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Ellison VN, Berlin KS, Desai KR, Harry KR, Jackson CT, Keenan-Pfeiffer ME, Cook JL, Ankney RL, Klages KL, Semenkovich KA, Rybak TM, Banks GG, Sumpter K, Eddington AR. Development, validation, and item bias assessment of the Self-Care Inventory-Short-Form among racially and income-diverse adolescents living with type 1 diabetes and their caregivers. J Pediatr Psychol 2025; 50:420-432. [PMID: 40237288 DOI: 10.1093/jpepsy/jsaf022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2024] [Revised: 01/26/2025] [Accepted: 02/24/2025] [Indexed: 04/18/2025] Open
Abstract
OBJECTIVE 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. METHODS 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. RESULTS 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. CONCLUSIONS The results support initial evidence of equitable assessment, measurement invariance, validity, and reliability for SCI-SF6 across important socio-illness-demographic variables.
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Affiliation(s)
- Vinkrya N Ellison
- Department of Psychology, The University of Memphis, Memphis, TN, United States
| | - Kristoffer S Berlin
- 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
| | - Kishan R Desai
- Department of Psychology, The University of Memphis, Memphis, TN, United States
| | - Kasey R Harry
- Department of Psychology, University of Cincinnati, Cincinnati, Ohio, United States
| | - Corey T Jackson
- Department of Psychology, The University of Memphis, Memphis, TN, United States
| | - Mary E Keenan-Pfeiffer
- Department of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States
| | - Jessica L Cook
- Department of Psychology, St. Jude Children's Research Hospital, Memphis, TN, United States
| | - Rachel L Ankney
- Department of Psychology, The University of Memphis, Memphis, TN, United States
| | - Kimberly L Klages
- Department of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States
| | - Katherine A Semenkovich
- Department of Psychiatry and Behavioral Health, Nationwide Children's Hospital, Columbus, OH, United States
| | - Tiffany M Rybak
- Department of Psychology, University of Cincinnati, Cincinnati, Ohio, United States
| | - Gabrielle G Banks
- University of Mississippi Medical Center, Jackson, Mississippi, United States
| | - Kathryn Sumpter
- Division of Pediatric Endocrinology & Diabetes, University of Tennessee Health Science Center, Memphis, TN, United States
| | - Angelica R Eddington
- Department of Endocrinology & Diabetes, Children's National Hospital, Washington, DC, United States
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Suhs MC, O'Donnell A, Ellis J, Weissberg-Benchell J, Harris MA, Papadakis JL. Evaluating representativeness: recruitment for a virtual family-based intervention focused on the transition from pediatric to adult diabetes care†. J Pediatr Psychol 2025; 50:433-441. [PMID: 40233211 DOI: 10.1093/jpepsy/jsaf023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2024] [Revised: 02/27/2025] [Accepted: 02/28/2025] [Indexed: 04/17/2025] Open
Abstract
OBJECTIVE Recruiting representative samples of youth for behavioral health interventions is challenging yet necessary to translate research into practice and eliminate health disparities. Transition-aged youth with type 1 diabetes (T1D) represent a vulnerable population; not enough attention is given to their inclusion in behavioral health interventions. Behavioral Family Systems Therapy for Diabetes Transition (BFST-DT) is an intervention aimed at improving transition readiness and is currently being pilot tested. The objectives of this study are to (1) evaluate the representativeness of the enrolled sample based on demographic and medical characteristics and (2) evaluate recruitment communication preferences. METHODS Thirty adolescents (Mage = 16.57 years) with T1D and their caregiver(s) were recruited from a large urban hospital. Demographic and medical variables were collected via electronic medical record. Research staff recorded recruitment details about communication attempts and methods and reasons for participation decline. RESULTS Those who enrolled in the intervention had more insulin pump usage than the recruitment population. Those who enrolled communicated primarily over email, while those who declined preferred phone. The length of time before a participation decision was communicated was similar between the enrolled and declined groups at about 6 weeks. The main reason for declining to participate was lack of interest. CONCLUSIONS Recruitment strategies were mostly effective in recruiting a representative sample of adolescents with T1D. Findings have implications for recruiting populations that are challenging to engage in intervention research. Future research should prioritize the stratification of historically underrepresented groups during recruitment.
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Affiliation(s)
- Madeleine C Suhs
- Pritzker Department of Psychiatry and Behavioral Health, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States
| | - Alexander O'Donnell
- Pritzker Department of Psychiatry and Behavioral Health, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States
| | - Julia Ellis
- Pritzker Department of Psychiatry and Behavioral Health, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States
| | - Jill Weissberg-Benchell
- Pritzker Department of Psychiatry and Behavioral Health, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Michael A Harris
- Department of Pediatrics, Oregon Health & Science University, Portland, OR, United States
| | - Jaclyn L Papadakis
- Pritzker Department of Psychiatry and Behavioral Health, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
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Knauft KM, Jacques-Tiura AJ, Idalski Carcone A, Evans M, Weissberg-Benchell J, Buggs-Saxton C, Boucher-Berry C, Miller JL, Drossos T, Dekelbab B, Ellis DA. The moderating role of diabetes distress on the effect of a randomized eHealth intervention on glycemic control in Black adolescents with type 1 diabetes. J Pediatr Psychol 2024; 49:538-546. [PMID: 38775162 PMCID: PMC11335142 DOI: 10.1093/jpepsy/jsae033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 04/11/2024] [Accepted: 04/28/2024] [Indexed: 05/31/2024] Open
Abstract
OBJECTIVE Due to systemic inequities, Black adolescents with type 1 diabetes are more likely to have suboptimal glycemic control and high rates of diabetes distress, but tailored interventions for this population are lacking. In primary outcomes of a randomized clinical trial, a family-based eHealth intervention improved glycemic control in Black adolescents with type 1 diabetes and elevated depressive symptoms. The present study is a secondary analysis of these clinical trial data examining the moderating effect of diabetes distress on the efficacy of the intervention. METHODS Using secondary data from a multicenter randomized clinical trial (Clinicaltrials.gov [NCT03168867]), caregiver-adolescent dyads were randomly assigned to either up to three sessions of an eHealth parenting intervention (n = 75) or a standard medical care control group (n = 74). Black adolescents (10 years, 0 months to 14 years, 11 months old) with type 1 diabetes and a caregiver willing to participate were eligible. Adolescents reported their diabetes distress at baseline, and hemoglobin A1c (HbA1c) data were collected at baseline, 6-, 13-, and 18-month follow-up. RESULTS No between-group contrasts emerged in a linear mixed-effects regression (p's > .09). Within-group contrasts emerged such that adolescents assigned to the intervention who reported high diabetes distress had lower HbA1c at the 18-month follow-up relative to baseline (p = .004); the 18-month decrease in HbA1c was -1.03%. CONCLUSIONS Black adolescents with type 1 diabetes and high levels of diabetes distress showed significant decreases in HbA1c following a family-based eHealth intervention, suggesting diabetes distress may be a key moderator of intervention efficacy within this population.
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Affiliation(s)
- Katherine M Knauft
- Department of Psychology, Wayne State University, 5057 Woodward Ave, Detroit, MI 48202, United States
- Department of Family Medicine and Public Health Sciences, Wayne State University School of Medicine, Detroit, MI, United States
| | - Angela J Jacques-Tiura
- Department of Family Medicine and Public Health Sciences, Wayne State University School of Medicine, Detroit, MI, United States
| | - April Idalski Carcone
- Department of Family Medicine and Public Health Sciences, Wayne State University School of Medicine, Detroit, MI, United States
| | - Meredyth Evans
- Pritzker Department of Psychiatry and Behavioral Health, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL, United States
- Department of Psychiatry and Behavioral Sciences, Northwestern Feinberg School of Medicine, Chicago, IL, United States
| | - Jill Weissberg-Benchell
- Pritzker Department of Psychiatry and Behavioral Health, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL, United States
- Department of Psychiatry and Behavioral Sciences, Northwestern Feinberg School of Medicine, Chicago, IL, United States
| | - Colleen Buggs-Saxton
- Department of Pediatrics, Wayne State University School of Medicine, Detroit, MI, United States
| | - Claudia Boucher-Berry
- Department of Pediatrics, University of Illinois School of Medicine at Chicago, Chicago, IL, United States
| | - Jennifer L Miller
- Department of Pediatrics, Northwestern Feinberg School of Medicine, Chicago, IL, United States
| | - Tina Drossos
- Department of Psychiatry and Behavioral Neurosciences, University of Chicago Pritzker School of Medicine, Chicago, IL, United States
| | - Bassem Dekelbab
- Pediatric Endocrinology, Corewell Health, Royal Oak, MI, United States
| | - Deborah A Ellis
- Department of Family Medicine and Public Health Sciences, Wayne State University School of Medicine, Detroit, MI, United States
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Shapiro JB, Garza KP, Feldman MA, Suhs MC, Ellis J, Terry A, Howard KR, Weissberg-Benchell J. Psychosocial Care for Youth with Type 1 Diabetes: Summary of Reviews to Inform Clinical Practice. Endocrinol Metab Clin North Am 2024; 53:107-122. [PMID: 38272590 DOI: 10.1016/j.ecl.2023.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2024]
Abstract
The intensive demands of diabetes care can be difficult for youth with type 1 diabetes and their families to integrate into daily life. Standards of care in pediatric diabetes highlight the importance of evidence-based psychosocial interventions to optimize self-management behaviors and psychological well-being. The current review summarizes select systematic reviews and meta-analyses on evidence-based behavioral health interventions in pediatric diabetes. Interventions include strategies to strengthen youth psychosocial skills, improve family dynamics and caregiver mental health, enhance health and mental health equity, and address psychosocial factors related to diabetes technology use.
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Affiliation(s)
- Jenna B Shapiro
- Ann & Robert H. Lurie Children's Hospital of Chicago, Pritzker Department of Psychiatry and Behavioral Health, 225 East Chicago Avenue, Box 10, Chicago, IL 60611, USA; Northwestern University Feinberg School of Medicine, Department of Psychiatry & Behavioral Sciences, 446 E Ontario Street, Chicago, IL, USA.
| | | | - Marissa A Feldman
- Johns Hopkins All Children's Hospital, Child Development and Rehabilitation Center, 880 Sixth Street South #170, Saint Petersburg, FL 33701, USA
| | - Madeleine C Suhs
- Ann & Robert H. Lurie Children's Hospital of Chicago, Pritzker Department of Psychiatry and Behavioral Health, 225 East Chicago Avenue, Box 10, Chicago, IL 60611, USA
| | - Julia Ellis
- Ann & Robert H. Lurie Children's Hospital of Chicago, Pritzker Department of Psychiatry and Behavioral Health, 225 East Chicago Avenue, Box 10, Chicago, IL 60611, USA
| | - Amanda Terry
- Ann & Robert H. Lurie Children's Hospital of Chicago, Pritzker Department of Psychiatry and Behavioral Health, 225 East Chicago Avenue, Box 10, Chicago, IL 60611, USA; Northwestern University Feinberg School of Medicine, Department of Psychiatry & Behavioral Sciences, 446 E Ontario Street, Chicago, IL, USA
| | - Kelsey R Howard
- Ann & Robert H. Lurie Children's Hospital of Chicago, Pritzker Department of Psychiatry and Behavioral Health, 225 East Chicago Avenue, Box 10, Chicago, IL 60611, USA; Northwestern University Feinberg School of Medicine, Department of Psychiatry & Behavioral Sciences, 446 E Ontario Street, Chicago, IL, USA
| | - Jill Weissberg-Benchell
- Ann & Robert H. Lurie Children's Hospital of Chicago, Pritzker Department of Psychiatry and Behavioral Health, 225 East Chicago Avenue, Box 10, Chicago, IL 60611, USA; Northwestern University Feinberg School of Medicine, Department of Psychiatry & Behavioral Sciences, 446 E Ontario Street, Chicago, IL, USA
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