Development and psychometric testing of the online Adolescent Diabetes Needs Assessment Tool (ADNAT)

Aim. To report on the development and psychometric testing of the Adolescent
Diabetes Needs Assessment Tool.
Background. The UK has the fifth largest paediatric diabetes population in the
world, but one of the poorest levels of diabetes control, highlighting the need for
intervention development.
Design. Mixed methods following recommendations for questionnaire design and
validation.
Methods. A total of 171 young people (12–18 years) participated between 2008–
2011. Methods included item selection using secondary framework analysis, item
review, pre-testing, piloting and online transfer. Statistical tests assessed reliability
using item-total correlations, interitem consistency and test–retest reliability; and
validity using blood glucose (HbA1c) levels and the Self-Management of type 1
Diabetes in Adolescence questionnaire.
Results. The Adolescent Diabetes Needs Assessment Tool consists of 117
questions divided between six domains of educational and psychosocial support
needs. It combines reflective questioning with needs assessment to raise selfawareness
to support adolescent decision-making in relation to diabetes self-care.
Thirty-six of the questions provide self-care and psychosocial health assessment
scores. Face and content validity of the scoring items were all positively evaluated
in terms of appropriateness and readability and tests for validity found significant
correlations with Self-Management of type 1 Diabetes in Adolescence and weak
correlation with HbA1c, which compared favourably with Self-Management of
type 1 Diabetes in Adolescence, the only comparable (USA) tool. Item response
analysis validated the use of simple additive scores.
Conclusions. The Adolescent Diabetes Needs Assessment Tool combines reflective
learning with needs assessment to support patient-centred clinical consultations.