Learning Objective #1: Identify considerations that may be necesary in developing an instrument for a culturally diverse adolescent population

Learning Objective #2: Identify innovative ways to obtain access to large numbers of adolescents necessary for instrument development

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Background: Insurance providers scrutinize health care utilization choices; some to restrict access if resources have been used inappropriately. The “inappropriate” use of emergency services for nonurgent illnesses has been identified as a major cost in health care utilization. Parents with limited resources often utilize the emergency room for primary care for their children. Parent's appropriate use of health care resources for their children depends on the ability to recognize the degree of illness in their child. This is difficult for new parents, particularly adolescents, with little prior experience caring for ill children. Conversely, the inability of caregivers to recognize how ill a child is and not seek health care in a timely manner can have potentially detrimental outcomes for the child. Significance: The instrument developed measured ability of young caregivers (or potential caregivers) to differentiate varying degrees of severity of illness of young children. Purpose and Specific Aims: The study purpose was to develop a reliable and valid instrument that measures ability of adolescents to recognize severity of illness in children. Aims of the study: (1) develop a scenario based instrument to measure the ability of subjects to recognize varying degrees of illness severity; (2) evaluate psychometric properties including content validity, construct validity test-retest reliability and internal consistency. Setting and Sample: A diverse convenience sample of 722 adolescents was sampled from clinics and schools in Western NY. Test-retest validity was done with 24 participants. Research Design: The study was conducted in 3 stages. Stage 1: The item pool was developed with extensive literature reviews and expert input for content validity. It was administered to 35 subjects for a pilot study. Stage 2: The instrument was administered twice with two week separation for test/retest procedures. Stage 3: The instrument was administered to a large diverse sample with examination of psychometric properties.