Development and validation of the diabetic self-management scale based on information-motivation-behavioral skills theory

Zhenwei Dai; Shu Jing; Xiaoyang Liu; Haoran Zhang; Yijin Wu; Hao Wang; Weijun Xiao; Yiman Huang; Jiaqi Fu; Xu Chen; Lei Gao; Xiaoyou Su

doi:10.3389/fpubh.2023.1109158

Development and validation of the diabetic self-management scale based on information-motivation-behavioral skills theory

Front Public Health. 2023 Feb 24:11:1109158. doi: 10.3389/fpubh.2023.1109158. eCollection 2023.

Authors

Zhenwei Dai¹, Shu Jing¹, Xiaoyang Liu¹, Haoran Zhang², Yijin Wu¹, Hao Wang¹, Weijun Xiao¹, Yiman Huang¹, Jiaqi Fu¹, Xu Chen¹, Lei Gao², Xiaoyou Su¹

Affiliations

¹ School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
² NHC Key Laboratory of Systems Biology of Pathogens, Institute of Pathogen Biology, and Center for Tuberculosis Research, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.

Abstract

Background: Self-management is important for the blood sugar control of middle-aged and elderly Type 2 diabetes mellitus (T2DM) patients, of which diet, exercise, and drug compliance are the most common components. The Information-Motivation-Behavioral Skills Model (IMB) has been widely used in health behavior management and intervention.

Objective: The purpose of this study is to develop and validate the Diabetic Self-Management Scale (DSMS) based on the IMB model.

Methods: Self-report survey data was collected from middle-aged and elderly T2DM patients in Zhongmu City, Henan Province, China in November 2021 using convenience sampling. The original DSMS was developed through a literature review and summary of previous similar scales using an inductive approach. Item modification was finished by a panel of specialists. Exploratory factor analysis and confirmatory factor analysis were used to evaluate the reliability, convergent validity, discriminant validity, and criterion validity of DSMS.

Results: Four hundred and sixty nine T2DM patients completed the questionnaire survey. The final DSMS consists of 22 items with three dimensions, including information (five items), motivation (eight items), and behavior skills (nine items). The results of simple factor analysis showed that the KMO value was 0.839, Bartlett spherical test 2 = 3254.872, P < 0.001. The results of confirmatory factor analysis showed that 2/df = 2.261, RMSEA = 0.073, CFI = 0.937, TLI = 0.930, and SRMR = 0.096. The standardized factor loadings of 22 DSMS items were all above 0.6, and the CR values of 3 dimensions were all higher than 0.9. In addition, DSMS also showed good discriminant and criterion validity.

Conclusion: The 22-item DSMS has good reliability and validity, and can be used to make diabetic self-management assessment regarding diet, physical activity, and medication among middle-aged and elderly Chinese T2DM patients. DSMS is of moderate length and easy to understand. It can be promoted in China in the future to understand the self-management status of middle-aged and elderly T2DM patients in China.

Keywords: Information-Motivation-Behavioral Skills Model (IMB); psychometric properties; self-management; type 2 diabetes mellitus; validation.

Publication types

Review
Research Support, Non-U.S. Gov't

MeSH terms

Aged
Diabetes Mellitus, Type 2*
Humans
Middle Aged
Motivation
Reproducibility of Results
Self-Management*
Surveys and Questionnaires

Grants and funding

This study was funded by the Innovative Engineering Program sponsored by Chinese Academy of Medical Sciences (2020-I2M-2-015).