Evaluation of the Spoken Knowledge in Low Literacy in Diabetes Scale for Use With Mexican Americans

Abstract

Purpose: This article evaluates the Spoken Knowledge in Low Literacy in Diabetes (SKILLD) questionnaire, a measure of essential knowledge for type 2 diabetes self-management, after it was modified for English- and Spanish-speaking Mexican Americans. Method: We collected surveys (SKILLD, demographic, acculturation) and blood for A1C analysis from 72 community-recruited participants to analyze the SKILLD’s internal consistency, interrater reliability, item analysis, and construct validity. Clinical experts evaluated content validity. Results: The SKILLD demonstrated low internal consistency but high interrater reliability and content and construct validity. There were significant correlations in expected directions between SKILLD scores and acculturation, education, and A1C and significant differences in SKILLD scores between and within groups after an educational intervention and between high- and low-acculturated participants. Conclusion/Implications: The SKILLD generates useful information about Mexican Americans’ diabetes knowledge. Lower SKILLD scores suggest less diabetes knowledge, lower health literacy, and participants’ difficulties understanding items. Further modifications should improve use with low-acculturated Mexican Americans.

Keywords

transcultural health survey design type 2 diabetes mellitus Latino

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References

Agency for Healthcare Research and Quality. (2001). Diabetes disparities among racial and ethnic minorities (Publication No. 02-P007). Rockville, MD: Author. Retrieved from http://www.ahrq.gov/research/diabdisp.htm

American Diabetes Association. (2012). Standards of medical care in diabetes—2012. Diabetes Care, 35, S11-S63.

American Medical Association. (1999). Health literacy: Report of the Council on Scientific Affairs. Journal of the American Medical Association, 281, 552-557.

Britigan

D. H.

Rojas-Guyler

(2009). A qualitative study examining Latino functional health literacy levels and sources of health information. Journal of Community Health, 34, 222-230.

Cavenaugh

Huizinga

M. M.

Wallston

K. A.

Gebretsadik

Shintani

Davis

. . . Rothman

R. L.

(2008). Association of numeracy and diabetes control. Annals of Internal Medicine, 148, 737-745.

Centers for Disease Control and Prevention. (2004). Health disparities experienced by Hispanics: United States. Morbidity & Mortality Weekly Report, 53, 935-941.

Centers for Disease Control and Prevention, & Office of Minority Health & Health Disparities. (2009). Hispanic or Latino populations. Retrieved from http://www.cdc.gov/minorityhealth/populations/REMP/hispanic.html

Funnel

M. M.

Brown

T. L.

Childs

B. P.

Haas

L. B.

Hosey

G. M.

Jensen

. . . Weiss

M. A.

(2012). National standards for diabetes self-management education. Diabetes Care, 35, S101-S108.

Garcia

A. A.

(2008). Clinical and life quality differences between Mexican American diabetic patients at a free clinic and a hospital-affiliated clinic in Texas. Public Health Nursing, 25, 149-158.

10.

Heisler

Piette

J. D.

Spencer

Kieffer

Vijan

(2005). The relationship between knowledge of recent HbA1c values and diabetes care understanding and self management. Diabetes Care, 28, 816-822.

11.

Ishikawa

Takeuchi

Yano

(2008). Measuring functional, communicative, and critical health literacy among diabetic patients. Diabetes Care, 31, 874-879.

12.

Jones

P. S.

Lee

J. W.

Phillips

L. R.

Zhang

X. E.

Jaceldo

K. B.

(2001). An adaptation of Brislin’s translation model for cross-cultural research. Nursing Research, 50, 300-304.

13.

Kohler

A. D.

Lazarin

(2007). Hispanic education in the United States (Statistical Brief No. 8). Retrieved from http://www.nclr.org/images/uploads/publications/file_SB8_HispEd_fnl.pdf

14.

Livingston

Minushkin

Cohn

(2008). Hispanics and health care in the United States: Access, information, and knowledge (A Joint Pew Hispanic Center and Robert Wood Johnson report). Retrieved from www.pewhispanic.org/files/reports/91.pdf

15.

Lynn

M. R.

(1986). Determination and quantification of content validity. Nursing Research, 35, 382-385.

16.

Marín

B. V.

(1991). Research with Hispanic populations. Newbury Park, CA: Sage.

17.

Persell

S. D.

Keating

N. L.

Landrum

M. B.

Landon

B. E.

Ayanian

J. Z.

Borbas

Guadagnoli

(2004). Relationship of diabetes-specific knowledge to self-management activities, ambulatory preventive care, and metabolic outcomes. Preventive Medicine, 39, 746-752.

18.

Powell

C. K.

Hill

E. G.

Clancy

D. E.

(2007). The relationship between health literacy and diabetes knowledge and readiness to take actions. Diabetes Educator, 33, 144-151.

19.

Rothman

R. L.

DeWalt

D. A.

Malone

Bryant

Shintani

Crigler

. . . Pignone

(2004). Influence of patient literacy on the effectiveness of a primary care-based diabetes disease management program. Journal of the American Medical Association, 292, 1711-1716.

20.

Rothman

R. L.

Malone

Bryant

Wolfe

Padgett

DeWalt

D. A.

. . . Pignone

(2005). Spoken Knowledge in Low Literacy in Diabetes Scale: A diabetes knowledge scale for vulnerable patients. Diabetes Educator, 31, 215-224.

21.

Schillinger

Barton

Karter

A. J.

Wang

Adler

(2006). Does literacy mediate the relationship between education and health outcomes? A study of a low-income population with diabetes. Public Health Reports, 121, 245-254.

22.

Schillinger

Grumbach

Piette

Wang

Osmond

Daher

. . . Bindman

A. B.

(2002). Association of health literacy with diabetes outcomes. Journal of the American Medical Association, 288, 475-482.

23.

Streiner

D. L.

Norman

G. R.

(2008). Health measurement scales: A practical guide to their development and use. Oxford, England: Oxford University Press.

24.

U.S. Department of Health and Human Services. (2008). America’s health literacy: Why we need accessible health information. Washington, DC: Author. Retrieved from http://www.health.gov/communication/literacy/issuebrief/

25.

U.S. Department of Health and Human Services, & National Diabetes Information Clearinghouse. (2011). National diabetes statistics, 2011. Retrieved from http://diabetes.niddk.nih.gov/dm/pubs/statistics/