Development and validation of an instrument to measure resources and support for chronic illness self-management: a model using diabetes.
Few comprehensive and practical instruments exist to measure the receipt of self-management support for chronic illness. An instrument was developed to measure resources and support for self-management (RSSM) for the survey component of the evaluation of the Robert Wood Johnson Foundation's Diabetes Initiative. It includes items to measure an ecological range of RSSM. This article describes the development and validation of the instrument, focusing on individuals' reported access to RSSM from providers and from nonclinical, social, and community sources.



Cross-sectional analyses of the second wave of a survey of participants in the Diabetes Initiative (68% response rate, n = 957) were used.



Confirmatory factor analyses supported grouping the 17 items into 5 subscales, measuring key aspects of RSSM: individualized assessment, collaborative goal setting, enhancing skills, ongoing follow-up and support, and community resources (comparative fit index = 0.97, Tucker-Lewis fit index = 0.99, and root means square error of approximation = 0.06). The overall scale and 5 subscales were internally consistent (Cronbach alpha >or= .70) and were significantly, positively related to diabetes self-management behaviors, supporting their construct validity.



This instrument shows promise for measuring RSSM. Although it was developed for diabetes programs, its ecological orientation and link to the broad framework of chronic care suggest broader application.
McCormack
Lauren A
LA
RTI International, Research Triangle Park, North Carolina (Drs McCormack, Williams-Piehota, Bann, and Kamerow, and Mr Burton and Ms Squire)
Williams-Piehota
Pamela A
PA
RTI International, Research Triangle Park, North Carolina (Drs McCormack, Williams-Piehota, Bann, and Kamerow, and Mr Burton and Ms Squire)
Bann
Carla M
CM
RTI International, Research Triangle Park, North Carolina (Drs McCormack, Williams-Piehota, Bann, and Kamerow, and Mr Burton and Ms Squire)
Burton
Joseph
J
RTI International, Research Triangle Park, North Carolina (Drs McCormack, Williams-Piehota, Bann, and Kamerow, and Mr Burton and Ms Squire)
Kamerow
Douglas B
DB
RTI International, Research Triangle Park, North Carolina (Drs McCormack, Williams-Piehota, Bann, and Kamerow, and Mr Burton and Ms Squire)
Squire
Claudia
C
RTI International, Research Triangle Park, North Carolina (Drs McCormack, Williams-Piehota, Bann, and Kamerow, and Mr Burton and Ms Squire)
Fisher
Edwin
E
UNC-Chapel Hill, North Carolina (Dr Fisher)
Brownson
Carol A
CA
Washington University School of Medicine, St Louis, Missouri (Ms Brownson)
Glasgow
Russell E
RE
Kaiser Permanente Colorado, Denver, Colorado (Dr Glasgow)
D002908:Chronic Disease; D003071:Cognition; D003920:Diabetes Mellitus / Q000534:rehabilitation*; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D010353:Patient Education as Topic; D044469:Racial Groups; D012648:Self Care; D012944:Social Support