Development and psychometric testing of the online Adolescent Diabetes Needs Assessment Tool (ADNAT)

Authors

  • Helen Cooper BNurs PhD RN RHV,

    Professor of Community and Child Health, Corresponding author
    1. Department of Community Health and Well-being, University of Chester, UK
    2. Research and Development Department, Alder Hey Children's NHS Foundation Trust, Liverpool, UK
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  • Joy Spencer BSc PhD,

    Researcher
    1. Research and Development Department, Alder Hey Children's NHS Foundation Trust, Liverpool, UK
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  • Gillian A. Lancaster BSc MSc PhD,

    Director, Postgraduate Statistics
    1. Department of Mathematics & Statistics, Fylde College, Lancaster University, UK
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  • Andrew Titman BSc MSc PhD,

    Lecturer
    1. Department of Mathematics & Statistics, Fylde College, Lancaster University, UK
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  • Mark Johnson B Mus MSc PhD,

    Reader in Applied Research in Educational Technology and Systems
    1. Department of Games Computing/Creative Technologies, Bolton University, UK
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  • Sara Louise Wheeler BA PhD,

    Researcher
    1. Department of Community Health and Well-being, Faculty of Health and Social Care, University of Chester, UK
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  • Rebekah Lwin BSc MSc PhD

    Senior Lecturer/Consultant Clinical Psychologist
    1. Department of Social Studies and Counselling, University of Chester, UK
    2. Psychological Services Department, Alder Hey Children's NHS Foundation Trust, Liverpool, UK
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Abstract

Aim

To report on the development and psychometric testing of the Adolescent Diabetes Needs Assessment Tool.

Background

The UK has the fifth largest paediatric diabetes population in the world, but one of the poorest levels of diabetes control, highlighting the need for intervention development.

Design

Mixed methods following recommendations for questionnaire design and validation.

Methods

A total of 171 young people (12–18 years) participated between 2008– 2011. Methods included item selection using secondary framework analysis, item review, pre-testing, piloting and online transfer. Statistical tests assessed reliability using item-total correlations, interitem consistency and test–retest reliability; and validity using blood glucose (HbA1c) levels and the Self-Management of type 1 Diabetes in Adolescence questionnaire.

Results

The Adolescent Diabetes Needs Assessment Tool consists of 117 questions divided between six domains of educational and psychosocial support needs. It combines reflective questioning with needs assessment to raise self-awareness to support adolescent decision-making in relation to diabetes self-care. Thirty-six of the questions provide self-care and psychosocial health assessment scores. Face and content validity of the scoring items were all positively evaluated in terms of appropriateness and readability and tests for validity found significant correlations with Self-Management of type 1 Diabetes in Adolescence and weak correlation with HbA1c, which compared favourably with Self-Management of type 1 Diabetes in Adolescence, the only comparable (USA) tool. Item response analysis validated the use of simple additive scores.

Conclusions

The Adolescent Diabetes Needs Assessment Tool combines reflective learning with needs assessment to support patient-centred clinical consultations.

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