Validation Of A Contemporary Adherence Measure For Children With Type 1 Diabetes: The Diabetes Management Questionnaire

AimsTo evaluate the psychometric properties of the Diabetes Management Questionnaire, a brief, self-report measure of adherence to contemporary diabetes management for young people with Type 1 diabetes and their caregivers.MethodsA total of 273 parent-child dyads completed parallel versions of the Diabetes Management Questionnaire. Eligible children (aged 8-18years) had Type 1 diabetes for 1year. A multidisciplinary team designed the Diabetes Management Questionnaire as a brief, self-administered measure of adherence to Type 1 diabetes management over the preceding month; higher scores reflect greater adherence. Psychometrics were evaluated for the entire sample and according to age of the child.ResultsThe children (49% female) had a mean sd (range) age 13.32.9 (8-18) years and their meansd HbA1c was 7115mmol/mol (8.6 +/- 1.4%). Internal consistency was good for parents (=0.83) and children (=0.79). Test-retest reliability was excellent for parents (intraclass correlation coefficient =0.83) and good for children (intraclass correlation coefficient=0.65). Parent and child scores had moderate agreement (intraclass correlation coefficient=0.54). Diabetes Management Questionnaire scores were inversely associated with HbA1c (parents: r=-0.41, P<0.0001; children: r=-0.27, P<0.0001). Psychometrics were stronger in the children aged 13years compared with those aged <13years, but were acceptable in both age groups. Mean +/- sd Diabetes Management Questionnaire scores were higher among children who were receiving insulin pump therapy (n=181) than in children receiving multiple daily injections (n=92) according to parent (75.9 +/- 11.8 vs. 70.5 +/- 15.5; P=0.004) and child report (72.2 +/- 12.1 vs. 67.6 +/- 13.9; P=0.006).ConclusionsThe Diabetes Management Questionnaire is a brief, valid self-report measure of adherence to contemporary diabetes self-management for people aged 8-18years who are receiving either multiple daily injections or insulin pump therapy.