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The Diabetes Educator
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FEATURES

Development and Validation of an Instrument to Measure Resources and Support for Chronic Illness Self-management

A Model Using Diabetes

Lauren A. McCormack, PhD, MSPH, Pamela A. Williams-Piehota, PhD, Carla M. Bann, PhD, Joseph Burton, MA, Douglas B. Kamerow, MD, MPH, Claudia Squire, MS, Edwin Fisher, PhD, Carol A. Brownson, MSPH and Russell E. Glasgow, PhD

From RTI International, Research Triangle Park, North Carolina (Drs McCormack, Williams-Piehota, Bann, and Kamerow, and Mr Burton and Ms Squire); UNC-Chapel Hill, North Carolina (Dr Fisher); Washington University School of Medicine, St Louis, Missouri (Ms Brownson); and Kaiser Permanente Colorado, Denver, Colorado (Dr Glasgow).

Correspondence to Lauren A. McCormack, PhD, MSPH, Director, Health Communication Program, RTI International, 3040 Cornwallis Road, PO Box 12194, Research Triangle Park, NC 27709 (Lmac{at}rti.org).

Purpose

Few comprehensive and practical instruments exist to measure the receipt of self-management support for chronic illness. An instrument was developed to measure resources and support for self-management (RSSM) for the survey component of the evaluation of the Robert Wood Johnson Foundation's Diabetes Initiative. It includes items to measure an ecological range of RSSM. This article describes the development and validation of the instrument, focusing on individuals' reported access to RSSM from providers and from nonclinical, social, and community sources.

Methods

Cross-sectional analyses of the second wave of a survey of participants in the Diabetes Initiative (68% response rate, n = 957) were used.

Results

Confirmatory factor analyses supported grouping the 17 items into 5 subscales, measuring key aspects of RSSM: individualized assessment, collaborative goal setting, enhancing skills, ongoing follow-up and support, and community resources (comparative fit index = 0.97, Tucker-Lewis fit index = 0.99, and root meansquare error of approximation = 0.06). The overall scale and 5 subscales were internally consistent (Cronbach {alpha} ≥ .70) and were significantly, positively related to diabetes self-management behaviors, supporting their construct validity.

Conclusions

This instrument shows promise for measuring RSSM. Although it was developed for diabetes programs, its ecological orientation and link to the broad framework of chronic care suggest broader application.

The Diabetes Educator, Vol. 34, No. 4, 707-718 (2008)
DOI: 10.1177/0145721708321021
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