Development, validation, and item bias assessment of the Self-Care Inventory-Short-Form among racially and income-diverse adolescents living with type 1 diabetes and their caregivers

Authors

• Vinkrya N. Ellison, College of Arts & Sciences
• Kristoffer S. Berlin, College of Arts & Sciences
• Kishan R. Desai, College of Arts & Sciences
• Kasey R. Harry, University of Cincinnati
• Corey T. Jackson, College of Arts & Sciences
• Mary E. Keenan-Pfeiffer, Cincinnati Children's Hospital Medical Center
• Jessica L. Cook, St. Jude Children's Research Hospital
• Rachel L. Ankney, College of Arts & Sciences
• Kimberly L. Klages, Cincinnati Children's Hospital Medical Center
• Katherine A. Semenkovich, Nationwide Children’s Hospital
• Tiffany M. Rybak, University of Cincinnati
• Gabrielle G. Banks, University of Mississippi Medical Center
• Kathryn Sumpter, University of Tennessee Health Science Center
• Angelica R. Eddington, Children’s National Hospital

Abstract

Objective: Youth with type 1 diabetes and their families engage in complex health behaviors to help manage blood glucose levels and to reduce the risk of serious health complications. Given well-documented health disparities in pediatric diabetes, rapid and equitable assessment of diabetes self-care can help identify potential areas where support is needed. This purpose of this study was to (a) develop a short-form of the Self-Care Inventory-Revised (SCI-R) and (b) evaluate validity, reliability, and differential item functioning (DIF) across several socio-illness-demographic variables of the full and short-form SCI-R. Methods: Participants were 181 adolescent–caregiver dyads from the Predicting Resiliency in Youth with Type 1 Diabetes (PRYDE) study who completed a 15-item version of the SCI-R. Adolescents (age: M = 14.64, SD =1.70, range 12–18 years), identifying as female (n = 92), male (n = 92), Black/AA (57%), and/or White (43%), also completed diabetes-specific measures of stress and Health-related Quality of Life (T1D-HRQoL). Youths’ most recent hemoglobin A1c (HbA1c) values were extracted from their medical records. Results: Initial items selected based on the six highest factor loadings of 15 were evaluated using DIF analyses. The final 6-item youth and caregiver SCI-SF6 totals correlated with HbA1c, stress, and T1D-HRQoL. They were invariant across participant dyads at the scalar level (root mean squared error of approximation =.077, 90% CI: .056–.098; comparative fit index =.971, standardized root mean square residual = .0490). DIF analyses failed to reject the null hypothesis for item bias factor loadings or item thresholds across age, family income, HbA1c, racial category, gender, and illness duration. Conclusions: The results support initial evidence of equitable assessment, measurement invariance, validity, and reliability for SCI-SF6 across important socio-illness-demographic variables.

Publication Title

Journal of Pediatric Psychology

Recommended Citation

Ellison, V., Berlin, K., Desai, K., Harry, K., Jackson, C., Keenan-Pfeiffer, M., Cook, J., Ankney, R., Klages, K., Semenkovich, K., Rybak, T., Banks, G., Sumpter, K., & Eddington, A. (2025). Development, validation, and item bias assessment of the Self-Care Inventory-Short-Form among racially and income-diverse adolescents living with type 1 diabetes and their caregivers. Journal of Pediatric Psychology, 50 (5), 420-432. https://doi.org/10.1093/jpepsy/jsaf022