Validation of the Normalization MeAsure Development (NoMAD) Questionnaire in School-Based Mental Health Research

Abstract

Abstract School administrators play a pivotal role in the implementation and sustainability of school-based mental health services. Utilizing the lens of Normalization Process Theory, a framework within implementation science, we employed the Normalization MeAsure Development (NoMAD) Questionnaire to examine school principals’ perspectives of the implementation of school-based mental health services. Drawn from a sample of school principals in one Midwestern state in the United States, the purpose of the present study was to investigate whether the original factor structure of the NoMAD as applied in health care and clinical settings held with its application in the school setting. Through exploratory item factor analysis, we evaluated the psychometric properties of the NoMAD-SBMH, an adapted version of the NoMAD related to school-based mental health service implementation. Results identified a 1-factor solution yielding good psychometric properties of the NoMAD-SBMH. A shorter version of the NoMAD-SBMH was also proposed. Implications for practice, limitations, and directions for future research are discussed.