title: Youth and parent measures of self-efficacy for continuous glucose monitoring: survey psychometric properties.
abstract: BACKGROUND
  This study aimed to describe the development and psychometric evaluation of novel youth and parent measures of self-efficacy related to continuous glucose monitoring (CGM) in pediatric patients with type 1 diabetes. This evaluation also assessed the predictive validity of the CGM Self-Efficacy (CGM-SE) surveys on CGM use and hemoglobin A1c (HbA1c) levels.
  
  
  METHODS
  Study participants included 120 youth with type 1 diabetes for ≥1 year enrolled in a 2-year randomized clinical trial comparing CGM use with and without the addition of a family-focused CGM behavioral intervention. Youth and parents completed the CGM-SE surveys at randomization after a 1-week run-in to assess CGM tolerability. Analyses of predictive validity excluded the intervention group and included 61 youth in the control group in order to assess CGM use and HbA1c outcomes 3 and 6 months after randomization.
  
  
  RESULTS
  At study entry, youth were 12.7±2.7 years old with a diabetes duration of 6.1±3.6 years and an HbA1c level of 8.0±0.8% (64±9 mmol/mol); blood glucose monitoring frequency was 6.8±2.4 times/day, and 84% received pump therapy. CGM-SE surveys had acceptable internal consistency (Cronbach's α=0.80 for youth and 0.82 for parents). Youth reporting higher baseline CGM self-efficacy (CGM-SE score of >80) had significantly greater CGM use and lower HbA1c level after 3 and 6 months compared with youth reporting lower baseline CGM self-efficacy (CGM-SE score of ≤80).
  
  
  CONCLUSIONS
  The CGM-SE surveys appear to have strong psychometric properties. CGM self-efficacy may offer an opportunity to assess the likelihood of CGM adherence and glycemic improvement in youth with type 1 diabetes in clinical and research settings.
authors.affiliation: 1 Pediatric, Adolescent, and Young Adult and Genetics and Epidemiology Sections, Joslin Diabetes Center , Harvard Medical School, Boston, Massachusetts.
authors.forename: Lisa E
authors.initials: LE
authors.lastname: Rasbach
authors.forename: Lisa K
authors.initials: LK
authors.lastname: Volkening
authors.forename: Jessica T
authors.initials: JT
authors.lastname: Markowitz
authors.forename: Deborah A
authors.initials: DA
authors.lastname: Butler
authors.forename: Michelle L
authors.initials: ML
authors.lastname: Katz
authors.forename: Lori M B
authors.initials: LM
authors.lastname: Laffel
mesh_terms: D000293:Adolescent; D001786:Blood Glucose / Q000032:analysis; D015190:Blood Glucose Self-Monitoring / Q000523:psychology* / Q000706:statistics & numerical data; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000523:psychology* / Q000628:therapy; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008297:Male; D010290:Parents / Q000523:psychology; D011237:Predictive Value of Tests; D011594:Psychometrics; D015203:Reproducibility of Results; D020377:Self Efficacy; D011795:Surveys and Questionnaires
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human