Development and Initial Validation of a Self-Care Problem Solving Measure for Adolescents with Type 1 Diabetes

Development and Initial Validation of a Self-Care Problem Solving Measure for Adolescents with Type 1 Diabetes Adolescents generally show wor Adolescents generally show worse glycemic control compared to children and adults. Glycemic control is directly related to successful adherence to medical self-care recommendations. Problem solving is considered a critical self-care skill in diabetes. Currently, there is no self-report instrument to assess problem solving in adolescents with type 1 diabetes. In order to address this need, the goal of the research was to develop and provide initial validation for a scale to measure diabetes problem solving skills in adolescents. Items were generated through literature review and in collaboration with a multidisciplinary team of diabetes professionals. The problem solving items, along with measures of diabetes self-care behaviors, diabetes numeracy, and diabetes beliefs were administered to 115 adolescents age 13-17 in a large academic diabetes clinic. Glycemic control was obtained through chart review. Data were subjected to principle components, psychometric, and bivariate correlational analyses. All items loaded on one of 5 factors that accounted for 61% of the variance. All factor loadings were over .40. The factors were labeled 1) Problem Solving Actions, 2) Problem Awareness, 3) Thinking / Planning, 4) Avoidance, and 5) Approach. The Total Problem Solving Score and all subscales except for Thinking/ Planning were significantly related to A1C (range -.18-.24). The Total Score was significantly correlated in the predicted direction with all measures of self-care behaviors, numeracy, and diabetes beliefs (range .33-.71). The results provide insights into the structure and nature of adolescent diabetes problem solving, and support the use of this new instrument for research and clinical assessment. SHELAGH A. MULVANEY, RUSSELL L. ROTHMAN, DAVID G. SCHLUNDT, ERIC J. PITTEL, KENNETH A. WALLSTON 802-P Nashville, TN Psychosocial - Behavioral Medicine