Validation of the youth version of the Alimetry® Gut-Brain Wellbeing Survey: a mental health scale for young people with chronic gastroduodenal symptoms

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Abstract Background Chronic gastroduodenal symptoms present significant challenges for young people, often negatively impacting their quality of life and mental health. However, there is currently a lack of validated tools to assess mental health in young people with chronic gastroduodenal symptoms. This research outlines the development and validation of the Alimetry® Gut-Brain Wellbeing Survey-Youth Version (AGBW-Y), a novel tool for assessing mental health in young people with chronic gastroduodenal symptoms aged 12-17 years. Methods An iterative multi-phase approach was employed. In Phase 1, feedback was gathered from 19 paediatric clinicians in the gastroenterology field and 33 young people over multiple rounds to adapt the adult version of the AGBW Survey to be age-appropriate for young people aged 12-17 years. In Phase 2, rigorous psychometric testing of the adapted scale was conducted in a sample of 128 patients aged 12-17 years with chronic gastroduodenal symptoms, using an anonymous online survey. Results Based on the feedback from Phase 1, an interdisciplinary team of experts improved the survey’s language and usability for young people, including the removal of reverse-coded items. These adjustments enhanced the scale’s clarity, acceptability, and face and content validity. The final AGBW-Y comprises a patient preface, an opt-out option, 10 closed-ended questions, and an optional open-ended question. It assesses general mental health, alongside subscales of depression, stress, and anxiety. Phase 2 demonstrated excellent psychometric properties of the scale, including high internal consistency (α= .91 for the total scale; α= .75-.85 for subscales) and strong convergent, divergent, and concurrent validity with large effect sizes. Conclusions The AGBW-Y is a brief, reliable, and valid tool to assess mental health in young people with chronic gastroduodenal symptoms. This novel scale was developed through a rigorous co-design process with clinicians and young people, ensuring it is contextually relevant and clinically impactful. The AGBW-Y complements existing physiological assessments, enabling more accurate mental health evaluations which can be used to guide psychological referrals, support multidisciplinary care, and evaluate treatment outcomes.

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