A participatory approach to creating reliable quality improvement measures for evaluating a school-based health education program among American Indian youth

Measuring psycho-social constructs for the purpose of evaluation among ATOD health-education programs can be challenging. When evaluating health-education programs that have been culturally adapted for diverse populations, a primary concern is developing psychometrically sound instruments that fit within cultural and program domains. The Dare to Be You middle-school program was developed by Colorado State University Cooperative Extension service. The University of New Mexico Prevention Research Center (UNMPRC) received permission to culturally adapt the curriculum for use in our 12-17 year old school-based health education program. Culturally adapting the program for use among the population of American Indian youth served by the PRC brought about the need to develop new evaluation instruments for the adolescent populations. Using a participatory approach, UNMPRC health educators had conversations with youth about how they relate to family and friends as they encounter the challenges of adolescence. Based upon participant comments and curriculum content, four constructs emerged as important assessment indicators: peer communication, self-concept, developmental efficacy, and self-esteem. Thirty-four American Indian youth participated in the study. Internal consistency reliabilities of the constructs were satisfactory with alphas ranging from .69 to .78. The internal consistency measures of this evaluation tool serve as starting points in determining the psychometric properties of the instrument. Using a participatory approach when developing quality improvement measures is of paramount importance as we strive for culturally sound evaluations of school-based health education programs in diverse communities.