Evaluation of a diabetes knowledge and behaviour (DKB) questionnaire

The primary prevention of type 2 (non-insulin-dependent) diabetes is now considered possible through adopting lifestyle changes. Population strategies for preventing diabetes are now being developed. The South Auckland Diabetes Project has developed a questionnaire to assess the impact of a diabetes awareness, exercise/healthy eating programme in the local communities. The questionnaire was evaluated among local adult Europeans (n=127), Maori (n=103) and Pacific Islands people (n =167). The questionnaire is interviewer-directed and takes approximately 30 min to administer. Diabetes knowledge was assessed using four open questions and 31 closed true/false questions which had good reliability (Cronbach's a range: 0.59-0.90), reproducibility (Pearson's r range: 0.39-0.74) and external validity (r range: 0.28-0.56) among all ethnic groups. Median scores increased by 7-13% on re-testing. The open and closed question scores were 7-13% and l0-26% higher respectively among those with diabetes or a family history of diabetes (n = 78). Important dietary habits were assessed using four tools: (1) a seven-item food preparation/fat content 'fat index'; (2) a four-item high-fat/high-refined-carbohydrate score had good reliability (Cronbach's α 0.51-0.74), reproducibility (r = 0.37-0.70) and external validity when compared with a dietetic assessment (total fat r = 0.44-0.90); (3) a 12-item food frequency questionnaire based on standard portion sizes also shared good reproducibility (Pearson's r = 0.45-0.52) and correlated well with the dietetic assessment of total calories (r = 0.48 0.64) and of calories due to fat (r = 0.41-0.65), and (4) a simple question related to the frequency of fruit consumption correlated negatively with the fat index in Europeans (r = 0.25, P<0.05) and Maori (r = -0.33, P<0.01). While the questionnaire does not give a quantitative assessment of nutritional habits, it does offer a speedy tool for evaluating population-based lifestyle and diabetes awareness interventions directed at the prevention and control of type 2 (non-insulin-dependent) diabetes.