Assessing Regimen Adherence of Adolescents With Type 1 Diabetes
- Ronald J. Iannotti, PHD1,
- Tonja R. Nansel, PHD1,
- Stefan Schneider, PHD1,
- Denise L. Haynie, PHD1,
- Bruce Simons-Morton, EDD1,
- Douglas O. Sobel, MD2,
- Linda Zeitzoff, CDE3,
- Leslie P. Plotnick, MD4 and
- Loretta Clark, CDE4
- 1Division of Epidemiology, Statistics and Prevention Research, National Institute of Child Health and Human Development, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland
- 2Department of Pediatrics, Georgetown University School of Medicine, Washington, DC
- 3Pediatric Endocrinology Clinic, Mount Washington Pediatric Hospital, Baltimore, Maryland
- 4Pediatric Endocrinology Department, Johns Hopkins Medical Center, Baltimore, Maryland
- Address correspondence and reprint requests to Ronald J. Iannotti, PhD, Prevention Research Branch, Division of Epidemiology, Statistics, and Prevention Research, National Institute of Child Health and Human Development/National Institutes of Health/Department of Health and Human Services, 6100 Executive Blvd., 7B05, Bethesda, MD 20892-7510. E-mail: iannottr{at}mail.nih.gov
Abstract
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.
RESEARCH DESIGN AND 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.
Footnotes
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A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.
The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C Section 1734 solely to indicate this fact.
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- Accepted July 16, 2006.
- Received March 29, 2006.
- DIABETES CARE
