Psychometric Properties of the Parent and Child Problem Areas in Diabetes Measures

Objective: Children with type 1 diabetes and their parents face daily self-care demands, leading to diabetes-specific emotional distress. A standardized measure of diabetes distress can guide clinical care and prevent negative outcomes. Methods: This study evaluated the psychometric properties of child-and parent-report measures of the Problem Areas in Diabetes Scale, adapted for children ages 8-12 (PAID-C) and their parents (P-PAID-C). Participants were from 42 diabetes camps in the United States. Children (N = 804; mean age = 10.3 ± 1.1) and parents (N = 968) completed measures of diabetes distress, diabetes-related strengths, and self-care skills. Half of the sample was used for exploratory factor analyses (EFA) with direct oblimin rotation and the other half for confirmatory factor analyses (CFAs). Results: For the PAID-C, EFA and CFAs supported an 11-item two-factor measure, Cronbach's α =. 91, accounting for 54.6% of the variance. For the P-PAID-C, analyses resulted in a 16-item measure, Cronbach's α =. 92, accounting for 51.9% of the variance. PAID-C and P-PAID-C scores were positively correlated with HbA1c (r_child =. 08, p =. 04; r_parent =. 18, p <. 001), and negatively correlated with diabetes-related strengths (r_child =-.38, p <. 001, r_parent =-.29, p <. 001) and parent report of child self-care skills (r_parent =-.13, p <. 001; r_child =-0.07, p = ns). Conclusions: Initial psychometrics suggest that the PAID-C and P-PAID-C reliably and validly capture diabetes-specific emotional distress for children and their parents. Associations with glycemic control, self-care, and diabetes strengths demonstrate criterion validity. Both measures have potential applications for routine, clinic-based assessments of diabetes distress and may guide clinical decision-making.