TY - JOUR
T1 - Development of a new Adolescent Patient-Provider Interaction Scale (APPIS) for youth at risk for STDs/HIV
AU - Woods, Elizabeth R.
AU - Klein, Jonathan D.
AU - Wingood, Gina M.
AU - Rose, Eve S.
AU - Wypij, David
AU - Harris, Sion Kim
AU - Diclemente, Ralph J.
N1 - Funding Information:
This work was supported in part by National Institute of Mental Health Grants 1 R03 MH65152-02 and 1 R01 MH61210-05, National Institutes of Health; and Project 5T71MC00009-13 and 5T1MC00012-13 from the Maternal and Child Health Bureau (Title 5, Social Security Act), Health Resources and Services Administration, Department of Health and Human Services. Special thanks to Jennifer Lackett for her library searches, and S. Jean Emans, M.D. for her review of the manuscript. We would like to thank the HORIZONS Project research team for their assistance with data collection and data management.
PY - 2006/6
Y1 - 2006/6
N2 - Purpose: Although an adult model of patient-provider mutual exchange of information has been proposed, there is no guiding model for adolescents or measurement methodology. Our purpose was to develop a new scale of patient-provider interaction for adolescents accessing reproductive health care and at risk for sexually transmitted diseases (STDs) and human immunodeficiency virus (HIV), and assess the reliability and validity of the scale. Methods: The Adolescent Patient-Provider Interaction Scale (APPIS) was developed from the Roter and Hall theory of doctor-patient relationships, previously validated adolescent satisfaction and communication scales, and focus group and individual elicitation interviews. To assess construct validity, the new nine-item APPIS was compared with the satisfaction scale used by the Young Adult Health Care Survey (YAHCS), and Kahn's Provider Communication Scale. Pearson correlation coefficients were used to examine convergence across scales, and factor analysis of the APPIS was performed. Results: The study recruited 192 African American girls aged 17.9 ± 1.7 years (range 15-21 years) from three sites: a county STD clinic (n = 51), urban adolescent clinic (n = 99), and a family planning clinic (n = 42). Most participants (85%) rated their overall health care highly (≥ 7 on a 10-point scale); 49% felt that both the provider and patient were "in charge" of the visit, and 88% "strongly agreed" or "agreed" that there was an equal "exchange of information" during the visit. The APPIS showed good internal consistency (Cronbach alpha = .75), and moderate convergence with the six-item YAHCS scale (r = .57, p < .001) and seven-item Kahn scale (r = .48, p < .001). Three factors emerged from exploratory factor analyses, supporting our conceptualization of patient-provider interaction as being multi-dimensional. Conclusions: A new theory-based scale of adolescent patient-provider interaction compares favorably with previous scales of health care satisfaction and communication. The new APPIS may be useful for evaluating approaches to improve health care outcomes for adolescents at-risk for STDs and HIV.
AB - Purpose: Although an adult model of patient-provider mutual exchange of information has been proposed, there is no guiding model for adolescents or measurement methodology. Our purpose was to develop a new scale of patient-provider interaction for adolescents accessing reproductive health care and at risk for sexually transmitted diseases (STDs) and human immunodeficiency virus (HIV), and assess the reliability and validity of the scale. Methods: The Adolescent Patient-Provider Interaction Scale (APPIS) was developed from the Roter and Hall theory of doctor-patient relationships, previously validated adolescent satisfaction and communication scales, and focus group and individual elicitation interviews. To assess construct validity, the new nine-item APPIS was compared with the satisfaction scale used by the Young Adult Health Care Survey (YAHCS), and Kahn's Provider Communication Scale. Pearson correlation coefficients were used to examine convergence across scales, and factor analysis of the APPIS was performed. Results: The study recruited 192 African American girls aged 17.9 ± 1.7 years (range 15-21 years) from three sites: a county STD clinic (n = 51), urban adolescent clinic (n = 99), and a family planning clinic (n = 42). Most participants (85%) rated their overall health care highly (≥ 7 on a 10-point scale); 49% felt that both the provider and patient were "in charge" of the visit, and 88% "strongly agreed" or "agreed" that there was an equal "exchange of information" during the visit. The APPIS showed good internal consistency (Cronbach alpha = .75), and moderate convergence with the six-item YAHCS scale (r = .57, p < .001) and seven-item Kahn scale (r = .48, p < .001). Three factors emerged from exploratory factor analyses, supporting our conceptualization of patient-provider interaction as being multi-dimensional. Conclusions: A new theory-based scale of adolescent patient-provider interaction compares favorably with previous scales of health care satisfaction and communication. The new APPIS may be useful for evaluating approaches to improve health care outcomes for adolescents at-risk for STDs and HIV.
KW - Adolescents
KW - Mutual exchange of information
KW - Patient satisfaction
KW - Patient-provider interaction
KW - Provider communication
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U2 - 10.1016/j.jadohealth.2005.08.013
DO - 10.1016/j.jadohealth.2005.08.013
M3 - Article
C2 - 16730606
AN - SCOPUS:33646778808
SN - 1054-139X
VL - 38
SP - 753.e1-753.e7
JO - Journal of Adolescent Health
JF - Journal of Adolescent Health
IS - 6
ER -