Purpose-The purpose of this study is to investigate parent reports of the diabetes care support their children receive in school, their concerns about diabetes management in school, and their knowledge of federal laws that protect children with diabetes. In addition, the study explores ethnic and socioeconomic status differences in diabetes management in school.Methods-An ethnically heterogeneous sample of 309 parents of children with diabetes was recruited from a community-based and a university-based diabetes outpatient clinic. Parents completed a survey assessing supports their child's school provides for diabetes care, worries about diabetes care in school, and awareness of federal laws that pertain to children with diabetes.Results-Many children did not have a written care plan or a nurse at school, but significantly more white children had these supports than Hispanic or black children. Most children were not allowed to check blood glucose levels or administer insulin in class. Most parents were worried about hyperglycemia and hypoglycemia in school, and most were not at all or only a little confident in the school's ability to care for diabetes. Most parents were not aware of federal laws, but high-income and white parents were more likely to be aware.Conclusions-According to parents in the current study, children receive inadequate diabetes management support in schools. Minority children are less likely to receive supports than white children. Parents are worried about diabetes management in school, but most do not have the knowledge of federal laws necessary to protect their children.Diabetes mellitus is one of the most common chronic conditions of childhood. 1 Type 1 diabetes is the most common diagnosis, with 1 in every 400 to 600 individuals younger than 20 years affected. 2 Recent studies suggest that the incidence of type 1 diabetes may be increasing in the United States and worldwide. 3,4 Although type 2 diabetes is less common among school-age children than type 1 diabetes, the incidence of type 2 diabetes has increased in the past several years in concordance with the unprecedented rates of obesity among youth. 5 The increasing prevalence of type 2 diabetes among overweight children and adolescents is especially dramatic among minorities. 4,6 In total, an estimated 18 700 children younger than 20 years are newly diagnosed with diabetes mellitus each year in the United States. 4 Diabetes self-care is complex and requires significant lifestyle adaptations that can be difficult for all people with diabetes; however, these changes are especially complicated for children and adolescents. Frequent monitoring of blood glucose levels is required, and constant access to glucose meters is a necessity. Food intake, particularly carbohydrates, must be carefully Balancing the array of diabetes self-care behaviors can be frustrating. 7 For children and adolescents, who spend approximately half of their waking hours at school, these frustrations can be compounded by difficulties getting the support...

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OBJECTIVEFew validated measures exist to evaluate self-management of diabetes in families with limited English proficiency. The present study evaluated the psychometric properties and the factorial equivalence of a Spanish translation of the parent report version of the Diabetes Self-Management Profile (DSMP-Parent-Sp).RESEARCH DESIGN AND METHODSHispanic families of youth (mean 13.7 years old) with type 1 diabetes were recruited from three clinics in South Florida and represented a wide range of nationalities and acculturation levels. A total of 127 parents reported on their child's self-management behaviors using either the original DSMP-Parent (59.8%) or the DSMP-Parent-Sp (40.2%). In addition, youth reported their self-management using the original DSMP in English, and physicians rated their perceptions of the youth's self-management. Glycemic control was indexed by A1C in the past 3 months and collected from medical chart review.RESULTSItem analysis confirmed that the DSMP-Parent-Sp items related to the overall composite score in expected ways, and internal consistency estimates were adequate. Paired correlations demonstrated strong parent-child concordance and a significant relationship with physician perceptions of self-management. Evidence of concurrent and convergent validity, as well as “strict factorial invariance,” was demonstrated.CONCLUSIONSThese preliminary findings indicate that the DSMP-Parent-Sp is a reliable and valid parent report measure of the diabetes self-management behaviors of Hispanic youths. In addition, there is preliminary evidence that the translated measure may be considered equivalent to the original English measure when used to measure self-management in Hispanic youth with diabetes.

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