Objective: The goal of this project was to develop a migraine functional measurement instrument, derived from the World Health Organization International Classification of Impairments, Disabilities, and Handicaps version 2 classification system, which focuses on functional outcomes, and is both reliable and valid.
Methods: The Functional Assessment in Migraine (FAIM) questionnaire was developed using a multistep approach to ensure the brevity, relevance, reliability, and validity of items. A test set of 71 Mental Functioning and 50 Activity and Participation items was generated and administered to migraineurs in the United States and Germany. A subset of 22 Mental Functioning and 28 Activity and Participation items that rated highly on frequency-weighted importance and showed strong psychometric properties was piloted to determine a final item set and to test reliability and validity.
Results: The final version of the FAIM included nine Mental Functioning items measuring the dimensions of Attention/Thought (5 items) and Perception (4 items), and a list of 28 Activity and Participation items from which respondents chose the five items most relevant to their lifestyle. Construct validity analysis of FAIM dimensions found significant positive correlations with self-reported symptom severity, moderately significant positive correlations with dimensions of the Migraine-Specific Quality of Life questionnaire and no significant correlation with Short Form Health Survey (SF-12) component scores.
Conclusion: The FAIM offers physicians a brief and valid method of measuring the impact of migraine on mental functioning and activity and participation as defined by the WHO International Classification of Functioning, Disability, and Health. Additional testing is underway to assess its responsiveness to change.
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Background: Mental health remains among the top 10 leading causes of disease burden globally, and there is a significant treatment gap due to limited resources, stigma, limited accessibility, and low perceived need for treatment. Problem Management Plus, a World Health Organization-endorsed brief psychological intervention for mental health disorders, has been shown to be effective and cost-effective in various countries globally but faces implementation challenges, such as quality control in training, supervision, and delivery. While digital technologies to foster mental health care have the potential to close treatment gaps and address the issues of quality control, their development requires context-specific, interdisciplinary, and participatory approaches to enhance impact and acceptance.
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