Validation of a diabetes numeracy test in Arabic

Abstract

BackgroundThe prevalence of diabetes Mellitus in Saudi Arabia is 24%, ranking it among the top ten Worldwide. Diabetes education focuses on self-management and relies on numeracy skills. Poor numeracy may go unrecognized and it is important to have an assessment tool in Arabic to measure such a skill in diabetes care.ObjectivesTo validate a 15-item Diabetes Numeracy Test (DNT-15) in the Arabic Language as a tool to assess the numeracy skills of patients with diabetes and to test its properties among Saudi patients with diabetes.MethodsA 15-question Arabic-language test to assess diabetes numeracy among patients with diabetes on the basis of the diabetes numeracy test (DNT-15) was validated among a sample Arabic speaking Saudi patients with diabetes. Data collection included patients’ demographics, long-term glycemic control, diabetes type, duration, co-morbidities, and diabetes related knowledge questions. Internal reliability was assessed using Kuder-Richardson Formula 20 (KR-20).ResultsThe average score of Arabic DNT-15 was 53.3% and took an average of 30 minutes to complete. The scores significantly correlated with education, income, HbA1c, and diabetes knowledge (p<0.05). Content Validity Ratio (CVR) of 0.75 and Content Validity Index (CVI) of 0.89 supported good content validity. The Arabic DNT-15 also had good internal reliability (KR20 = 0.90).ConclusionPatients with diabetes need numeracy skills to manage their disease. Level of education does not reflect level of numeracy, and low numeracy skills might be unnoticed by health care providers. The Arabic DNT-15 is a valid and reliable scale to identify Arabic speaking patients with difficulties in certain diabetes-related numeracy skills.

Building a House of Skills—A Study of Functional Health Literacy and Numeracy among Patients with Type 2 Diabetes in Hungary

“…Based on the results, the higher scores on the DNT-15 test showed no statistically significant association with the duration of diabetes. This finding is consistent with the observations of previous studies [45,47]. However, it is possible that the diabetes-specific numeracy skills do not show an explicit connection with the time of diabetes diagnosis, since such skills may be more related to an individual's self-efficacy and self-management behavior [62].…”

“…The number of clinical studies on general HL and numeracy is growing; there are much fewer still (especially in Europe) focusing on patients with specific chronic diseases such as those diagnosed with T2DM and prescribed different insulin regimes. The research by Alghodaier et al (2017) clearly states that the influence of numeracy on the health of patients with diabetes has been investigated in a small number of studies [45]. Based on one meta-analysis it is recommended to invest the assessment of diabetes numeracy to produce more evidence on the relationship with different diabetes outcomes, including self-care activities [11].…”

A New Objective Health Numeracy Test for Patients with Type 2 Diabetes: Development and Evaluation of Psychometric Properties

“…Convergent validity is tested based on the association between a focal measure (the DHNT in this study) and a comparator instrument with which conceptual convergence is expected [40]. As expected, the DHNT exhibited a moderate correlation with diabetes knowledge in the present study, which is consistent with the findings of previous studies [4,41]. The presence of criterion validity implies that a focal measure is consistent with a criterion measuring the same construct [40].…”

The association between diabetes numeracy and diabetes self-management among Saudi adults with insulin-treated diabetes

“…46 Furthermore, patients of our study had a lower mean diabetes numeracy score (41.3%) in comparison to other studied patients. 13,34,37 Saudi patients of another study had a relatively higher mean diabetes numeracy score (53.3%). 34 Also, another study demonstrated that 60% of patients on insulin pump therapy scored 90% and higher on DNT-15 test.…”

“…13,34,37 Saudi patients of another study had a relatively higher mean diabetes numeracy score (53.3%). 34 Also, another study demonstrated that 60% of patients on insulin pump therapy scored 90% and higher on DNT-15 test. 37 Additionally, the patients in our study were found to perform best at addition and subtraction, and worst at multistep mathematics.…”