{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T14:00:51Z","timestamp":1790949651939,"version":"4.1.0"},"reference-count":41,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The Science of Diabetes Self-Management and Care"],"abstract":"<jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>The purpose of this study is to develop and establish content validity evidence for the Perceived Barriers to Diabetes Self-Management Scale (PB-DSMS) for adolescents and young adults (15-39\u2009years) with type 1 diabetes mellitus (T1DM).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A methodological scale-development and content-validation study was conducted in June 2023. Item generation was guided by the social ecological model and informed by a synthesis of qualitative literature on barriers to diabetes self-management. An initial pool of 57 items was generated and subsequently refined to 47 items through internal review. Content validity was evaluated by a multidisciplinary panel of 6 experts using the item-level content validity index (I-CVI), scale-level content validity index, and modified kappa statistics. Cognitive interviews with 6 individuals with T1DM were conducted to evaluate item clarity, comprehensibility, and contextual relevance, and findings were incorporated into item refinement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Eight domains of perceived barriers were identified: lack of knowledge and skills, psychological barriers, time constraints and competing life priorities, lack of family support, lack of community\/peer support, health system-related barriers, availability and accessibility barriers, and digital barriers. Of the 47 preliminary items, 43 achieved an excellent I-CVI. Cognitive interviews supported the comprehensibility and contextual relevance of the instrument and informed item refinement. Following expert review and cognitive interviewing, 4 items were removed and 16 items were revised, resulting in a final 44-item scale.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The PB-DSMS is a comprehensive, patient-informed, and contextually relevant instrument for assessing perceived barriers to diabetes self-management among adolescents and young adults with T1DM. It has the potential to facilitate patient-centered assessment and support the development of targeted interventions to improve diabetes self-management in clinical practice and research.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/26350106261483743","type":"journal-article","created":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T12:03:51Z","timestamp":1790683431000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Development and Content Validation of the Perceived Barriers to Diabetes Self-Management Scale (PB-DSMS) Among Adolescents and Young Adults With Type 1 Diabetes"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-5420-9504","authenticated-orcid":false,"given":"Sadhana","family":"Mishra","sequence":"first","affiliation":[{"name":"Institute of Medical Sciences, BHU, Varanasi, UP, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-6549-9118","authenticated-orcid":false,"given":"Arun Kumar","family":"Dubey","sequence":"additional","affiliation":[{"name":"Institute of Medical Sciences, BHU, Varanasi, UP, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaya Prakash","family":"Mishra","sequence":"additional","affiliation":[{"name":"Arogya Shiksha Foundation, Varanasi, UP, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7322-4134","authenticated-orcid":false,"given":"Neeraj Kumar","family":"Agrawal","sequence":"additional","affiliation":[{"name":"Institute of Medical Sciences, BHU, Varanasi, UP, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,29]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc22-S002"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.2337\/dci18-0023"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.2337\/diaclin.22.3.123"},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.1177\/0145721720978154"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.1111\/dme.12067"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2014.03.011"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.2174\/1573399811666150421114957"},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(14)00080-7"},{"key":"e_1_3_5_10_2","doi-asserted-by":"publisher","DOI":"10.1111\/dme.12639"},{"key":"e_1_3_5_11_2","doi-asserted-by":"publisher","DOI":"10.1155\/2019\/6271591"},{"key":"e_1_3_5_12_2","doi-asserted-by":"publisher","DOI":"10.21037\/tp.2017.09.06"},{"key":"e_1_3_5_13_2","doi-asserted-by":"publisher","DOI":"10.1177\/0145721718825342"},{"key":"e_1_3_5_14_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-5491.2007.02137.x"},{"key":"e_1_3_5_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2011.06.010"},{"key":"e_1_3_5_16_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjdrc-2021-002583"},{"key":"e_1_3_5_17_2","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.18.6.754"},{"key":"e_1_3_5_18_2","doi-asserted-by":"publisher","DOI":"10.1186\/1477-7525-11-138"},{"key":"e_1_3_5_19_2","volume-title":"Scale Development: Theory and Applications","author":"DeVellis RF","year":"2021","unstructured":"DeVellis RF, Thorpe CT. 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