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adolescence, instrument development, self-management, type 1 diabetes



  1. Schilling, Lynne S.
  2. Dixon, Jane K.
  3. Knafl, Kathleen A.
  4. Lynn, Mary R.
  5. Murphy, Kathryn
  6. Dumser, Susan
  7. Grey, Margaret


Background: The development of instruments to measure self-management in youth with type 1 diabetes has not kept up with current understanding of the concept.


Objective: This study aimed to report the development and the testing of a new self-report measure to assess the Self-Management of Type 1 Diabetes in Adolescents (SMOD-A).


Methods: Following a qualitative study, items were identified and reviewed by experts for content validity. A total of 515 adolescents, 13 to 21 years old, participated in a field study by completing the SMOD-A (either once or twice) and additional measures of diabetes-related self-efficacy (Self-Efficacy for Diabetes Scale), quality of life (Diabetes Quality of Life for Youth Questionnaire), self-management (Diabetes Self-Management Profile), and adherence (Self-Care Inventory). Data were collected also on metabolic control (glycosylated hemoglobin [HbA1c]).


Results: The content validity index was .93. Exploratory alpha factor analyses revealed five subscales: Collaboration With Parents, Diabetes Care Activities, Diabetes Problem Solving, Diabetes Communication, and Goals ([alpha] = .71 to .85). The stability of the SMOD-A ranged from .60 to .88 at 2 weeks (test-retest) to .59 to .85 at 3 months. Correlations of SMOD-A subscales with Self-Efficacy for Diabetes Scale-Diabetes; Diabetes Quality of Life for Youth Questionnaire satisfaction, impact, and worry; Diabetes Self-Management Profile; and Self-Care Inventory were generally significant and in the expected direction. Collaboration with parents and HbA1c values were related significantly and positively (r = .11); all other SMOD-A subscales were related significantly and negatively to HbA1c (r = -.10 to -.26), demonstrating that better self-management is associated somewhat with better metabolic control and supporting construct validity of the new measure.


Discussion: The SMOD-A has been found to be a reliable, stable, and valid measure of SMOD-A.