A New Self-Report Measure of Self-Management of Type 1 Diabetes for Adolescents

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: This study aimed to report the development and the testing of a new self-report measure to assess the Self-Management of Type 1 Diabetes in Adolescents (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 (Self-Efficacy for Diabetes Scale), quality of life (Diabetes Quality of Life for Youth Questionnaire), self-management (Diabetes Self-Management Profile), and adherence (Self-Care Inventory). Data were collected also on metabolic control (glycosylated hemoglobin HbA1c). RESULTS: The content validity index was .93. Exploratory alpha factor analyses revealed five subscales: Collaboration With Parents, Diabetes Care Activities, Diabetes Problem Solving, Diabetes Communication, and Goals (alpha = .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 Self-Efficacy for Diabetes Scale-Diabetes; Diabetes Quality of Life for Youth Questionnaire satisfaction, impact, and worry; Diabetes Self-Management Profile; and Self-Care Inventory 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 SMOD-A.