Introduction: Tracking self-efficacy may be useful for identifying children at risk for medical noncompliance. We created the Pediatric Rating of Chronic Illness Self-Efficacy (PRCISE) to measure self-efficacy in children and adolescents dealing with a chronic illness (CI). Method: Data were collected from 217 families where one child aged 7-20 (Mage = 13.62, SDage = 2.92; 62.7% Latino, 58.1% female) had a CI. Parent participants provided demographic information. Youth completed a depression measure, the Patient Health Questionnaire for Adolescents (PHQ-A), and the PRCISE. To determine the underlying latent structure of the scale, an exploratory factor analysis was conducted using parallel analysis. We also carried out three multiple linear regressions to explore the data and establish preliminary predictive validity. Results: The measure was reduced to 15 items, demonstrating a one-factor solution with strong reliability. Predictors of lower self-efficacy included having parents who had not attended college, being African American, and having higher PHQ-A scores (R2 = .23, F[11, 174] = 5.62, p < .001.) Main effects were qualified by a two-way interaction, such that the decrease in PRCISE scores associated with depressive symptoms was attenuated in children with less educated parents. In terms of predictive validity, higher PRCISE scores unexpectedly predicted more number of ER visits (R2 = .12, F[9, 113] = 2.73, p < .01). Discussion: The PRCISE appears to be a reliable measure of a single self-efficacy construct. Secondary analyses revealed important health disparities in pediatric CI self-efficacy. Next steps may include validation of the PRCISE using confirmatory factor analysis. Key Words: self-efficacy; chronic illness; health disparities; pediatrics

LLU Discipline

Clinical Psychology




School of Behavioral Health

First Advisor

Neece, Cameron L.

Second Advisor

Boyd, Kendal C.

Third Advisor

Distelberg, Brian J.

Fourth Advisor

Morrell, Holly E. R.

Degree Name

Doctor of Philosophy (PhD)

Degree Level


Year Degree Awarded


Date (Title Page)




Library of Congress/MESH Subject Headings

Pediatrics - Psychology; Child psychology; Chronic illness; Health Status Disparities; Health Behavior;

Subject - Local

Self-efficacy; Health disparities; Patient Health Questionnaire for Adolescents; PRCISE



Page Count


Digital Format


Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.


Loma Linda University Electronic Theses and Dissertations

Collection Website



Loma Linda University. Del E. Webb Memorial Library. University Archives