Psychometric properties of the Persian versions of acceptance and action diabetes questionnaire (AADQ) and the diabetes acceptance and action scale (DAAS), in Iranian youth with type 1 diabetes

Psychological flexibility has considerable effects on medical and psychosocial outcomes in youth with type 1 diabetes mellitus (T1DM). This study aimed to evaluate the psychometric properties of the Persian versions of the Acceptance and Action Diabetes Questionnaire (AADQ) and the Diabetes Acceptance and Action Scale for children and adolescents (DAAS), the measures of diabetes-specific psychological flexibility.

196 youth with T1DM completed the DAAS, AADQ (youth-report), Child and Adolescent Mindfulness Measure (CAMM), Emotion Regulation Questionnaire for Children and Adolescents (ERQ-CA), and the Avoidance and Fusion Questionnaire for Youths (AFQ-Y8). Also, their parents completed AADQ (parent-report). Data analyzed by SPSS V.26 and LISREL 8.8.

The mean and standard deviation of participants’ age was 14.7 ± 2.08.The internal consistency due to Cronbach’s alpha method was 0.87, 0.8, 0.84, and 0.83 for DAAS total scores, avoidance, values impairment, and fusion, respectively. The internal consistency of AADQ (both parent-report and youth report) was above 0.8. Test-retest reliability (from 45 participants) with a one-week interval was assessed by the interclass correlation coefficient (ICC). The DAAS, AADQ-parent report, and AADQ-youth report’s reliability coefficients were 0.93, 0.82, and 0.92, respectively. The AADQ (both forms) and DAAS evidence good content validity based on correlations with other measures. Confirmatory factor analysis (CFA) and Exploratory Factor Analysis (EFA) showed DAAS has the three-factor model, which strongly a suitable model is fitting. EFA also verified the AADQ model fitting.

In general, these results support the psychometric properties of the Persian versions of DAAS and AADQ among the Iranian youth patients with T1DM.