Feasibility, acceptability, and predictive validity of a psychosocial screening program for children and youth newly diagnosed with type 1 diabetes

Diabetes Care. 2011 Feb;34(2):326-31. doi: 10.2337/dc10-1553. Epub 2011 Jan 7.


Objective: Psychosocial screening has been recommended for pediatric patients with newly diagnosed type 1 diabetes and their families. Our objective was to assess a psychosocial screening protocol in its feasibility, acceptability to families, and ability to predict early emerging complications, nonadherent family behavior, and use of preventive psychology services.

Research design and methods: A total of 125 patients and their caregivers were asked to participate in a standardized screening interview after admission at a large urban children's hospital with a new diagnosis of type 1 diabetes. Medical records were reviewed for subsequent diabetes-related emergency department (ED) admissions, missed diabetes clinic appointments, and psychology follow-up within 9 months of diagnosis.

Results: Of 125 families, 121 (96.8%) agreed to participate in the screening, and a subsample of 30 surveyed caregivers indicated high levels of satisfaction. Risk factors at diagnosis predicted subsequent ED admissions with a sensitivity of 100% and a specificity of 98.6%. Children from single-parent households with a history of behavior problems were nearly six times more likely to be seen in the ED after diagnosis. Missed appointments were likeliest among African Americans, 65% of whom missed at least one diabetes-related appointment. Psychology services for preventive intervention were underutilized, despite the high acceptability of the psychosocial screening.

Conclusions: Psychosocial screening of newly diagnosed patients with type 1 diabetes is feasible, acceptable to families, and able to identify families at risk for early emerging complications and nonadherence. Challenges remain with regards to reimbursement and fostering follow-up for preventive care.

Publication types

  • Clinical Trial
  • Validation Study

MeSH terms

  • Adaptation, Psychological
  • Adolescent
  • Child
  • Child, Preschool
  • Diabetes Mellitus, Type 1 / drug therapy
  • Diabetes Mellitus, Type 1 / psychology*
  • Feasibility Studies
  • Female
  • Follow-Up Studies
  • Humans
  • Infant
  • Male
  • Mass Screening / methods*
  • Mass Screening / standards*
  • Patient Acceptance of Health Care / psychology*
  • Patient Compliance / psychology*
  • Predictive Value of Tests
  • Psychology
  • Reproducibility of Results
  • Risk Factors
  • Sensitivity and Specificity