Rachel A Sebastian1, Mary M Ramos2, Scott Stumbo3, Jane McGrath2, Gerry Fairbrother4. 1. Child Policy & Population Health, James M. Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio. Electronic address: rachel.sebastian@cchmc.org. 2. Department of Pediatrics, University of New Mexico, Albuquerque, New Mexico. 3. Child and Adolescent Health Measurement Initiative, Oregon Health and Science University, Portland, Oregon. 4. Academy Health, Washington, DC.
Abstract
PURPOSE: The purpose of this study was to create and validate a survey instrument designed to measure Youth Engagement with Health Services (YEHS!). METHODS: A 61-item YEHS! survey was created through a multistaged process, which included literature review, subject matter expert opinion, review of existing validated measures, and cognitive interviewing with 41 adolescents in Colorado and New Mexico. The YEHS! was then pilot tested with a diverse group of high school students (n = 354) accessing health services at one of eight school-based health centers in Colorado and New Mexico. We conducted psychometric analyses and examined correlations between the youth health engagement scales and measures of quality of care. RESULTS: We created scales to measure two domains of youth health engagement: health access literacy and health self-efficacy. The youth health engagement scales demonstrated strong reliability (Cronbach's α .76 and .82) and construct validity (mean factor loading .71 and .76). Youth health engagement scores predicted higher experiences of care scores (p < .001) and receipt of more anticipatory guidance (p < .01). CONCLUSIONS: This study supports the YEHS! as a valid and reliable measure of youth health engagement among adolescents using school-based health centers. We demonstrate an association between youth health engagement and two quality of care measures. Additional testing is needed to ensure the reliability and validity of the instrument in diverse adolescent populations.
PURPOSE: The purpose of this study was to create and validate a survey instrument designed to measure Youth Engagement with Health Services (YEHS!). METHODS: A 61-item YEHS! survey was created through a multistaged process, which included literature review, subject matter expert opinion, review of existing validated measures, and cognitive interviewing with 41 adolescents in Colorado and New Mexico. The YEHS! was then pilot tested with a diverse group of high school students (n = 354) accessing health services at one of eight school-based health centers in Colorado and New Mexico. We conducted psychometric analyses and examined correlations between the youth health engagement scales and measures of quality of care. RESULTS: We created scales to measure two domains of youth health engagement: health access literacy and health self-efficacy. The youth health engagement scales demonstrated strong reliability (Cronbach's α .76 and .82) and construct validity (mean factor loading .71 and .76). Youth health engagement scores predicted higher experiences of care scores (p < .001) and receipt of more anticipatory guidance (p < .01). CONCLUSIONS: This study supports the YEHS! as a valid and reliable measure of youth health engagement among adolescents using school-based health centers. We demonstrate an association between youth health engagement and two quality of care measures. Additional testing is needed to ensure the reliability and validity of the instrument in diverse adolescent populations.
Authors: Warren Scott Comulada; Mary Step; Jesse B Fletcher; Amanda E Tanner; Nadia L Dowshen; Sean Arayasirikul; Kristin Keglovitz Baker; James Zuniga; Dallas Swendeman; Melissa Medich; Uyen H Kao; Adam Northrup; Omar Nieto; Ronald A Brooks Journal: J Med Internet Res Date: 2020-11-02 Impact factor: 5.428