title: The LMC Skills, Confidence & Preparedness Index (SCPI): development and evaluation of a novel tool for assessing self-management in patients with diabetes.
abstract: BACKGROUND
  Optimal diabetes care requires a specific set of self-management behaviours. The purpose of this study was to present the development and initial psychometric evaluation of a new tool to measure three key aspects of a patient's diabetes self-management: knowledge of the skill, confidence in being able to perform the skill and preparedness to implement the skill.
  
  
  METHODS
  A sequential exploratory mixed-methods design was used. A panel of educators, researchers and clinicians established a scale with items that would adequately capture skills, confidence and preparedness in seven core health behaviours central to diabetes care. The psychometric properties of the items were pilot tested on 120 participants with diabetes from a tertiary referral centre, and repeated 6 months later on 70 participants. Item selection was informed by factor analysis, item-total statistics and the need for brevity.
  
  
  RESULTS
  Twenty five items from a pool of 36 were retained, with an excellent overall intraclass correlation (ICC) of 0.94 (95% CI 0.92-0.99; p < 0.001). Internal consistency for the subscales (skills-9 items, confidence - 8 items, preparedness - 8 items) was very good (intraclass correlation between 0.83 and 0.88), and retest reliability after 6 months was also good (r = 0.48; p < 0.01). The scale was positively correlated to established scales that assess skill (Michigan Diabetes Knowledge Test) (r = 0.21;p = 0.01), and assess skill and confidence (Diabetes Empowerment Scale) (r = 0.28;p < 0.01).
  
  
  CONCLUSIONS
  The Skills, Confidence & Preparedness Index is a brief and easy to administer new scale that is more comprehensive than existing tools. It should be used to assess self-management in patients with diabetes, optimize the resources applied to each patient, and determine educational needs and direct clinical management. The scale should be further evaluated in a broader population of patients with diabetes.
authors.affiliation: Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada.|Biostatistics Unit, Father Sean O'Sullivan Research Centre, St Joseph's Healthcare, Hamilton, ON, Canada.|Centre for the Development of Best Practices in Health, Yaoundé Central Hospital, Yaoundé, Cameroon.
authors.forename: Lawrence
authors.initials: L
authors.lastname: Mbuagbaw
authors.affiliation: LMC Diabetes & Endocrinology, 1929 Bayview Ave., Toronto, ON, M4G 3E8, Canada.
authors.forename: Ronnie
authors.initials: R
authors.lastname: Aronson
authors.affiliation: LMC Diabetes & Endocrinology, 1929 Bayview Ave., Toronto, ON, M4G 3E8, Canada.
authors.forename: Ashleigh
authors.initials: A
authors.lastname: Walker
authors.affiliation: LMC Diabetes & Endocrinology, 1929 Bayview Ave., Toronto, ON, M4G 3E8, Canada. ruth.brown@LMC.CA.
authors.forename: Ruth E
authors.initials: RE
authors.lastname: Brown
authors.affiliation: LMC Diabetes & Endocrinology, 1929 Bayview Ave., Toronto, ON, M4G 3E8, Canada.
authors.forename: Naomi
authors.initials: N
authors.lastname: Orzech
mesh_terms: D003924:Diabetes Mellitus, Type 2 / Q000523:psychology*; D005163:Factor Analysis, Statistical; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D009864:Ontario; D011594:Psychometrics; D011788:Quality of Life; D015203:Reproducibility of Results; D012648:Self Care; D011795:Surveys and Questionnaires
keywords: Diabetes; Measurement; Patient education; Self-efficacy; Self-management