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Assessing daily management of childhood diabetes using 24-hour recall interviews: reliability and stability
A Freund1, S B Johnson, J Silverstein
1Department of Psychiatry, J. Hillis Miller Health Center, University of Florida, Gainesville 32610-0234.
Insights
Parent-child agreement in diabetes management improved with more interviews and weekday focus. Younger children
Area of Science:
- Pediatric Endocrinology
- Behavioral Science
- Health Psychology
Background:
- Effective diabetes management in children requires consistent adherence to treatment plans.
- Parental involvement is crucial for pediatric diabetes care, influencing patient outcomes.
- Assessing adherence accurately is vital for optimizing therapeutic strategies in young patients.
Purpose of the Study:
- To evaluate parent-child concordance in reporting daily diabetes management behaviors.
- To identify factors influencing the accuracy of adherence reporting over time.
- To develop reliable measures for assessing pediatric diabetes self-management.
Main Methods:
- Conducted 24-hour recall interviews with 78 pediatric patients (ages 6-19) and their parents.
- Utilized nine independent interviews per dyad over a 3-month period.
- Developed 13 adherence measures to quantify parent-child agreement on diabetes care tasks.
Main Results:
- Statistically significant parent-child concordance was observed across all 13 adherence measures.
- Higher agreement was noted for weekday behaviors compared to weekend activities.
- Agreement improved with an increased number of interviews (nine vs. three).
- Younger children (6-9 years) showed lower agreement on time-sensitive measures, which improved with practice.
- Dietary and glucose testing measures demonstrated moderate 3-month stability; exercise and injection measures showed lower stability.
Conclusions:
- Parent-child concordance in reporting diabetes management is significant but influenced by behavior type and interview frequency.
- Younger children's reporting accuracy improves with familiarity with the interview process.
- Adherence measures for diet and glucose testing are more stable over time than those for exercise and injections.
Abstract:
Conducted 24-hr recall interviews concerning daily diabetes management with seventy-eight 6- to 19-year-old patients and their parents. Patients and parents were interviewed independently nine times over 3 months. Data obtained were used to construct 13 adherence measures. All measures yielded statistically significant estimates of parent-child concordance. Parent-child agreement was higher for weekday versus weekend behaviors and when based on nine versus three interviews. For the sample as a whole, parent-child concordance remained stable over the course of the study. Compared to the older patients, the 6- to 9-year-olds exhibited poorer parent-child agreement on measures involving time (e.g., injection and exercise-duration measures). This deficit disappeared, however, as the children became more practiced with the interview procedure. The dietary and glucose-testing measures exhibited moderate stability over the 3-month study. Lower stability estimates were obtained for the exercise and injection measures.