OBJECTIVE: Despite recommendations that primary care clinicians counsel adolescents to reduce health-compromising behaviors, little is known about how to measure the quality of counseling clinicians provide. The objective of our study is to develop a self-administered questionnaire that assesses adolescents' perceptions of health counseling quality.

METHODS: We generated a pool of 52 Likert scale items based on a motivational counseling model and administered the items to 396 adolescents from 15 pediatric and family medicine practices immediately following preventive health care visits. Principle components factor analyses with varimax rotation were performed, varying the number of factors from 2 to 10. Subscales were shortened when possible while preserving internal consistency.

RESULTS: Mean age of respondents was 16 years (SD=1.7); 59% were female, and 25% were non-white. Twenty-two items were retained in the overall measure of quality (α=.89). A five factor solution appeared to best represent the constructs in the model. These subscales assess adolescent perceptions of clinician: patient-centeredness (6 items,α=.83); helpfulness (5 items, α=.79);clinician-centeredness (5 items α=.78); competence(4 items, α=.72); and empathy (2 items, α=.64).

CONCLUSIONS: This adolescent health counseling quality questionnaire appears to reliably assess important components of counseling quality. Given the emphasis of current adolescent health promotion strategies on primary care health counseling, reliable and valid measures of counseling quality are needed. Further development of this instrument is warranted.