The Psychometric Properties of the Type 1 Diabetes Mellitus Screening Acceptability Assessment (DMSA) Scale among General Population.

Abstract

Background: Type 1 diabetes mellitus (T1DM) screening facilitates access to early intervention and prevention of severe complications, such as diabetic ketoacidosis. Despite its significance, many countries lack a systematic T1DM screening program. Understanding how the public perceives T1DM screening for children is essential for successfully implementing such programs but is currently an area with limited research. Our study aims to fill this gap by developing a standardized tool designed to assess the acceptability of T1DM screening programs for children, focusing on caregiver perspectives within the general population.

Materials and methods: We developed the Type 1 Diabetes Mellitus Screening Acceptability (DMSA) scale based on the theoretical framework of acceptability and integrated components from the Pediatric Testing Attitudes Scale-Diabetes (P-TAS-D). It covers a broad spectrum of acceptability constructs. The DMSA scale underwent iterative modifications following expert feedback to refine clarity and content validity. We tested the scale in both Arabic and English with adults living in Saudi Arabia, regardless of their parental status, focusing on the potential of screening their children. The psychometric strengths of the scale were evaluated through reliability analyses and exploratory factor analysis.

Results: Of the 599 participants, the majority were female (89.2%), with a mean age of 35.9 ± 8.6 years. The final DMSA scale consists of 10 items, with two distinct factors: "individual acceptability" and "psychosocial acceptability." The mean total score was 42.9 ± 5.1 across a potential range of 10-50 points. The English and Arabic versions of the scale demonstrated strong reliability, with Cronbach's alpha values of 0.84 and 0.79, respectively.

Conclusions: The DMSA scale emerges as a valid and reliable tool for gauging the acceptability of the general population of screening children for T1DM. It integrates key elements of the acceptability construct, pivotal for guiding the implementation of culturally sensitive T1DM screening initiatives. Future research should expand its application across various cultural settings and examine the correlation between scale scores and actual screening behaviors.