Type 2 Diabetes Health Literacy Assessment Tool: Translation and Psychometric Evaluation of the Iranian Version

Adequate health literacy can lead to self-care behaviors among patients with type 2 diabetes (T2D). Although there is an instrument for measuring the health literacy of patients with diabetes, there is no Persian version of the instrument in Iran.

The aim of this study was to translate the Chinese Health Literacy Scale for Diabetes (CHLSD) and evaluate the psychometric parameters of the Iranian version.

In this methodological study, using a standard forward-backward translation procedure, the original English language version of the questionnaire was translated into Persian. Face and content validity steps were performed for psychometric measurements. To perform construct (convergent) validity, a cross-sectional study was carried out with the participation of T2D patients admitted to the diabetes clinic (aged over 25 years old). To test the reliability, internal consistency was assessed by Kuder-Richardson (K-R) coefficient, and a test-retest was performed by Spearman correlation coefficient.

A total of 283 patients with T2D (mean age: 52.4 years and standard deviation: 11.5) were included in the study. The factor loadings of the variables were checked by calculating the correlation value of the characteristics of a construct with that construct, whose value was greater than 0.4. The K-R coefficients for the whole instrument and its four subscales (remembering, application, analysis, and comprehension) were 0.8, 0.71, 0.73, 0.87, and 0.89, respectively. Re-testing of the instrument with an interval of two weeks indicated the acceptable stability of the instrument (ICC ≥ 0.8).

Our findings showed that the Iranian version of CHLSD is a valid and reliable instrument for measuring the health literacy in patients with diabetes.