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J Gen Intern Med. 2012 Feb;27(2):207-12. doi: 10.1007/s11606-011-1900-9. Epub 2011 Oct 18.

A validation study of the spoken knowledge in low literacy in diabetes scale (SKILLD).

Author information

1
Department of Family Medicine, McKay-Dee Hospital Center, 4401 Harrison Blvd, Ogden, UT 84403, USA. kelly.jeppesen@imail.org

Abstract

BACKGROUND:

In 2005 the Spoken Knowledge in Low Literacy in Diabetes scale (SKILLD) was introduced as a diabetes knowledge test. The SKILLD has not been validated since its introduction.

OBJECTIVE:

To perform a validation analysis on the SKILLD.

DESIGN AND PARTICIPANTS:

Cross-sectional observational study of 240 patients with diabetes at an academic family practice center.

MAIN MEASURES:

SKILLD's correlation with an oral form of the Diabetes Knowledge Test (DKT) was used to assess criterion validity. A regression model tested construct validity, hypothesizing that SKILLD score was independently related to health literacy and education level. Content validity was tested using Cronbach's Alpha for inter-item relatedness and by comparing SKILLD items with the content of a National Institutes of Health (NIH) diabetes education website. We assessed inter-rater reliability and bias using Spearman correlation coefficients and sign-rank tests between interviewers scoring the same interview.

KEY RESULTS:

The SKILLD demonstrated fair correlation with the DKT (Pearson's coefficient 0.54, 95% CI=0.49 to 0.66, p<0.001). Health literacy, education level, male gender, household income, and years with diabetes were independent predictors of SKILLD score in the regression model. Cronbach's Alpha for inter-item relatedness was 0.54. There were some topics on the NIH website not addressed by the SKILLD. The inter-rater correlation coefficient was 0.79 (95% CI 0.56 to 0.91, p<0.001).

CONCLUSIONS:

The SKILLD is an adequate diabetes knowledge test and is appropriate for people of all literacy levels. However, it should be expanded to more completely evaluate diabetes knowledge.

PMID:
22005940
PMCID:
PMC3270246
DOI:
10.1007/s11606-011-1900-9
[Indexed for MEDLINE]
Free PMC Article
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