Content validity of the Mental Health Literacy Scale for perinatal use based on expert and patient input

Perinatal mental health disorders (PMHD) remain underdiagnosed and undertreated in the United Arab Emirates (UAE). Limited mental health literacy (MHL) among perinatal patients contributes significantly to poor help-seeking behavior and delayed interventions. Valid, culturally adapted measures are necessary to assess MHL in this population. This study aimed to translate and examine the Mental Health Literacy Scale's (MHLS) content validity for Emirati perinatal patients. A cross-sectional validation study was conducted at a tertiary hospital in the UAE using the Mutaba'ah cohort. The study followed the World Health Organization and COSMIN translation and content validity guidelines. The Arabic version, named MHLS-Emirate (MHLS-E), was evaluated by 20 healthcare professionals (10 perinatal clinical experts, 10 mental health experts) and 10 Emirati perinatal patients. Ratings for relevance, clarity, and comprehensiveness were analyzed using the Content Validity Index (CVI) and Kappa statistics. Expert reviewers determined that the majority of the items in the adapted Arabic scale were relevant to the concept of mental health and suitable to Emirati perinatal patients. Initially, perinatal patients regarded the items as generally clear and understandable, however some of the content was less relevant to their personal experiences. The scale was revised in response to this feedback by culturally adapting items and adding a new attribute to myths related to mental disorders. Post-revision, all items were considered clear, relevant, and appropriate for the target population by both experts and patients following these modifications.The MHLS-E demonstrated excellent content validity following cultural and contextual adaptation. Incorporating expert and patient perspectives ensured the measure's relevance and clarity for Emirati perinatal patients. Future psychometric testing is recommended to evaluate reliability and construct validity within this population.