YFHS-WHO+ Questionnaire: validation of a measure of youth-friendly primary care services.
OBJECTIVE
To develop and validate a research tool to measure the youth friendliness of primary care services from a client's perspective.


METHODS
The questionnaire was initially developed in English, but as it was to be used in Bosnia and Herzegovina (BiH), it was validated in the language of this country. Items were adapted from two sources: a reproductive health services quality improvement questionnaire from the World Health Organization, and an Australian survey used to assess youth-friendly primary care services. An English-speaking international panel reviewed the list of items for face validity. After translation-back translation, the questionnaire was pretested with adolescent patients from a family practice in BiH. The stability and construct validation were then conducted with 60 young people from six different health services in BiH. Items for the final questionnaire were selected using item response theory.


RESULTS
The validation and item response analysis led to a 49-item tool. Test-retest stability at 1 week was excellent (mean κ: .93). Construct validation was supported by the fact that services with the highest and the lowest scores on the questionnaire were also those that had many and few, respectively, youth-friendly characteristics, as assessed by experts, on a predefined evaluation grid. Services seeing a higher proportion of adolescents also had higher scores on the questionnaire.


CONCLUSIONS
This study supports the validity of the YFHS-WHO+ questionnaire for assessing the level of youth friendliness of family medicine services for research purposes. Further validations in English and French will allow wider use of this tool in the future.
Department of Community Medicine and Primary Care, Geneva University Hospitals, Geneva, Switzerland. dagmar.haller-hester@hcuge.ch
Dagmar M
DM
Haller
Anne
A
Meynard
Daliborka
D
Pejic
Ana
A
Sredic
Senad
S
Huseinagic
Delphine S
DS
Courvoisier
Nicolas
N
Perone
Lena A
LA
Sanci
Françoise
F
Narring
D000293:Adolescent; D016497:Adolescent Health Services / Q000592:standards*; D017522:Bosnia and Herzegovina; D002648:Child; D003144:Communication Barriers; D003219:Confidentiality; D005260:Female; D006801:Humans; D007802:Language; D008297:Male; D010342:Patient Acceptance of Health Care; D011320:Primary Health Care / Q000592:standards*; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires; D055815:Young Adult