Scale of perception of contraceptive counseling in adolescents: adaptation and validation

Abstract

Objective: To adapt and validate The Consumer Assessment Healthcare Providers and Systems (CAHPS) Cultural Competence (CC) Item Set for contraceptive counseling in adolescents.

Materials and methods: The adaptation and validation process included: 1) authorization from the original author, 2) consensus selection of items representative of patient-centered care, 3) calculation of the content validity index (CVI) through expert evaluation, 4) linguistic adaptation for adolescents through focus groups (n=6), 5) pilot testing (n=30), and psychometric analysis in a descriptive correlational study with non-probabilistic sampling (n=200) of adolescents attending prenatal consultations at clinics in Health Jurisdiction III of Guanajuato, Mexico. Exploratory factor analysis was used with varimax rotation with loadings of 0.40, Kaiser Meyer Olkin criterion, and Cronbach's alpha.

Results: Once authorized, 24 items were selected, the IVC was 0.92, wording adjustments were made changing the formal address from “usted” to “tú” and unknown words were replaced, the pilot test resulted in a Cronbach's Alpha of 0.912, the final scale consisted of 23 items, five factors, reliability of α= 0. 941, and an explained variance of 59.2%.

Conclusion: The adapted scale showed validity and reliability to evaluate the perception of contraceptive counseling in adolescents, constituting a pioneering tool specifically adapted for adolescents and young mothers in vulnerable contexts. It is suggested that it be validated in other populations, such as male and adult adolescents, as well as in order to deepen the concepts of shared decision and negative communication.

Keywords: Adolescent; Contraception; Validation study; Reproductive health services; Family planning services.