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.

Reliability and Validity of the Spoken Knowledge in Low Literacy in Diabetes in Measuring Diabetes Knowledge Among Hispanics With Type 2 Diabetes

“…Many participants in this study instead reported the signs and symptoms of hypoglycemia, unrelated symptoms, or stated "I don't know." This finding was similar to that reported in other studies with Hispanics in the US, 15,22 mixed racial and ethnic groups in the US, 18 and Brazilians. 21 Misinterpreting the signs and symptoms of hypoglycemia versus hyperglycemia may potentially cause harm because the treatment options are significantly different.…”

“…The finding is consistent with the NHANES study that Mexican Americans had the lowest knowledge of A1C, blood pressure, and LDL cholesterol. 14 Garcia et al 22 and Peña-Purcell and Boggess 15 similarly found that Hispanics with diabetes had low knowledge of A1C levels, although higher than this current study. The latter study reported high levels of knowledge related to fasting blood glucose.…”

“…The scale had been validated and deemed appropriate to assess diabetes knowledge across populations of diverse literacy levels among African Americans and whites 18,19 and patients with low literacy in other countries. 20,21 Although two studies 15,22 used the SKILLD to assess diabetes knowledge among Mexican-Americans living along the US-Mexico border region and Hispanics in Texas who have diabetes, there is limited evidence in reliability and validity 22 and no report of assessment of psychometric properties of the SKILLD. 23 Internal consistency and construct validity measured with factor analysis have not been fully established.…”

“…Low SKILLD scores are those ≤50%, and high scores are those >50%. 17 Validity and reliability and application of the SKILLD have been documented with Hispanics with T2DM 22,23 ; however, findings of internal consistency have not been established, nor has construct validity with factor analysis been examined.…”

Assessment of diabetic patients' adherence to insulin injections on basal-bolus regimen in diabetic care center in Saudi Arabia 2018: Cross sectional survey

“…[28] As previous investigations have reported poor glycaemic control among diabetic patients, it is necessary that physicians pay greater attention to illiterate patients and bring to bear more patience in their education with a view to attaining favourable treatment results. [30]…”