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Diabetes Res Clin Pract. 2020 Mar 16;162:108110. doi: 10.1016/j.diabres.2020.108110. [Epub ahead of print]

Assessing readiness for independent self-care in adolescents with type 1 diabetes: Introducing the RISQ.

Author information

1
Joslin Diabetes Center, Harvard Medical School - One Joslin Place, Boston, MA 02215, USA; KU Leuven, Tiensestraat 102, 3000 Leuven, Belgium. Electronic address: Eveline.Goethals@joslin.harvard.edu.
2
Joslin Diabetes Center, Harvard Medical School - One Joslin Place, Boston, MA 02215, USA. Electronic address: Persis.Commissariat@joslin.harvard.edu.
3
Joslin Diabetes Center, Harvard Medical School - One Joslin Place, Boston, MA 02215, USA. Electronic address: Lisa.Volkening@joslin.harvard.edu.
4
Modus Outcomes, 1 Broadway, Cambridge, MA 02142, USA.
5
Joslin Diabetes Center, Harvard Medical School - One Joslin Place, Boston, MA 02215, USA. Electronic address: lori.laffel@joslin.harvard.edu.

Abstract

AIM:

To design and evaluate psychometrics of adolescent self-report and parent proxy-report questionnaires assessing readiness for independent self-care in adolescents with type 1 diabetes (RISQ-T and RISQ-P).

METHODS:

178 adolescents with type 1 diabetes (ages 13-17 years) and their parents completed the 20-item RISQ-T and 15-item RISQ-P, along with diabetes-specific measures of parent involvement, self-efficacy, burden, and treatment adherence. Evaluation of psychometric properties included calculation of internal consistency, adolescent and parent agreement, test-retest reliability, concurrent and predictive validity.

RESULTS:

The RISQ-T (α = 0.78) and RISQ-P (α = 0.77) demonstrated sound internal consistency. Higher RISQ-T and RISQ-P scores (indicating more adolescent readiness for independent self-care) showed significant associations with less parent involvement in diabetes care (adolescent r = -0.34; parent r = -0.47; p < .0001), greater adolescent diabetes self-efficacy (adolescent r = 0.32; parent r = 0.54; p < .0001), less parent-endorsed diabetes-related burden (parent r = -0.30; p < .0001), and greater treatment adherence (adolescent r = 0.26, p = .0004; parent r = 0.31, p < .0001). Adolescent and parent scores were significantly correlated (r = 0.35; p < .0001); test-retest reliability was reasonable (ICC RISQ-T r = 0.66; RISQ-P r = 0.71). Higher baseline RISQ-P scores significantly predicted reduced family involvement after six months (β = -0.14, p = .02).

CONCLUSIONS:

RISQ-T and RISQ-P demonstrate sound psychometric properties. Surveys may help inform diabetes teams of the level of support needed to facilitate shift to independent self-management.

KEYWORDS:

Adolescents; Readiness; Self-care; Transition; Type 1 diabetes

Conflict of interest statement

Declaration of Competing Interest We have no relevant conflict of interest to disclose.

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