagement with virtual mental health platforms (Ekeleme et al., 2024; MacPherson, 2023). Structural factors such as internet access and affordability continue to constrain utilization (Matlin et al., 2024). Despite these barriers, theory-based tools assessing refugees’ behavioral intentions toward virtual mental health screening remain lacking.
Objectives: Develop and validate a culturally and theoretically grounded instrument (TPB-RIVMHS Scale) to measure attitudes, subjective norms, perceived behavioral control, and intention related to refugees’ participation in virtual mental health screening.
Methods: An instrument development and validation study was conducted to develop the TPB-RIVMHS Scale.A 21-item self-administered questionnaire measured attitudes (6 items), subjective norms (5 items), perceived behavioral control (7 items), and behavioral intention (3 items) using 7-point scales (Ajzen, 1991). Item generation followed established scale development procedures (DeVellis, 2016).
Content validity was assessed using the Content Validity Index (CVI) by a seven-member expert panel (Polit & Beck, 2006). Four open-ended questions explored perceived advantages, disadvantages, facilitators, and barriers to participation.
Conclusion: The TPB-RIVMHS Scale demonstrates strong content validity as a culturally grounded, theory-based instrument for assessing refugees’ intentions to participate in virtual mental health screening. This instrument addresses a critical measurement gap and provides a foundation for future studies to evaluate reliability and predictive validity in larger refugee populations.
Results: All items demonstrated acceptable relevance, with item-level CVI values ≥ .78. The scale-level CVI indicated strong overall content validity. Experts confirmed that items were clear, culturally appropriate, and theoretically aligned with TPB constructs. No items were removed, and only minor wording refinements were recommended.
Description
This study presents the development and content validation of a TPB-RIVMHS scale. Findings highlight a culturally grounded, validated tool addressing key barriers and supporting improved participation in virtual mental health services among refugee populations.