Developing and Testing a Cross-Cultural Measure of Gender Norms and Mental Health in Adolescence

心理健康问题影响着全世界高达20%的青少年（10-19岁）， 这一年龄组中与健康有关的残疾的原因。青春期也标志着持久性的出现， 心理健康方面的性别不平等，女孩通常表现出更多的情感，男孩更多 行为症状越来越多的研究表明，除了生物学，性别规范可能会发挥作用， 通过影响这些差异的发展和表达， 青少年心理健康问题。尽管有这些证据，但仍存在重大的研究差距，部分原因是 缺乏现有的措施来调查不同性别对青少年心理健康的影响， 社会文化背景。为了解决这些差距，拟议的R21将使用顺序混合方法 方法，以开发，完善和验证一种新的措施，性别规范的看法，关于心理 智利、刚果民主共和国和印度尼西亚这三个国家的青少年健康状况。的 研究目标将通过利用约翰霍普金斯大学（JHU）调查小组的广泛的 在青少年发展，性别规范，心理健康，混合方法和规模发展的专业知识， 通过JHU全球青少年早期研究（GEAS）， 与圣地亚哥大学、金沙萨公共卫生学院和Gadjah Mada大学合作。在目标1中， 我们将与三个研究国家的青少年进行焦点小组讨论， 心理健康的性别规范观念，包括男孩和女孩习惯于 表达心理困扰，社会接受的应对策略，和社会制裁有关 违反这些规范。在目标2中，我们将开发一种新的测量方法来评估青少年对 规范心理健康各个方面的性别规范，包括来自以下方面的项目： 来自FGD的发现和（B）与心理健康相关的现有性别规范量表的回顾。这 将通过与GEAS利益攸关方的参与性研讨会和与 三个研究国家的青少年。在目标3中，我们将评估小说的信度和效度 通过在三个研究国家进行的以学校为基础的试点调查进行测量，并进行心理测量分析 用于评估和最终确定包含的项目。拟议的研究符合NIMH的研究重点， “根据神经行为、心理和环境方面的知识， 机制和轨迹，以及干预的最佳时间点。这项工作将奠定一个强有力的 未来纵向努力的方法学基础，以揭示推动 不同社会文化背景下青少年心理健康方面出现的性别差异， 美国的在这样做的过程中，它最终将为制定和实施性别平等政策提供信息， 采取变革性干预措施，改善世界各地弱势青少年的心理健康。

Mental health problems affect up to 20% of adolescents (ages 10-19) worldwide, and represent a leading cause of health-related disability among this age group. Adolescence also marks the emergence of persistent gender inequalities in mental health, with girls generally demonstrating more emotional and boys more behavioral symptoms. A growing body of research suggests that in addition to biology, gender norms may play a critical role in contributing to these differences by influencing both the development and expression of adolescent mental health problems. Despite such evidence, significant research gaps remain, driven in part by the lack of existing measures for investigating gendered influences on adolescent mental health across diverse sociocultural contexts. To address these gaps, the proposed R21 will use a sequential mixed methods approach to develop, refine, and validate a novel measure of gender normative perceptions regarding mental health in adolescence across three countries: Chile, the Democratic Republic of Congo, and Indonesia. The study aims will be completed by leveraging the Johns Hopkins University (JHU) investigative team’s extensive expertise in adolescent development, gender norms, mental health, mixed methods, and scale development, and by capitalizing upon longstanding collaborations through the JHU Global Early Adolescent Study (GEAS) with the University of Santiago, Kinshasa School of Public Health, and University of Gadjah Mada. In Aim 1, we will conduct focus group discussions (FGDs) with adolescents across the three study countries to explore gender normative perceptions of mental health, including the ways in which boys and girls are conditioned to express psychological distress, socially accepted coping strategies, and social sanctions related to transgressing these norms. In Aim 2, we will develop a novel measure to assess adolescents’ perceptions of gender norms regulating various dimensions of mental health, with included items drawn from (a) qualitative findings from the FGDs and (b) a review of existing gender norms scales with relevance to mental health. This measure will be refined through participatory workshops with GEAS stakeholders and cognitive testing with adolescents across the three study countries. In Aim 3, we will evaluate the reliability and validity of the novel measure through a school-based pilot survey across the three study countries, with psychometric analysis used to evaluate and finalize the included items. The proposed study aligns with NIMH’s research priority to “identify novel intervention targets based on knowledge of neurobehavioral, psychological, and contextual mechanisms and trajectories, and the optimal time points for intervention.” This work will lay a strong methodological foundation for future longitudinal efforts to uncover biopsychosocial processes driving the emergence of gender disparities in adolescent mental health across diverse sociocultural contexts, including the United States. In doing so, it will ultimately inform the development and implementation of gender- transformative interventions to improve mental health among vulnerable adolescents around the world.