Further examination of a structured adherence interview of diabetes for children, adolescents, and parents

This study evaluated the factor structure of the Diabetes Self-Management Profile (DSMP), a structured interview for diabetes regimen adherence for children with type I diabetes. Study aims included a detailed examination of parent-child agreement in ratings of adherence. The DSMP was administered to 121 children and their parents during routine visits to a tertiary care diabetes clinic. Confirmatory factor analysis of the rationally derived five subscales yielded poor fit indexes. Subsequent exploratory factor analysis supported a two-factor solution for both the parent and child DSMP adherence ratings with factors named Food and Insulin Schedule Adherence and Adherence to Blood Sugar Testing and Adjustments. The internal consistency of the factors was acceptable, and predictive validity was supported vis-A-vis positive correlations with metabolic control (HbA1c). This factor structure appears to provide a brief yet reliable and valid framework for assessing adherence and predicting metabolic control in children. In addition, parent-child agreement varied as a function of age. However, poor metabolic control did not relate to higher parent-child disagreement.