The Skills, Confidence & Preparedness Index (SCPI)

LMC Diabetes & Endocrinology Ltd.486 enrolled

Overview

The LMC Skills, Confidence and Preparedness Index (SCPI) is a tool that was developed by diabetes specialists to individualize the education/support that a healthcare provider delivers to patients with diabetes. It has been shown to have high reliability, validity and generalizability. This study assessed the validity and reliability of a revised, final version of the SCPI in a large sample of patients with type 1 and type 2 diabetes, as well as the clinical responsiveness of the SCPI to a diabetes self-management education intervention in a smaller cohort of patients with poor glycemic control.

Canadian experts in diabetes care developed the Skills, Confidence \& Preparedness Index (SCPI) to assess diabetes self-management in patients. The SCPI is web-based, gives immediate feedback to the healthcare provider, and is associated with glycemia. The SCPI was designed to allow a healthcare provider to individualize the education/support by assessing the three critical dimensions of self-management: knowledge of a skill; confidence in ability to change a behavior; and preparedness to begin implementing the behavior change. Two previous validation studies showed that the SCPI has high internal consistency, reliability, generalizability, and external validity. Following further focus groups with healthcare providers and patients, the SCPI questions and response scale were edited to further optimize clarity. This study assessed the validity and reliability of a revised, final version of the LMC SCPI in a large sample of diabetes patients, as well as clinical responsiveness of the SCPI to a diabetes self-management education (DSME) program intervention. This study recruited type 1 and type 2 patients from the waiting rooms of seven LMC Diabetes \& Endocrinology specialist clinics in Ontario, Canada. Patients completed the SCPI electronically and their demographic and health information was retrieved from their electronic medical records. A smaller cohort of patients with uncontrolled glycemia were enrolled into a DSME program. Participants completed the SCPI at their baseline visit and their individual results were incorporated into the care paths that were then customized for that participant. The DSME program provided five to seven visits with a diabetes educator over three to four months. Patients completed the SCPI again at their final visit.

Study Type

OBSERVATIONAL

Enrollment

486

Conditions

Diabetes Mellitus

Interventions

Diabetes self-management education (DSME) programBEHAVIORAL

Diabetes educators customized care paths for their patients based on their individual responses to the SCPI questions. Patients met with an educator five to seven times over the course of three to four months.

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Diagnosis of type 1 or type 2 diabetes * Age ≥ 18 years * Ability to read English * Duration of diabetes ≥ 6 months (DSME cohort only) * A1C ≥ 8.0% (DSME cohort only) Exclusion Criteria: \-

Locations (7)

LMC Barrie

Barrie, Ontario, Canada

LMC Brampton

Brampton, Ontario, Canada

LMC Etobicoke

Etobicoke, Ontario, Canada

LMC Oakville

Oakville, Ontario, Canada

Outcomes

Primary Outcomes

Internal consistency of the SCPI (Skills, Confidence & Preparedness Index)

Cronbach's alpha score for the total SCPI score (minimum score 1, maximum score 7) and the three subscales (minimum score 1, maximum score 7) in the waiting room sample. A higher score indicates greater diabetes self-management.

Time frame: 24-hours

Validity of the SCPI with HbA1c

Correlation between the total SCPI score (minimum score 1, maximum score 7) and the three subscale scores (minimum score 1, maximum score 7) with HbA1c in the waiting room sample. A higher SCPI score indicates greater diabetes self-management.

Time frame: 24-hours

Secondary Outcomes

Validity of the SCPI with demographic and diabetes variables

Correlation between the total SCPI score (minimum score 1, maximum score 7) and age, gender, education, ethnicity, duration of diabetes and diabetes therapy in the waiting room sample. A higher SCPI score indicates greater diabetes self-management.

Time frame: 24-hours

Test-retest reliability

Applicable to patients from the waiting room sample who completed the SCPI in the clinic and again one week later. Correlation between the first total SCPI score (minimum score 1, maximum score 7) and the second total SCPI scores.

Time frame: one week

Floor/ceiling effect of the total SCPI score

Assessment of a floor effect (\>15% of patients with a minimum score of 1) or a ceiling effect (\>15% of patients with a maximum score of 7)

Time frame: 24-hours

SCPI completion time

Mean number of minutes it took for patients to complete the SCPI

Data from ClinicalTrials.gov

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