Development and validation of the Personal Recovery Scale (ReConnect) for Mental Health in Ethiopia

Purpose To develop and validate a mental health personal recovery measure for people with mental health conditions (MHCs) in Ethiopia that is grounded in their recovery journey. Methods The study stages were: reviewing existing measures; qualitative exploration of the concept in Ethiopia (n = 25 interviews); expert workshops (n = 3 involving 28 experts); cognitive interviewing for semantic and content validity (n = 20); pilot study for item reduction and exploratory factor analysis (n = 213) and parallel analysis to determine the dimensional structure (n = 213); and assessment of construct (confirmatory factor analysis) and construct validity in an independent sample (n = 401), and test-retest reliability in a sub-sample (n = 48). Construct validity was assessed against symptom severity and disability. Results Participants gave greater emphasis to social recovery than self-actualisation or empowerment; hence, no existing measures had face validity. We piloted 26 items from existing measures and 19 newly developed items. The draft measure was unidimensional, explaining 71% of variance, and had item-test correlations > 0.58. Item reduction resulted in 20-item scale, ReConnect (Recovery and Connection Scale). In the validation study, ReConnect was unidimensional with acceptable goodness of fit indices and test-retest reliability and correlated significantly with symptom severity and functioning. Conclusion ReConnect is a valid and reliable measure of personal recovery in Ethiopia. It has potential applicability to other similar settings where the community has a greater role in the recovery journey.