Background
The development of instruments to measure self-management in youth with type 1 diabetes has not kept up with current understanding of the concept.
Objective
To report the development and testing of a new self-report measure to assess self-management of type 1 diabetes in adolescence (SMOD-A).
Methods
Following a qualitative study, items were identified and reviewed by experts for content validity. A total of 515 adolescents, 13 to 21 years old, participated in a field study by completing the SMOD-A (either once or twice) and additional measures of diabetes related self-efficacy (SEDS), quality of life (DQOL), self-management (DSMP), and adherence (SCI). Data were collected also on metabolic control (HbA1c).
Results
The content validity of the scale (CVI) was .93. Exploratory alpha factor analyses revealed five subscales: Collaboration with Parents, Diabetes Care Activities, Diabetes Problem-Solving, Diabetes Communication, and Goals (α = .71 to .85). The stability of the SMOD-A ranged from .60 to .88 at 2 weeks (test-retest) to .59 to .85 at 3 months. Correlations of SMOD-A subscales with SEDS-Diabetes; DQOL satisfaction, impact, and worry; DSMP; and SCI were generally significant and in the expected direction. Collaboration with Parents and HbA1c values were related significantly and positively (r =.11); all other SMOD-A subscales were related significantly and negatively to HbA1c (r = −.10 to −.26), demonstrating that better self-management is associated somewhat with better metabolic control and supporting construct validity of the new measure.
Discussion
The SMOD-A has been found to be a reliable, stable, and valid measure of self-management of type 1 diabetes in adolescence.