Measuring caregivers’ psychological flexibility in relation to their child’s type 1 diabetes in an income and racially diverse sample

Abstract Objective Caregivers’ psychological flexibility is a key factor influencing both caregiver and child well-being, particularly among families managing youth type 1 diabetes (T1D); yet, no existing measures capture diabetes-specific flexibility in caregivers or its impact on family functioning. To address this gap, this study developed and evaluated the Diabetes Acceptance and Action Scale-Caregiver Report (DAAS-C), along with 9- and 3-item short forms, to assess caregivers’ flexibility regarding their child’s diabetes. Method A sample of caregivers of adolescents with T1D completed the DAAS-C and related measures of family impact, parenting, and caregiver acceptance, and youth glycated hemoglobin (HbA1c) data were collected from medical records. Results Analyses supported a three-factor structure of the DAAS-C, with short forms derived from the most reliable items. The full and short forms demonstrated strong reliability and validity, maintained consistency across diverse caregiver groups, and were associated with illness and psychosocial variables in theoretically expected ways. Conclusions These findings suggest that the DAAS-C and its short forms are effective tools for assessing diabetes-specific psychological flexibility in caregivers, providing a foundation for future research and interventions aimed at improving outcomes for families managing T1D.