Electronic Theses and Dissertations



Document Type


Degree Name

Master of Science



Committee Chair

Kristoffer Berlin

Committee Member

Randy Floyd

Committee Member

Angelica Eddington


Objective: For youth with Type 1 Diabetes and their families, engaging in multiple complex health behaviors may delay and/or reduce serious complications by attempting to keep blood glucose levels within a specific range for as long as possible. As such, quick and rapid assessment of diabetes self-care behaviors is important, yet few brief (e.g., 2-5 items) established measures exist; and even fewer have been evaluated for bias across socio-medical-demographic proxies for privilege/oppression. Therefore, the purpose of this study was to develop a short form of the Self-Care Inventory (SCI-R) and to evaluate validity, reliability, and measurement bias across socio-demographics. Methods: Participants were 181 adolescent/caregiver dyads from the PRYDE study who completed a 15-item version of the SCI-R. Adolescents (Age: M =14.62, SD =1.69, range 12–18 years) identifying as 89 female and 89 male (53%), Black/AA, and/or white (41.4%), also completed measures of Diabetes Stress (Diabetes Stress Questionnaire) and Diabetes Health-related Quality of Life (T1D-HRQoL, PedsQL Diabetes Module 3.2). Youth’s most recent HbA1c was extracted from their medical record. Results: Uniform and Non-Uniform Differential Item Functioning (DIF) analyses were conducted using Structural Equation Modeling. The 4-item youth and caregiver SCI Totals, correlated with HbA1c, Stress, HRQOL, and were found to be invariant across youth and caregiver dyads at the scalar level (RMSEA =.05, 90% CI: .02-.08; CFI=.974, SRMR=.05). Adding “MIMIC” variables to this scalar model, the direct and moderating effects of socio-demographic proxies on each item and factor loading (respectively) were explored to investigate Uniform (i.e., bias in means/intercepts), and Non-Uniform DIF (i.e., bias in covariances). All items were found to be meaningfully free of bias (all Holm’s corrected p values >.05). Conclusions: The SCI-SF appears to be meaningfully free of bias across proxies of interlocking ecological systems of inequality (supporting the validity of past correlations with HbA1c). As researchers and clinicians, it is a justice and ethical imperative to utilize valid and reliable assessment tools that work equivalently in diverse groups.


Data is provided by the student.

Library Comment

Dissertation or thesis originally submitted to ProQuest.


Open Access