Measuring youth health engagement: development of the youth engagement with health services survey.
OBJECTIVE
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.
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.
Rachel A
RA
Sebastian
Department of Pediatrics, University of New Mexico, Albuquerque, New Mexico.
Mary M
MM
Ramos
Child and Adolescent Health Measurement Initiative, Oregon Health and Science University, Portland, Oregon.
Scott
S
Stumbo
Department of Pediatrics, University of New Mexico, Albuquerque, New Mexico.
Jane
J
McGrath
Academy Health, Washington, DC.
Gerry
G
Fairbrother
D000293:Adolescent; D016497:Adolescent Health Services / Q000706:statistics & numerical data*; D003120:Colorado; D003710:Demography; D005260:Female; D015438:Health Behavior; D057220:Health Literacy; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D009516:New Mexico; D011594:Psychometrics / Q000379:methods*; D011795:Surveys and Questionnaires
Adolescent health services; Health literacy; Patient engagement; Preventive health services; Quality of health care; Self-efficacy