P-343: Equitable psychosocial assessment in youth with type 1 diabetes: a scoping review
K Desai, K Berlin, V Ellison, V Gleason, J Valenzuela, M Huenergarde, B Greenberg, P Enlow, R Carr, M McDaniel, R Williams, C Jackson, M Keenan, D Adamolekun, A McDonnell, L Hinojosa, G I Todd, M Phanse, A Choquette, P Maity, C McDonald, J Saucier, S Monroe, R Smith, A Parson, J Westrick, C Stiles-ShieldsAbstract
Introduction
Psychosocial screening is recommended in routine diabetes care for youth with type 1 diabetes (T1D). However, it remains unclear whether patient-reported outcome (PRO) measures have been evaluated using equity-informed reporting and measurement bias detection methods.
Objectives
This scoping review aimed to map psychometric studies of psychosocial PRO measures in pediatric diabetes, examine equity-related reporting practices, and identify measurement bias methods, such as differential item functioning (DIF) and measurement invariance (MI), across sample characteristics.
Methods
Multiple databases were searched in May 2022. Included studies had pediatric diabetes samples with mean age ≤ 18 years, included youth with diabetes and/or immediate family members, reported measurement development or psychometric evaluation, and were published in English. Records were screened in Covidence, and data were extracted using a standardized form and synthesized using descriptive statistics and content analysis.
Results
Of 2,238 records identified, 212 studies were included. Most studies evaluated measures for youth with T1D in clinic, hospital, or medical settings (k = 184, 86.8%). PRO measures most frequently assessed quality of life (k = 48, 22.5%), behavioral self-management (k = 41, 19.2%), and coping/adjustment (k = 21, 9.9%). Reporting of equity-related descriptive statistics was inconsistent, particularly for race, ethnicity, insurance, and gender diversity beyond binary categories. Measurement bias testing was rare (5.7% overall), with few studies examining DIF (k = 4, 1.9%) or MI (k = 8, 3.8%). See Table for a summary of studies reporting DIF and MI evidence.
Conclusions
Pediatric diabetes PRO measures are commonly evaluated for validity and reliability, but equity-related reporting and measurement bias testing remain limited. Future psychometric studies should prioritize transparent reporting, representative samples, and equivalence testing.