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. 2023 Sep 1;31(3):458-469.
doi: 10.1891/JNM-2021-0065. Epub 2022 Oct 3.

The Design and Testing of the Psychometric Properties of the Adolescent Capacity to Engage Index Instrument to Measure an Adolescent's Capacity to Engage in Healthcare

Ellen Swartwout  1 , Edward J Hass  2 , Patricia Deyo  3 , Ashley El-Zein  4 , Brennan Lewis  5 , Suma Rao-Gupta  6
Affiliations

The Design and Testing of the Psychometric Properties of the Adolescent Capacity to Engage Index Instrument to Measure an Adolescent's Capacity to Engage in Healthcare

Ellen Swartwout et al. J Nurs Meas. .

Abstract

Background and Purpose: Engagement in one's healthcare is paramount to improving health outcomes. As adolescents begin their journey into adulthood and increase involvement in their health-care decision-making, it is critical to understand their ability to be involved in their healthcare. The purpose of this instrumentation study was to develop and evaluate the psychometric properties and underlying factors of the Adolescent Capacity to Engage Index (ACEI) tool which measures the construct of an adolescent's capacity to engage in their healthcare. Methods: This study had a two-phase approach. Phase 1 consisted of the pilot and cognitive testing of the items developed based on the literature and content expertise. Phase 2 was the testing of the final 21 item revised instrument among 15- to 17-year-old online teen panel (n = 226). Results: Psychometric testing revealed a valid and reliable 21 item scale with a four-factor solution. The Cronbach's alpha for the total scale was .901. The four subscales and each subscale Cronbach's alpha were: (a) Active Participation In Healthcare with Psychosocial Support to Aid/Foster Good Healthcare Choices, (.826); (b) Transition Readiness to Self-Management with Family Support to Guide/Foster Health/Healthcare Decisions, (.825); (c) Proactivity and Empowerment to Have a Say in Health/Healthcare, (.747); and (d) Technology Use to Seek Health/Healthcare Information (.648). Conclusions: This study demonstrated the ACEI is a psychometrically sound instrument with good internal consistency for the overall scale and subscales. The ACEI can be implemented in clinical practice to measure adolescents' engagement capacity in their healthcare and identify appropriate interventions based on ACEI score. Further research to determine engagement capacity among teens of various populations is warranted.

Keywords: activation; adolescent; autonomy and self-management; engagement; healthcare; measurement.

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