Department of Psychology, The University of Memphis, Memphis, TN, United States.
Division of Pediatric Endocrinology & Diabetes, University of Tennessee Health Sciences Center, Memphis, TN, United States.
J Pediatr Psychol. 2024 Nov 1;49(11):791-801. doi: 10.1093/jpepsy/jsae059.
Racially minoritized youth with T1D are made vulnerable to disproportionately adverse health outcomes compared to White peers due to enduring systems of oppression. Thus, understanding modifiable psychosocial factors associated with diabetes-related outcomes in racially minoritized youth may help to buffer deleterious effects of racism. One factor meriting exploration is racial-ethnic identity. There is currently limited research on measures fit to assess ethnic identity in youth with chronic illnesses. This study's purpose is to examine the factor structure, reliability, and validity of the revised Multigroup Ethnic Identity Measure (MEIM-R) in a racially- and income-diverse sample of youth with T1D across sociodemographic and illness-related proxies for one's positionality in oppressive systems.
As part of a larger study examining resilience, 142 youth with T1D ages 12-18 (Mage = 14.66, SDage = 1.62, 55.6% Black/African-American, 44.4% White) completed the MEIM-R and various psychosocial measures. HbA1c levels and illness duration were extracted from medical records and caregivers reported income information. Confirmatory factor analyses compared the structural validity of competing MEIM-R models, and uniform and non-uniform differential item functioning (DIF) was explored across sociodemographic and illness-related factors.
While a bifactor structure was supported, the MEIM-R was found to exhibit DIF by race and gender on multiple MEIM-R items and did not demonstrate linear bivariate relations with other psychosocial factors.
Since different MEIM-R item response patterns were observed across racial/ethnic and gender groups, caution is warranted in using this measure in racially and gender diverse youth with T1D.
与白人同龄人相比，少数族裔青少年 1 型糖尿病患者由于长期存在的压迫制度，更容易出现健康结果明显不利的情况。因此，了解与少数族裔青少年糖尿病相关结果相关的可改变的心理社会因素，可能有助于缓冲种族主义的有害影响。一个值得探讨的因素是种族认同。目前，关于适合评估慢性病青少年种族认同的测量方法的研究有限。本研究的目的是在一个种族和收入多样化的青少年 1 型糖尿病样本中，通过社会人口统计学和与疾病相关的因素，来检验修订后的多群体种族认同测量（MEIM-R）的结构、信度和效度，这些因素可以代理一个人在压迫性系统中的地位。
作为一项研究韧性的更大研究的一部分，142 名年龄在 12-18 岁的青少年 1 型糖尿病患者（Mage=14.66，SDage=1.62，55.6%黑人/非裔美国人，44.4%白人）完成了 MEIM-R 和各种心理社会测量。HbA1c 水平和疾病持续时间从病历中提取，照顾者报告收入信息。验证性因子分析比较了竞争 MEIM-R 模型的结构有效性，并探讨了社会人口统计学和与疾病相关因素对 MEIM-R 项目的均匀和非均匀差异功能（DIF）的影响。
虽然支持双因素结构，但发现 MEIM-R 在多个 MEIM-R 项目上存在种族和性别差异功能，并且与其他心理社会因素之间没有表现出线性双变量关系。
由于在不同种族/族裔和性别群体中观察到不同的 MEIM-R 项目反应模式，因此在种族和性别多样化的青少年 1 型糖尿病患者中使用该测量方法时需要谨慎。
