Provider adherence to system of care principles in service interactions with families is an important indicator of behavioral health service quality for youth; however, valid and pragmatic measures suitable for monitoring this quality indicator at population scale have not been developed. This article reports on two studies that developed and evaluated such a measure. In Study 1, an iterative, family-partnered process resulted in generation of 18 items that demonstrated unidimensionality and strong reliability among caregivers of youth participating in behavioral health services (N = 141). In Study 2, data from a second, statewide, stratified random sample of caregivers (N = 351) confirmed the items’ unidimensionality, discriminant validity, and criterion-related validity. Higher scores on the System of Care Adherence Scale were associated with lower risk of youth psychiatric hospitalization, greater perceived improvement in youth functioning, and greater increases in caregivers’ self-efficacy to access services. Item response theory analyses indicated the items were strongly related to adherence; however, most were optimal for differentiating between low to moderate levels of adherence. The System of Care Adherence Scale is a psychometrically sound measure suitable for population surveillance of the extent to which families experience system of care principles in their interactions with providers.

提供者在与家庭的服务互动中遵守护理原则系统是青少年行为健康服务质量的重要指标；然而，尚未制定适用于在人口规模上监测这一质量指标的有效和务实的措施。本文报告了开发和评估此类措施的两项研究。在研究 1 中，一个迭代的、家庭合作的过程产生了 18 个项目，这些项目在参与行为健康服务的青年照顾者中表现出单维性和强可靠性（N = 141）。在研究 2 中，数据来自第二个全州范围的护理人员分层随机样本 ( N= 351) 确认了项目的单维性、区分效度和标准相关效度。照护依从性量表系统得分越高，青少年精神病住院风险越低，青少年功能的感知改善程度越大，以及看护者获得服务的自我效能感的提高越大。项目反应理论分析表明项目与依从性密切相关；然而，大多数是区分低到中等依从性水平的最佳选择。护理依从性量表是一种心理测量学上合理的测量方法，适用于人口监测家庭在与提供者互动时体验护理原则系统的程度。