Standardized assessment tools developed in western contexts may systematically miss certain problems that are considered important in non-western cultures. In this mixed-methods study, we used an open-ended assessment tool (the Top Problem Assessment; TPA) to identify culturally relevant concerns among low-income Kenyan youth. We then (a) applied thematic analysis to identify the most frequently reported problems and (b) examined the extent to which these problems were reflected in standardized mental health measures. Using the TPA, we identified common social, academic, and economic problems facing Kenyan youths. Specifically, 61% of the sample reported a social problem, 38% an academic problem, and 35% an economic problem. By contrast, the standardized assessments revealed that worrying and difficulty concentrating were the most commonly reported symptoms. However, the emotional and behavioral problems assessed via the standardized measures were only reported as top problems by 17% of the sample. Overall, our findings are consistent with the idea that standardized measures can miss certain culturally-salient concerns that can be acquired through open-ended assessments. We discuss how brief open-ended assessment tools could complement standardized measures, inform the development of culturally relevant standardized measures, and offer rich data about the experiences of people in understudied cultural contexts.

在西方背景下开发的标准化评估工具可能会系统地忽略某些在非西方文化中被认为重要的问题。在这项混合方法研究中，我们使用开放式评估工具（顶级问题评估；TPA）来确定低收入肯尼亚青年的文化相关问题。然后，我们 (a) 应用主题分析来确定最常报告的问题，并 (b) 检查这些问题在标准化心理健康措施中的反映程度。使用 TPA，我们确定了肯尼亚青年面临的共同社会、学术和经济问题。具体来说，61% 的样本报告了社会问题，38% 报告了学术问题，35% 报告了经济问题。相比之下，标准化评估显示，担心和难以集中注意力是最常报告的症状。然而，通过标准化措施评估的情绪和行为问题仅被 17% 的样本报告为首要问题。总体而言，我们的研究结果与标准化措施可能会遗漏某些可以通过开放式评估获得的文化突出问题的想法是一致的。我们讨论了简短的开放式评估工具如何补充标准化措施，为与文化相关的标准化措施的发展提供信息，并提供有关人们在未充分研究的文化背景下的经历的丰富数据。我们的研究结果与标准化措施可能会遗漏某些可以通过开放式评估获得的文化突出问题的想法是一致的。我们讨论了简短的开放式评估工具如何补充标准化措施，为与文化相关的标准化措施的发展提供信息，并提供有关人们在未充分研究的文化背景下的经历的丰富数据。我们的研究结果与标准化措施可能会遗漏某些可以通过开放式评估获得的文化突出问题的想法是一致的。我们讨论了简短的开放式评估工具如何补充标准化措施，为与文化相关的标准化措施的发展提供信息，并提供有关人们在未充分研究的文化背景下的经历的丰富数据。