Adaptation and validation of a self-report measure of youth-friendly primary healthcare services

Aim To adapt the Youth-Friendly Health Services-World Health Organization+ questionnaire to suit the health needs of youth in the South African context, and estimate its psychometric properties. Background Youth-friendly health services promote health-seeking behaviour amongst young people. The perceptions of youth and adolescents are thus important whilst assessing the youth-friendliness of health services. Methods We conducted six focus group interviews to evaluate the clarity and relevance of the questionnaire items and adapted the questionnaire which was was administered to 101 youth who visited primary healthcare clinics. We reduced the number of items through quantitative analysis of responses and item analysis. Cronbach's alpha was used to optimize internal consistency reliability. Experts established a baseline of youth-friendliness. We ranked the responses from the youth against the baseline of youth-friendliness and used independent two sample t-test to test for construct validity of the final adapted version, titled Youth-Friendly Health Services- South Africa. Results or Findings After the focus group interviews, we rephrased 27 items, removed four items and added eight items. We reduced the questionnaire to 57 items whilst optimizing internal consistency reliability. The statistical analysis supported construct validity. Conclusion The Youth-Friendly Health Services-South Africa is the first English validated version and demonstrates good psychometric properties. Implication for nursing practice and health policy The Youth-Friendly Health Services-South Africa can be useful to evaluate the youths' satisfaction with the health care and nursing service they receive. This study's findings indicate that the original questionnaire can be adapted for use in different contexts to shape local and global nursing practice and policies.