Date of Award
Master of Science
Type 1 Diabetes (T1D) is one of the most common chronic diseases among children in the United States, affecting around 244,000 children and adolescents. In 2014–2015 around 18,200 youth were diagnosed with T1D. T1D requires youth to participate in complex and burdensome health behaviors that can affect health-related quality of life (HRQoL). Measures such as the Pediatric Quality of Life Inventory- Diabetes Module Version 3.2 (PedsQL-DM) are used to determine how T1D has influenced youth and caregivers’ daily lives. Recently, a 5-item version of the Pediatric Quality of Life Inventory- Diabetes Module (PedsQL-DMSF5) was developed; however, it is presently unclear if this measure is meaningfully free of bias across varying sociodemographic-illness durations. As such, this study aims to explore the measurement invariance of the PedsQL-DMSF5 across racialized categories (Black/ African American and White), genders, HbA1c, illness duration, and income. Youth with T1D (N= 181, 49% female, 51% male,56 % African American, age M= 14.6, SD= 1.7, Hba1c M= 10.32, SD= 2.48, Median income = $30,000 for 152 of the participants) and their caregivers completed the full PedsQL-DM. Youth also completed Diabetes Stress Questionnaire, and their HbA1c and illness duration were obtained through medical record review. Confirmatory Factor Analyses (CFAs) and correlations were conducted in Mplus. The youth and caregiver’s report of the youth’s T1D-HRQoL provided an excellent fit (RMSEA =.068, 90% CI: .039-.096; CFI=.957, SRMR=.053), acceptable reliability (youth/caregiver omega = .80/.68), and preliminary evidence of validity showed significant correlations of the PedsQL-DMSF5 Y/CG totals with the full 33 item PedsQL: r=.85/.84, Diabetes Stress: r=-.60/-.32., and HbA1c: r=.26/-35. There was a significant but small caregiver-youth concordance (r=.26). Youth and Caregiver PedsQL-DMSF5 scores were also found to be invariant at the scalar level across HbA1c, illness duration, gender, and median income, and partially invariant at the scalar level for race once item 1 was removed. In families with youth living with type-1 diabetes, the PedsQL-DMSFs show promise to be a psychometrically robust, measure of T1D HRQoL that may be meaningfully free of bias across some sociodemographic and illness-specific categories. Caregiver-youth concordance highlights the importance of obtaining both youth and caregiver perspectives. Further validation suggests that the PedsQL-DM SFs may be a useful, brief, and equitable measure of Health-Related Quality of Life for youth with T1D and their families.
Dissertation or thesis originally submitted to ProQuest
Harry, Kasey, "Evaluating Item Bias and Equitability of the Pediatric Quality of Life Inventory- Diabetes Module 5 Item Version Amongst Income and Racially Diverse Youth Living with Type 1 Diabetes" (2023). Electronic Theses and Dissertations. 3140.