Development and Validation of the McGill Empowerment Assessment–Diabetes (MEA-D)

Abstract

BACKGROUND Diabetes is a prevalent chronic condition that poses a major burden for patients and the health care system. Evidence suggests that patient engagement in self-care improves diabetes control and reduces the risk of complications. To provide effective interventions that aim to improve empowerment processes relating to diabetes, a comprehensive and valid measure of empowerment is needed. This article details the development and validation of the McGill Empowerment Assessment–Diabetes (MEA-D). METHODS The development and validation of the MEA-D questionnaire comprised three steps: item generation, qualitative face validation, and factorial content validation. An initial version was created by combining existing items and inductively generated items. Items were mapped to an empowerment framework with four domains: attitude, knowledge, behavior, and relatedness. Semi-structured interviews were conducted with 21 adults living with diabetes to assess face validity. The questionnaire was revised by a team of clinicians, researchers, and patient-partners. Factorial content validation was then performed using responses from 300 adult Canadians living with type 1 or type 2 diabetes. RESULTS The final version of the MEA-D contained 28 items. A moderately good item-domain correlation was found between the individual items within the four domains. Cronbach’s α was 0.81 (95% CI 0.78–0.85) for attitude, 0.73 (95% CI 0.67–0.79) for knowledge, 0.84 (95% CI 0.81–0.87) for behavior, and 0.81 (95% CI 0.77–0.84) for relatedness. CONCLUSION The evaluation of diabetes programs demands a validated measure of empowerment. We developed the MEA-D to address this need. The MEA-D may be adapted to measure patients’ empowerment regarding other chronic health conditions.

The Quebec Diabetes Empowerment Group Program: Program Description and Considerations Regarding Feasibility and Acceptability of Implementation in Primary Health Care Settings

“…Second, in support of the evaluation of the DEGP, the research team developed and validated the McGill Empowerment Assessment - Diabetes ( 20 ). This measure of empowerment related to diabetes self-care addresses the four domains of Christens' ( 19 ) empowerment framework: attitude, emotion, behavior, and relatedness.…”

“…To further support its implementation and adaptation, we are currently developing an implementation guide, which will provide more concrete and practical recommendations. We also developed and validated a measure of empowerment (MEA-D McGill Empowerment Assessment -Diabetes) ( 20 ), which will better enable an assessment of participants' needs prior to the program, and measurement of change following the program. We plan to disseminate these documents and tools across Quebec and Canadian research networks.…”

“…Through their collaborative involvement in the research, patient partners would develop recruitment material; clinicians would develop recruitment, training material, and implementation guides; administrators would provide resources to support the program's implementation and evaluation; researchers would help ensure the knowledge generation processes followed rigorous standards. Second, in support of the evaluation of the DEGP, the research team developed and validated the McGill Empowerment Assessment -Diabetes (20). This measure of empowerment related to diabetes self-care addresses the four domains of Christens' (19) empowerment framework: attitude, emotion, behavior, and relatedness.…”