Relevant Functional Domains from the Integration Framework:
Child and Adolescent Health Measurement Initiative
The Young Adult Health Care Survey (YAHCS) was developed to complement existing performance measurement methods. This 56-item survey was designed to provide a streamlined, comprehensive, and actionable assessment of adherence to adolescent preventive counseling and screening guidelines.
a. Communication and experience of care: mean score on seven items asking about helpfulness of office staff, overall rating of care, and whether doctor/other providers listen carefully, explain things clearly, respect you, and spend enough time
b. Private and confidential care: average proportion reporting that they had a private and/or confidential visit
Administrative clinical data; patient/individual survey (Young Adult Health Care Survey)
Development and testing:
- 1999: Five health plans and one professional review organization: CIGNA HealthCare (Southern California Branch), Blue Cross Blue Shield of the Rochester Area, Permanente Medical Group, San Francisco Health Plan, United Health Plan, and the Institute for Child Health Policy, as part of their Florida KidCare evaluation efforts. The psychometric properties of the Young Adult Health Care Survey (YAHCS) measures of care were examined and confirmed to be sound.
- In-depth cognitive testing of the draft survey was conducted with 35 adolescents representing different socioeconomic groups, resulting in adjustments to the design, formatting, and wording of survey items. Readability analyses indicate that the YAHCS survey items are written at the 6th- to 8th-grade reading level, and cognitive testing confirmed the readability of the YAHCS across adolescents with a range of educational levels.
- YAHCS measurement scales demonstrated strong construct validity (mean factor loading = 0.64) and reliability (mean Cronbach’s alpha = .77).
- 2000-2001: Washington State Department of Health to assess for quality of care provided to adolescents enrolled in Medicaid in Snohomish County. Psychometric properties assessed and were confirmed again. Findings were similar to those shown by Bethell and colleagues.
- 2002: New York State Department of Health to "pilot" the YAHCS for assessing quality of care in five chosen health plans. Psychometric properties assessed and were confirmed again. Findings were similar to those shown by Bethell and colleagues.
Past or validated applications:
- Setting: Primary care
- Population: Young adults (14 and older)
- Level of evaluation: Health system, hospital, department clinical practice, or individual or groups of health care professionals.
The Child and Adolescent Health Measurement Initiative (CAHMI)
Oregon Health & Science University, Department of Pediatrics
Available at: www.cahmi.org. Accessed January 23, 2013.
www.childhealthdata.org. Accessed January 23, 2013.
National Quality Measures Clearinghouse (NQMC). Available at:
The YAHCS manual and development of the YAHCS tools and resources is a project of the Child and Adolescent Health Measurement Initiative (www.cahmi.org).
If you plan to use the CAHMI’s tools or measures, please visit the Web site for more detailed information (available at: www.cahmi.org) and complete the one-page User’s Form (http://cahmi.org/pages/SEctions.aspx?section=9). The CAHMI tools are nonproprietary and available at no charge. CAHMI asks that potential users review its Web site and complete this form to ensure proper implementation of the tools and keep parties up to date on modifications, improvements, or additional resources developed.