Development and validation of the Diabetes Knowledge Assessment Test for use in medical rehabilitation

Abstract

Purpose: To develop and validate the Diabetes Knowledge Assessment Test (DKAT), an assessment designed to measure diabetes knowledge of medical rehabilitation patients with or without diabetes. Methods: Content validity methods were used to develop the DKAT, which was administered to rehabilitation patients to examine psychometric properties. Results: Subjects were 75 inpatients (56% with diabetes; 45% male), and 75 outpatients (49% with diabetes; 69% male). The initial DKAT consisted of 49 items, which was reduced to 32 items based on psychometric criteria. Point-biserial item discrimination indices ranged from 0.26 to 0.61. Item difficulty indices ranged from 27 to 96%. Cronbach’s alpha was 0.82. Known groups construct validity comparisons revealed that patients with diabetes obtained significantly higher DKAT scores than patients without diabetes (p = 0.01), supporting construct validity. Scores did not differ significantly by gender, educational attainment, age, or outpatient versus inpatient (all p > 0.05), further supporting construct validity. Confirmatory factor analysis identified two factors: “Complications” and “Risks-Symptoms-Management”. Conclusions: Findings support claims that DKAT scores are valid and reliable for diabetes knowledge assessment across a range of rehabilitation conditions. It is appropriate for use with persons with or without diabetes engaging in rehabilitation services as an inpatient or outpatient.

Implications for Rehabilitation

• Medical rehabilitation patients represent an important population in which to assess core diabetes knowledge due to the extremely high prevalence of diabetes.

• We were unable to identify instruments with validity evidence aimed at assessing diabetes knowledge in rehabilitation populations, therefore undertook development of the DKAT.

• The DKAT represents a psychometrically promising assessment that can inform individuals at risk with the signs and symptoms of diabetes, as well as behavioral actions to reduce risk.

• The DKAT can also be used to identify those with a diagnosis of diabetes in need of formal diabetes education.

• Diabetes
• Diabetes Knowledge Assessment Test
• psychometrics
• reliability
• validity

Declaration of interest

The authors declare that there is no conflict of interest, and that the research supporting this article will not confer a benefit on us or on any organization with which we are associated. Portions of this work were supported by funding from the Washington Association of Diabetes Educators. Article contents are solely the responsibility of the authors and do not necessarily represent the official views of the Washington Association of Diabetes Educators.