25 - Cooperative experiences may be a novel protective factor for youth mental health

Publication Number: 3022.25

Benjamin P. L.. Meza, University of California, Los Angeles David Geffen School of Medicine, Los Angeles, CA, United States; Ron D.. Hays, UCLA, Los Angeles, CA, United States; Rebecca N. Dudovitz, University of California, Los Angeles David Geffen School of Medicine, Los Angeles, CA, United States; Mitchell D. Wong, University of California, Los Angeles David Geffen School of Medicine, Los Angeles, CA, United States

Background: Social environments for youth are changing in unprecedented ways as more of our social lives move online. Caregivers and health practitioners need feasible and effective solutions to rebuild and sustain healthy social environments for young people. Cooperative experiences (e.g., sports, clubs, or co-creation platforms) may be a key element in creating protective social environments that promote mental health and resilience. A critical step to developing and testing cooperative interventions is measuring aspects of cooperative experiences salient to health.

Objective: To develop a novel measure of exposure to cooperative experiences and assess its psychometric properties and associations with youth mental health.

Design/Methods: We developed and revised a 48-item measure of cooperative experiences (cooperation scale) based on the literature and 20 cognitive interviews. We recruited 262 English-proficient youth aged 13-25 years through youth-serving organizations and snowball sampling to complete an investigator-administered or self-administered survey including the MCE, health (self-reported mental health, self-reported health, depression (Patient Health Questionnaire Scale-2) and anxiety (General Anxiety Disorder Scale-2) symptoms, and demographics (age, gender, race/ethnicity, education level, employment). For all outcomes, lower values indicate better health. We assessed item distributions and dimensionality. Linear regressions tested whether cooperation and cooperation subscale scores were associated with health, controlling for demographic covariates.

Results: Table 1 shows the sample demographics. The cooperation scale was reduced to 24-items based on preliminary analyses (Cronbach's alpha=0.88). Three subscale factors were identified using exploratory factor analysis: positive interdependence (10 items, alpha=0.86), negative interdependence (6 items, alpha=0.87), and group belongingness (8 items, alpha=0.85). Higher cooperation simple-summated total score and its 3 subscales were associated with better self-reported mental health and self-reported health (i.e., lower scores) but were not significantly related to anxiety or depression screening total score.

Conclusion(s): The study provides preliminary support for the reliability and construct validity of a new measure of exposure to cooperative experiences among youth. The cooperation scale holds promise as a tool to examine the relationship between social environments and health outcomes in real-world settings. Future studies are needed to assess the cooperation scale longitudinally and evaluate interventions to promote youth mental health.

Table 1. Cooperation scale subscales and sample survey items.
The table lists the three subscales within the cooperation scale, description of each subscale domain, and example items. Respondents provide the name of the activity they feel has had the greatest impact on their lives in the last 12 months. The "" field populates with the name of the respondent's activity within each question.

Table 2. Participant characteristics (N = 262)


Figure 1. Associations between the measure of cooperative experiences score (total and individual dimensions) and health outcomes.
The x-axis values of the forest plot are standardized beta coefficients where zero indicates no association (null) and one indicates one standard deviation change in the outcome per standard deviation change in the exposure. Horizontal bars represent 95% confidence intervals around the estimate. Each facet represents a different outcome variable (i.e., self-reported mental health, self-reported health, PHQ-2 total summed score, or GAD-2 total summed score) and each y-axis label represents an exposure variable (i.e., total score, positive interdependence score, negative interdependence score, group belongingness score).