Ellison Vinkrya N, Berlin Kristoffer S, Desai Kishan R, Harry Kasey R, Jackson Corey T, Keenan-Pfeiffer Mary E, Cook Jessica L, Ankney Rachel L, Klages Kimberly L, Semenkovich Katherine A, Rybak Tiffany M, Banks Gabrielle G, Sumpter Kathryn, Eddington Angelica R
Department of Psychology, The University of Memphis, Memphis, TN, United States.
Division of Pediatric Endocrinology & Diabetes, University of Tennessee Health Science Center, Memphis, TN, United States.
J Pediatr Psychol. 2025 May 1;50(5):420-432. doi: 10.1093/jpepsy/jsaf022.
Youth with type 1 diabetes and their families engage in complex health behaviors to help manage blood glucose levels and to reduce the risk of serious health complications. Given well-documented health disparities in pediatric diabetes, rapid and equitable assessment of diabetes self-care can help identify potential areas where support is needed. This purpose of this study was to (a) develop a short-form of the Self-Care Inventory-Revised (SCI-R) and (b) evaluate validity, reliability, and differential item functioning (DIF) across several socio-illness-demographic variables of the full and short-form SCI-R.
Participants were 181 adolescent-caregiver dyads from the Predicting Resiliency in Youth with Type 1 Diabetes (PRYDE) study who completed a 15-item version of the SCI-R. Adolescents (age: M = 14.64, SD =1.70, range 12-18 years), identifying as female (n = 92), male (n = 92), Black/AA (57%), and/or White (43%), also completed diabetes-specific measures of stress and Health-related Quality of Life (T1D-HRQoL). Youths' most recent hemoglobin A1c (HbA1c) values were extracted from their medical records.
Initial items selected based on the six highest factor loadings of 15 were evaluated using DIF analyses. The final 6-item youth and caregiver SCI-SF6 totals correlated with HbA1c, stress, and T1D-HRQoL. They were invariant across participant dyads at the scalar level (root mean squared error of approximation =.077, 90% CI: .056-.098; comparative fit index =.971, standardized root mean square residual = .0490). DIF analyses failed to reject the null hypothesis for item bias factor loadings or item thresholds across age, family income, HbA1c, racial category, gender, and illness duration.
The results support initial evidence of equitable assessment, measurement invariance, validity, and reliability for SCI-SF6 across important socio-illness-demographic variables.
1型糖尿病青少年及其家庭会采取复杂的健康行为来帮助控制血糖水平并降低严重健康并发症的风险。鉴于儿科糖尿病中存在有充分记录的健康差异，对糖尿病自我护理进行快速且公平的评估有助于确定可能需要支持的潜在领域。本研究的目的是：（a）编制一份简化版的自我护理量表修订版（SCI-R），以及（b）评估完整版和简化版SCI-R在多个社会疾病人口统计学变量上的效度、信度和项目功能差异（DIF）。
研究对象为来自“预测1型糖尿病青少年的复原力”（PRYDE）研究的181对青少年-照顾者二元组，他们完成了一份15个条目的SCI-R版本。青少年（年龄：M = 14.64，标准差 = 1.70，范围12 - 18岁），其中女性（n = 92）、男性（n = 92）、黑人/非裔美国人（57%）和/或白人（43%），还完成了针对糖尿病的压力测量和健康相关生活质量（T1D-HRQoL）测量。从青少年的病历中提取他们最近的糖化血红蛋白（HbA1c）值。
基于15个条目中六个最高因子载荷选择的初始条目使用DIF分析进行评估。最终的6个条目青少年和照顾者SCI-SF6总分与HbA1c、压力和T1D-HRQoL相关。它们在标量水平上在参与者二元组之间是不变的（近似均方根误差 = 0.077，90%置信区间：0.056 - 0.098；比较拟合指数 = 0.971，标准化均方根残差 = 0.0490）。DIF分析未能拒绝关于年龄、家庭收入、HbA1c、种族类别（种族）、性别和病程的条目偏差因子载荷或条目阈值的零假设。
结果支持了SCI-SF6在重要社会疾病人口统计学变量上公平评估、测量不变性、效度和信度的初步证据。
