An Innovative Youth-Friendly Electronic Questionnaire to Identify Mental, Sexual and Reproductive Health Risks: A Validation Study of the Total Teen Assessment.
Garney W, Wilson K, et al. • Health expectations : an international journal of public participation in health care and health policy • 2025
The Total Teen Assessment is a statistically and clinically valid instrument that can be used to easily evaluate adolescent needs related to sexual, reproductive and mental health, helping providers identify risks early to reduce the likelihood of major issues.
Key Findings
Background
Only 50% of adolescents complete recommended screenings at their last annual preventive health appointment, with less than half of providers discussing recommended health topics.
The American Medical Association and the American Academy of Pediatrics both recommend screenings during adolescents' annual preventive health appointments.
Barriers contributing to low completion rates include time constraints and provider discomfort.
This gap in care motivated development of an electronic questionnaire solution.
Background
The Total Teen (TT) Assessment is a novel online questionnaire designed to assess adolescent health needs across three domains: sexual and reproductive health, mental health, and substance use behaviors.
The instrument was developed as a youth-friendly electronic questionnaire.
It is intended for use during adolescents' annual preventive health appointments.
The tool aims to address provider barriers such as time constraints and discomfort with sensitive topics.
It targets health needs that 'often go unnoticed until they require severe clinical intervention.'
Methods
The TT Assessment was developed and validated through a three-phase psychometric study.
Phase 1 focused on scale development.
Phase 2 validated content with both patients and healthcare providers.
Phase 3 utilized psychometric testing to ensure the scale adequately assessed its intended domains.
Both quantitative psychometric analyses and qualitative investigations were conducted.
Results
Parallel analysis of the TT Assessment's correlation matrix extracted three distinct factors corresponding to the instrument's intended domains.
Factor 1 was identified as sexual health.
Factor 2 was identified as mental health.
Factor 3 was identified as substance use.
The factor structure confirmed the instrument's intended multidomain assessment framework.
Results
The TT Assessment demonstrated both statistical validity and clinical validity.
Quantitative psychometric analyses revealed the instrument's 'soundness.'
Qualitative investigations revealed its 'clinical relevance and diagnostic accuracy.'
The instrument was described as 'statistically and clinically valid' for evaluating adolescent sexual, reproductive, and mental health needs.
Conclusions
The TT Assessment was found to be an instrument that can be easily adapted to assess the needs of adolescent patients.
The tool is designed to help providers identify sexual, reproductive, and mental health needs early.
Early identification is intended to 'reduce the likelihood of major issues.'
The electronic format was designed to address practical barriers faced by healthcare providers in clinical settings.
What This Means
This research describes the development and testing of a new electronic health questionnaire called the Total Teen (TT) Assessment, designed to help healthcare providers screen teenagers for sexual and reproductive health concerns, mental health issues, and substance use during routine annual checkups. The study was motivated by the fact that despite official recommendations from major medical organizations, only about half of adolescents receive complete recommended screenings, partly because providers face time pressure and discomfort discussing sensitive topics with young patients.
The researchers developed the questionnaire in three stages: first building the scale, then checking its content with both patients and healthcare providers, and finally conducting statistical testing to confirm it accurately measures what it is supposed to measure. The statistical analysis confirmed that the questionnaire captures three distinct areas — sexual health, mental health, and substance use — and both the numbers-based testing and the feedback from patients and providers confirmed the tool is accurate and clinically useful.
This research suggests that a structured, youth-friendly electronic questionnaire could help close the gap in adolescent preventive care by making it easier and less uncomfortable for providers to screen for sensitive health topics. By identifying problems early — before they escalate into serious medical or mental health crises — tools like the TT Assessment could potentially improve health outcomes for teenagers whose needs might otherwise go unrecognized until they become severe.
Garney W, Wilson K, Patterson M, Holden C, Flores S, Panjwani S, et al.. (2025). An Innovative Youth-Friendly Electronic Questionnaire to Identify Mental, Sexual and Reproductive Health Risks: A Validation Study of the Total Teen Assessment.. Health expectations : an international journal of public participation in health care and health policy. https://doi.org/10.1111/hex.70313