Assessing Readiness for Independent Self-Care in Adolescents with Type 1 Diabetes: Introducing the RISQ.

AIM: To design and evaluate psychometrics of adolescent self-report and parent proxy-report questionnaires assessing readiness for independent self-care in adolescents with type 1 diabetes (RISQ-T and RISQ-P). METHODS: 178 adolescents with type 1 diabetes (ages 13-17 years) and their parents completed the 20-item RISQ-T and 15-item RISQ-P, along with diabetes-specific measures of parent involvement, self-efficacy, burden, and treatment adherence. Evaluation of psychometric properties included calculation of internal consistency, adolescent and parent agreement, test-retest reliability, concurrent and predictive validity. RESULTS: The RISQ-T (alpha=.78) and RISQ-P (alpha=.77) demonstrated sound internal consistency. Higher RISQ-T and RISQ-P scores (indicating more adolescent readiness for independent self-care) showed significant associations with less parent involvement in diabetes care (adolescent r=-.34; parent r=-.47; p<.0001), greater adolescent diabetes self-efficacy (adolescent r=.32; parent r=.54; p<.0001), less parent-endorsed diabetes-related burden (parent r=-.30; p<.0001), and greater treatment adherence (adolescent r=.26, p=.0004; parent r=.31, p<.0001). Adolescent and parent scores were significantly correlated (r=.35; p<.0001); test-retest reliability was reasonable (ICC RISQ-T r=.66; RISQ-P r=.71). Higher baseline RISQ-P scores significantly predicted reduced family involvement after six months (beta=-.14, p=.02). CONCLUSIONS: RISQ-T and RISQ-P demonstrate sound psychometric properties. Surveys may help inform diabetes teams of the level of support needed to facilitate shift to independent self-management.