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Comparative Study
. 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)

Kelly Marvin Jeppesen  1 , Benjamin P Hull, Matthew Raines, William F Miser
Affiliations
Comparative Study

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

Kelly Marvin Jeppesen et al. J Gen Intern Med. 2012 Feb.

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.

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Figures

Figure 1
Figure 1
Construct of Diabetes Knowledge as it relates to Health Literacy, Education, and Behavior.
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