Diabetes problem solving by youths with type 1 diabetes and their caregivers: Measurement, validation, and longitudinal associations with glycemic control

Abstract

Objectives: This article introduces a new measure of problem-solving skills of youths with type 1 diabetes (T1DM) and adult caregivers in correcting glycemic fluctuations. Methods: The Diabetes Problem Solving Interview (DPSI), a structured interview, was validated during a pilot study of a behavioral intervention. DPSI data and measures of diabetes management were obtained at baseline from 114 youths (ages 9-14.5) and 109 caregivers. Glycosylated hemoglobin (HbA1c) was measured quarterly over 9 months. Results: Results confirmed the psychometric adequacy of the DPSI. For caregivers, but not youths, low DPSI scores (indicating poor problem-solving skills) were significantly associated with worse HbA1c over 9 months. Conclusions: The DPSI has clinical and research utility as a measure of diabetes problem-solving skills. Identification and targeted remediation of caregivers' deficient diabetes problem-solving skills or promotion of youths' utilization of these skills could possibly enhance glycemic control in youths with T1DM. © The Author 2008. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved.