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Development and validation of the Diabetes Numeracy Test (DNT)
Mary Margaret Huizinga1, Tom A Elasy, Kenneth A Wallston
1Division of General Internal Medicine and Public Health, Department of Medicine, Center for Health Services Research, Vanderbilt University Medical Center, Nashville, USA. mary.margaret.huizinga@vanderbilt.edu
BMC Health Services Research
|May 3, 2008
Summary
The Diabetes Numeracy Test (DNT) reliably measures essential numeracy skills for diabetes management. A shorter version, the DNT15, offers a time-efficient alternative for research and clinical use.
Area of Science:
- Health Sciences
- Medical Education
- Psychometrics
Background:
- Low literacy and numeracy skills are prevalent, impacting self-management of chronic conditions.
- Adequate numeracy is vital for diabetes patients to interpret data, manage medications, and adhere to dietary plans.
- Existing literacy scales may not adequately assess the specific numeracy demands of diabetes care.
Purpose of the Study:
- To develop and validate the Diabetes Numeracy Test (DNT), a novel scale assessing numeracy skills specific to diabetes self-management.
- To evaluate the psychometric properties, including reliability and validity, of the DNT.
- To create and validate a shortened, time-efficient version (DNT15) for practical application.
Main Methods:
- Expert panel development and cognitive interviews informed DNT item creation.
- A 43-item DNT and related measures were administered to 398 diabetes patients.
- Internal reliability (KR-20) and construct validity (correlations with education, income, literacy, math, and diabetes knowledge) were assessed.
Main Results:
- The DNT demonstrated excellent internal reliability (KR-20 = 0.95) and strong construct validity.
- Patients scored an average of 61% on the DNT, with completion time averaging 33 minutes.
- The DNT15 showed good internal reliability (KR-20 = 0.90/0.89) and high correlation with the full DNT (rho = 0.96/0.97).
Conclusions:
- The DNT is a reliable and valid instrument for assessing diabetes-related numeracy skills.
- The DNT15 provides an equally adequate yet more time-efficient option for evaluating numeracy in diabetes care.
- Both DNT versions are suitable for research and clinical settings to identify needs and guide interventions.
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