title: Feasibility, acceptability, and predictive validity of a psychosocial screening program for children and youth newly diagnosed with type 1 diabetes.
abstract: OBJECTIVE
  Psychosocial screening has been recommended for pediatric patients with newly diagnosed type 1 diabetes and their families. Our objective was to assess a psychosocial screening protocol in its feasibility, acceptability to families, and ability to predict early emerging complications, nonadherent family behavior, and use of preventive psychology services.
  
  
  METHODS
  A total of 125 patients and their caregivers were asked to participate in a standardized screening interview after admission at a large urban children's hospital with a new diagnosis of type 1 diabetes. Medical records were reviewed for subsequent diabetes-related emergency department (ED) admissions, missed diabetes clinic appointments, and psychology follow-up within 9 months of diagnosis.
  
  
  RESULTS
  Of 125 families, 121 (96.8%) agreed to participate in the screening, and a subsample of 30 surveyed caregivers indicated high levels of satisfaction. Risk factors at diagnosis predicted subsequent ED admissions with a sensitivity of 100% and a specificity of 98.6%. Children from single-parent households with a history of behavior problems were nearly six times more likely to be seen in the ED after diagnosis. Missed appointments were likeliest among African Americans, 65% of whom missed at least one diabetes-related appointment. Psychology services for preventive intervention were underutilized, despite the high acceptability of the psychosocial screening.
  
  
  CONCLUSIONS
  Psychosocial screening of newly diagnosed patients with type 1 diabetes is feasible, acceptable to families, and able to identify families at risk for early emerging complications and nonadherence. Challenges remain with regards to reimbursement and fostering follow-up for preventive care.
authors.affiliation: Department of Pediatrics, Section of Psychology, Baylor College of Medicine, Houston, Texas, USA. ddschwar@bcm.edu
authors.forename: David D
authors.initials: DD
authors.lastname: Schwartz
authors.forename: Virginia Depp
authors.initials: VD
authors.lastname: Cline
authors.forename: Marni E
authors.initials: ME
authors.lastname: Axelrad
authors.forename: Barbara J
authors.initials: BJ
authors.lastname: Anderson
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy / Q000523:psychology*; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D008403:Mass Screening / Q000379:methods* / Q000592:standards*; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D010349:Patient Compliance / Q000523:psychology*; D011237:Predictive Value of Tests; D011584:Psychology; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity