Development and validation of a scale measuring perceived barriers to physical activity in Spanish for children and adolescents with type 1 diabetes: the Physical Activity Barriers Scale for pediatric type 1 diabetes (PABS-1) questionnaire

Aims: To develop and validate the psychometric properties, reliability, and criterion validity of the Physical Activity Barriers Scale for pediatric type 1 diabetes (PABS-1) in Spanish-speaking children and adolescents with type 1 diabetes. Method: A cross-sectional study was conducted with a sample of 93 Spanish-speaking children and adolescents with type 1 diabetes. The PABS-1 questionnaire was developed by experts and refined with patient feedback. Its validity was assessed by comparing results with accelerometer data, linking scores to objective physical activity measures. Results: The PABS-1 showed good internal consistency, with a Cronbach's alpha (α) coefficient of 0.89, indicating strong reliability. Confirmatory factor analysis supported a four-factor structure, with physical, diabetes-related, psychological, and environmental barriers showing good fit indices (comparative fit index [CFA] = 0.94, root mean square error of [RMSEA] = 0.06, standardized root mean square residual [SRMR] = 0.05). Although the associations were small, the total PABS-1 score was significantly negatively correlated with cardiorespiratory fitness (Spearman's rho [ρ]= -0.15, p = 0.035) and moderate-to-vigorous physical activity (ρ = −0.12, p = 0.039). Among the four factors, motivational barriers exhibited the strongest associations with physical activity and fitness, showing significant negative correlations. Conclusions: The PABS-1 is a valid and reliable tool for assessing perceived barriers to physical activity in Spanish-speaking children and adolescents with type 1 diabetes.