Assessing regimen adherence of adolescents with type 1 diabetes.
OBJECTIVE
The purpose of this study is to evaluate two updated measures of diabetes regimen adherence. The Diabetes Self-Management Profile (DSMP) is a widely used, structured interview. Limitations include a substantial interviewer and respondent time burden and the need for well-trained interviewers to use appropriate prompts and score the open-ended responses. The Diabetes Behavior Rating Scale (DBRS) is a self-administered, fixed-choice survey.


METHODS
Both measures were administered to 146 youth with type 1 diabetes (aged 11-18 years) and their parents. Items were added to the DBRS to allow for both flexible and conventional regimens, and the DSMP was modified to use standardized wording across items, accommodate flexible regimens, and permit administration by nonmedical interviewers.


RESULTS
Both measures had good evidence of internal consistency (for the DSMP: parent 0.75 and youth 0.70; for the DBRS: parent 0.84 and youth 0.84). Scores on the DSMP and the DBRS were significantly related (r = 0.72 for parents and 0.74 for youth). There was moderate agreement between parent and youth (DSMP, r = 0.51; DBRS, r = 0.48). The measures were correlated with HbA1c for both parent (DSMP, r = -0.35; DBRS, r = -0.35) and youth (DSMP, r = -0.36; DBRS, r = -0.34) reports.


CONCLUSIONS
Both measures exhibit good psychometric properties and good criterion validity but varied in terms of respondent and interviewer burden, issues that should be considered in selecting assessment procedures.
Iannotti
Ronald J
RJ
Division of Epidemiology, Statistics, and Prevention Research, National Institute of Child Health and Human Development/National Institutes of Health, 6100 Executive Blvd., 7B05, Bethesda, MD 20892-7510, USA. iannottr@mail.nih.gov
Nansel
Tonja R
TR
Schneider
Stefan
S
Haynie
Denise L
DL
Simons-Morton
Bruce
B
Sobel
Douglas O
DO
Zeitzoff
Linda
L
Plotnick
Leslie P
LP
Clark
Loretta
L
D000293:Adolescent; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy*; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D010290:Parents; D010349:Patient Compliance / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires
D006442:Glycated Hemoglobin