The Skills, Confidence & Preparedness Index (SCPI) (SCPI)

The Skills, Confidence & Preparedness Index (SCPI) Version 3.0: An Online Version of the SCPI to Evaluate Self-Efficacy of Diabetes Management

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.

Study Overview

• Status: Completed
• Conditions: Diabetes Mellitus
• Intervention / Treatment: Behavioral: Diabetes self-management education (DSME) program

Detailed Description

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 (Actual): 486

Contacts and Locations

Study Locations

• Canada
  • Ontario
    • Barrie, Ontario, Canada
      • LMC Barrie
    • Brampton, Ontario, Canada, L6S 0C9
      • LMC Brampton
    • Etobicoke, Ontario, Canada
      • LMC Etobicoke
    • Oakville, Ontario, Canada
      • LMC Oakville
    • Thornhill, Ontario, Canada
      • LMC Thornhill
    • Toronto, Ontario, Canada, M1R 0B1
      • LMC Scarborough
    • Toronto, Ontario, Canada
      • LMC Bayview

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (ADULT, OLDER_ADULT)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

Waiting room cohort: adult patients with type 1 or type 2 diabetes attending their usual visit with their LMC healthcare provider

DSME cohort: patients with type 1 or type 2 diabetes with a recent A1C ≥ 8.0%

Description

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:

-

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Waiting room sample; Patients with type 1 or type 2 diabetes attending an LMC Diabetes & Endocrinology specialist clinic in Ontario completed the SCPI in the waiting room while attending their usual appointment with their healthcare provider.
DSME Intervention; Patients with poor glycemic control (A1C >8.0%) were enrolled into a diabetes self-management education (DSME) program. The SCPI was completed at their first and last visit and and their individual results were incorporated into the care paths that were then customized for that participant. The patient met with a diabetes educator five to seven times over the course of three to four months.	Behavioral: Diabetes self-management education (DSME) program; 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.; Other Names: DSME

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
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.	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.	24-hours

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
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.	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.	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)	24-hours
SCPI completion time	Mean number of minutes it took for patients to complete the SCPI	24-hours
Change in SCPI score	Mean change in SCPI total score between the baseline visit and follow-up visit in the DSME cohort	3 to 4 months
Change in HbA1c	Mean change in HbA1c between the baseline visit and the follow-up visit in the DSME cohort	3 to 4 months
Association between total SCPI score and HbA1c	Correlation between SCPI score at baseline and HbA1c at baseline in the DSME cohort	Baseline
Responsiveness of the total SCPI score to an intervention	Correlation between change in SCPI score and change in HbA1c in the DSME cohort	3 to 4 months

Collaborators and Investigators

• Sponsor: LMC Diabetes & Endocrinology Ltd.
• Investigators: Principal Investigator: Ronnie Aronson, MD, FRCPC, FACE, LMC Diabetes & Endocrinology

Publications and helpful links

General Publications

• Mbuagbaw L, Aronson R, Walker A, Brown RE, Orzech N. The LMC Skills, Confidence & Preparedness Index (SCPI): development and evaluation of a novel tool for assessing self-management in patients with diabetes. Health Qual Life Outcomes. 2017 Jan 31;15(1):27. doi: 10.1186/s12955-017-0606-z.
• Aronson R, Brown RE, Jiandani D, Walker A, Orzech N, Mbuagbaw L. Assessment of self-management in patients with diabetes using the novel LMC Skills, Confidence and Preparedness Index (SCPI). Diabetes Res Clin Pract. 2018 Mar;137:128-136. doi: 10.1016/j.diabres.2017.10.028. Epub 2017 Oct 31.
• Aronson R, Orzech N, Ye C, Brown RE, Goldenberg R, Brown V. Specialist-Led Diabetes Registries and Prevalence of Poor Glycemic Control in Type 2 Diabetes: The Diabetes Registry Outcomes Project for A1C Reduction (DROP A1C). Diabetes Care. 2016 Oct;39(10):1711-7. doi: 10.2337/dc15-2666. Epub 2016 Aug 11.
• Aronson R, Orzech N, Ye C, Goldenberg R, Brown V. Specialist-led diabetes registries and predictors of poor glycemic control in type 2 diabetes: Insights into the functionally refractory patient from the LMC Diabetes Registry database. J Diabetes. 2016 Jan;8(1):76-85. doi: 10.1111/1753-0407.12257. Epub 2015 Mar 24.
• Aronson R, Li A, Brown RE, Walker A, Lyons A, Orzech N. Optimizing Diabetes Self-management Using the Novel Skills, Confidence, and Preparedness Index (SCPI). Diabetes Care. 2019 Oct;42(10):1873-1878. doi: 10.2337/dc19-0699. Epub 2019 Aug 9.

Study record dates

Study Major Dates

• Study Start (ACTUAL): October 11, 2017
• Primary Completion (ACTUAL): December 3, 2018
• Study Completion (ACTUAL): December 3, 2018

Study Registration Dates

• First Submitted: February 22, 2019
• First Submitted That Met QC Criteria: March 4, 2019
• First Posted (ACTUAL): March 5, 2019

Study Record Updates

• Last Update Posted (ACTUAL): March 5, 2019
• Last Update Submitted That Met QC Criteria: March 4, 2019
• Last Verified: March 1, 2019

More Information

Terms related to this study

• Keywords: self-management; questionnaire; diabetes education
• Additional Relevant MeSH Terms: Glucose Metabolism Disorders; Metabolic Diseases; Endocrine System Diseases; Diabetes Mellitus
• Other Study ID Numbers: SCPI

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No