Limited surveys are available to assess diabetes prevention programs for young adolescents.
The objective of this study was to develop and validate a survey to assess diabetes knowledge, attitudes, and beliefs in middle school students.
Study Design, Setting, Participants
A 40-item survey was developed and validated in a convenience sample of middle school students in Utah. A panel of experts (n = 6) consisting of dietitians, diabetes educators, and 1 health teacher rated survey items using the Survey Validation Rubric for Expert Panel (VREP) approach. The instrument's Content Validity Index (CVI) was calculated. After pre-testing (n = 245) and pilot testing (n = 61), questionnaire items were excluded based on the correct response rate, Cronbach α, and item-to-total correlation. The resulting 25-item questionnaire was completed by 277 Middle School students (mean age of 13.2 ± 0.4 years).
Exploratory Factor Analysis (EFA) was used to identify potential factors within the survey, and subsequent calculation of Cronbach's alpha was used to determine the internal consistency of the potential factors. The Kaiser-Meyer-Olkin (KMO) test and scree plot analysis were performed to measure sample adequacy and to verify the number of extracted factors, respectively.
Based on the expert's responses, the overall Content Validity Index (CVI) for the survey items was 0.95. The Cronbach's α coefficients were 0.7 for the knowledge and 0.72 for the attitudes and beliefs subscales, which demonstrated good internal consistency for both subscales. The sample was adequate (KMO > 0.7), and the data were suitable for factor analysis (Bartlett's test of Sphericity χ2 = 532.94, P < .001). All factor loadings were above 0.4, revealing close relations between factors and items.
This survey demonstrates satisfactory internal consistency, construct validity, test-retest reliability, and factor structure. Results suggest nutrition educators can use this instrument to assess knowledge, attitudes, and beliefs in middle school students.