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Development and psychometric evaluation of the type 2 diabetes nutrition therapy adherence scale
Taha Gökmen Ülger1, Elif Gençer Şendur2, Murat Açik3
1Health Sciences Faculty, Department of Nutrition and Dietetics, Bolu Abant Izzet Baysal University, Gölköy Campus, Bolu 14030, Türkiye.
Aims:
Type 2 diabetes mellitus is a major global public health concern closely associated with unhealthy dietary patterns. Medical nutrition therapy plays a central role in its prevention and management; however, assessing adherence remains challenging. This study aimed to develop and psychometrically evaluate the Type 2 Diabetes Nutrition Therapy Adherence Scale (DNTA-S), a culturally appropriate instrument for assessing adherence to nutrition therapy among individuals with type 2 diabetes.
Methods:
This methodological and cross-sectional study was conducted with 420 adults diagnosed with type 2 diabetes. Content validity was assessed using the Davis technique based on expert evaluations. Construct validity was examined through exploratory and confirmatory factor analyses. Reliability was evaluated using Cronbach's alpha, split-half, and test-retest analyses.
Results:
The final 20-item scale consisted of four dimensions. The four-factor structure explained 61.29% of the total variance, with acceptable factor loadings. Confirmatory factor analysis supported the structure and demonstrated good model fit (RMSEA=0.060; CFI=0.943). The overall Cronbach's alpha was 0.915, and subdimension reliability coefficients were within acceptable ranges. Test-retest reliability indicated excellent stability (ICC=0.95).
Conclusions:
The DNTA-S is a valid and reliable multidimensional instrument that captures key aspects of dietary adherence and may support both clinical practice and research.
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