OBJECTIVETo develop The Diabetes Self-management Knowledge, Attitude, and Behavior Scale (DSKAB) with Chinese population social culture character in a good validity and reliability after Delphi method and pilot study.

METHODSThis study based on former knowledge, attitude, and behavior questionnaires, an index list was established through literature search, group discussion, and expert in-depth interviews. Then we identified the core indexes and developed a primary scale through the Delphi. We selected 24 experts who specialized in the field of diabetes related clinical medicine, non-communicable diseases self-management, non-communicable diseases control and prevention, and public health. The consultation tables were delivered by EMS and Email. All the experts were asked to grade the evaluation indexes based on overall consideration finality, scientificity, importance, applicability, and to explain the extent of similarity and the basis of judgment. The core indexes of the scale were determined through the positive coefficient, the degree of concentration, the harmonious coefficient, the authoritative coefficient. We selected 27 diabetes patients from the community, and interviewed them face to face. After finishing the field survey, we organized the staff who investigated the patients to participate the panel discussion, to modify and adjust the items formed the scale knowledge attitude behavior of self-management for patients with diabetes mellitus.

RESULTSTwo rounds of Delphi both reclaimed 20 experts(') responses, the positive coefficients were 83% and 100% respectively, the authoritative coefficients were 0.85 ± 0.10 and 0.87 ± 0.09, the harmonious coefficients were 0.16 and 0.23 (χ(2) were 283.49 and 398.00, P<0.001) respectively. We identified 75 core indexes through two-round Delphi, 86.30% (63/75) indexes had the importance of full marks than in 0.50 above, it developed the primary scale which included 100 items. Based on the pilot study, we increased 2 items, deleted 4 items, recomposed 2 items and reserved 96 items, the scale consisted of 98 items that were made of three subscales which were the knowledge subscale, the attitude subscale and the behavior subscale.

CONCLUSIONFor DSKAB through Delphi method and pilot study, the active coefficients, the authoritative coefficients, the harmonious coefficients fulfilled the scientific requires, it also laid the foundation for the good performance of the scale.

Delphi Technique ; Diabetes Mellitus ; therapy ; Health Knowledge, Attitudes, Practice ; Humans ; Pilot Projects ; Reproducibility of Results ; Self Care

OBJECTIVETo evaluate the validity and reliability of Diabetes Self-management Knowledge, Attitude, and Behavior Assessment Scale (DSKAB).

METHODSWe selected 460 patients with diabetes in the community, used the scale which was after two rounds of the Delphi method and pilot study. Investigators surveyed the patients by the way of face to face. by draw lots, we selected 25 community diabetes randomly for repeating investigations after one week. The validity analyses included face validity, content validity, construct validity and discriminant validity. The reliability analyses included Cronbach's α coefficient, θ coefficient, Ω coefficient, split-half reliability and test-retest reliability.

RESULTSThis study distributed a total of 460 questionnaires, reclaimed 442, qualified 432. The score of the scale was 254.59 ± 28.90, the scores of the knowledge, attitude, behavior sub-scales were 82.44 ± 11.24, 63.53 ± 5.77 and 108.61 ± 17.55, respectively. It had excellent face validity and content validity. The correlation coefficient was from 0.71 to 0.91 among three sub-scales and the scale, P<0.001. The common factor cumulative variance contribution rate of the scale and three sub-scales was from 57.28% to 67.19%, which achieved more than 50% of the approved standard, there was 25 common factors, 91 items of the total 98 items held factor loading ≥0.40 in its relevant common factor, it had good construct validity. The scores of high group and low group in three sub-scales were: knowledge (91.12 ± 3.62) and (69.96 ± 11.20), attitude (68.75 ± 4.51) and (58.79 ± 4.87), behavior (129.38 ± 8.53) and (89.65 ± 11.34),mean scores of three sub-scales were apparently different, which compared between high score group and low score group, the t value were - 19.45, -16.24 and -30.29, respectively, P<0.001, and it had good discriminant validity. The Cronbach's α coefficient of the scale and three sub-scales was from 0.79 to 0.93, the θ coefficient was from 0.86 to 0.95, the Ω coefficient was from 0.90 to 0.98, split-half reliability was from 0.89 to 0.95.Test-retest reliability of the scale was 0.51;the three sub-scales was from 0.46 to 0.52, P<0.05.

CONCLUSIONThe validity and reliability of the Diabetes Self-management Knowledge, Attitude, and Behavior Assessment Scale are excellent, which is a suitable instrument to evaluate the self-management for patients with diabetes.

Diabetes Mellitus ; therapy ; Health Knowledge, Attitudes, Practice ; Humans ; Pilot Projects ; Reproducibility of Results ; Self Care ; Surveys and Questionnaires

OBJECTIVETo develop a brief version scale with good validity and reliability to evaluate self-management knowledge, attitude and behavior (KAB) of diabetes patients in a shorter time.

METHODS20 authority experts who specialized in the field of diabetes clinical and non-communicable disease self-management, and familiar with the relevant content of diabetes self-management were selected. Face to face and Email consultation methods were applied in two rounds delphi expert consultations to choose items from the Diabetes Self-management Knowledge, Attitude, and Behavior Assessment Scale (DSKAB, total scale, 98 items). In the first round of expert consultation, experts were asked to select the core items from every dimension and score the extent of familiarity and basis of judgment. In the second round of expert consultation, the significance of the core items which were selected by experts in first round, were graded. The items which entered into the brief scale were determined by harmonious condition of expert opinions.

RESULTSTwo rounds of consultation reclaimed 16 and 15 responses respectively, Positive coefficients of experts were 80% and 94% respectively, and both authoritative coefficients were 0.90. In the first round of consultation, experts selected 44.3 ± 6.2 items on average, 42 items were selected according to the integrity of the scale for measuring dimension and content at last. In the second round of consultation, experts thought that the 42 items could measure the important contents of each dimension comprehensive and representative, the item importance scores of knowledge, attitude, and behavior subscale were 8.42 ± 1.17, 8.61 ± 1.24, 8.61 ± 1.02 respectively, and the coordination coefficients of the three subscale were 0.36, 0.20, 0.49 (χ(2) were 89.74, 11.13, 96.03, P<0.05). The total coordination coefficient was 0.38 (χ(2) =199.36, P<0.001), which indicated the concentration of experts(')opinion was acceptable, showed the brief scale with good face validity and content validity.

CONCLUSIONThe brief scale could evaluate Diabetes Self-management KAB Scale rapidly and relatively comprehensive in groups or individuals diabetes with good face validity and content validity.

Diabetes Mellitus ; therapy ; Health Knowledge, Attitudes, Practice ; Humans ; Reproducibility of Results ; Self Care ; Surveys and Questionnaires

Objective: This epidemiology survey is intended to assess the periodontal health conditions of 12 to 15-year-old adolescents and the associated factors in Shenzhen. Methods: The study utilized a multistage stratified cluster method and recruited 5 509 middle school students aged 12 to 15. Gingival bleeding and calculus were conducted and a self-reported questionnaire was administered. Additional periodontal pocket depth and attachment loss examination were performed in the 15-year-age group. Periodontal conditions and the associated factors were analyzed by t-test, Chi-square method and Logistic regression. Results: The prevalence of gingival bleeding and calculus among adolescents was 43.95% and 44.25%, and the prevalence of periodontal pockets ≤3 mm was 0.57%. No periodontal pockets ≥6 mm or attachment loss ≥4 mm were detected. Gender, family income and frequency of teeth brushing were significantly associated with calculus detection (P＜0.05). The use of fluoride had an significant effect on gingival bleeding detection and calculus detection (χ 2=9.70，6.16，P＜0.05). Conclusion The periodontal health condition among 12-15 years old adolescents in Shenzhen is generally better than the national level. Adolescents living in high-economic districts and females had better periodontal health condition. The government can promote health education in schools and popularize the use of fluoride to improve the periodontal health condition among adolescents.

Objective To evaluate the validity, reliability, and acceptability of the brief version of the self-management knowledge, attitude, and behavior (KAB) assessment scale for diabetes patients. Methods Diabetes patients who were managed at the Xinkaipu Community Health Service Center of Tianxin in Changsha, Hunan Province were selected for survey by cluster sampling. A total of 350 diabetes patients were surveyed using the brief scale to collect data on knowledge, attitudes, and behaviors of self-management. Content validity was evaluated by Pearson correlation coefficient between the brief scale and subscales of knowledge, attitude, and behavior. Structure validity was evaluated by factor analysis, and discrimination validity was evaluated by an independent sample t-test between the high-score and low-score groups. Reliability was tested by internal consistency reliability and split-half reliability. The evaluation indexes of internal consistency reliability were Cronbach's α coefficients, θ coefficient, and Ω coefficient. Acceptability was evaluated by valid response rate and completion time of the brief scale. Results A total of 346(98.9%) valid questionnaires were returned, with average survey time of (11.43±3.4) minutes. Average score of the brief scale was 78.85 ± 11.22; scores of the knowledge, attitude, and behavior subscales were 16.45 ± 4.42, 21.33 ± 2.03, and 41.07 ± 8.34, respectively. Pearson correlation coefficients between the brief scale and the knowledge, attitude, and behavior subscales were 0.92, 0.42, and 0.60, respectively;P-values were all less than 0.01, indicating that the face validity and content validity of the brief scale were achieved to a good level. The common factor cumulative variance contribution rate of the brief scale and three subscales was from 53.66%to 61.75%, which achieved more than 50%of the approved standard. There were 11 common factors;41 of the total 42 items had factor loadings above 0.40 in their relevant common factor, indicating that the brief scale and three subscales had good construct validity. Patients were divided into a high-score group and a low-score group, then scores of the brief scale and three subscales were compared between the groups using a t-test. The results were all significant, indicating that the brief scale and three subscales had good discriminate validity. Mean scores of the brief scale and three subscales of the high-score group were 91.55±6.81, 19.51±2.17, 22.74±1.88, and 49.30±6.20, respectively;these were higher than the low-score group (65.89 ± 5.79, 12.29 ± 4.76, 20.22 ± 1.88, and 33.39 ± 6.17, respectively) with t-values 27.76, 13.31, 9.20, and 17.56 (P-values were less than 0.001). The Cronbach's α coefficient, θ coefficient,Ω coefficient, and split-half reliability of the brief scale were 0.83, 0.87, 0.96, and 0.84, respectively. These values for the three subscales were all above 0.70, except for theθcoefficient of the attitude subscale with 0.64, indicating that the brief scale and three subscales had acceptable internal consistency reliability. Conclusion The brief version of the diabetes self-management knowledge, attitude, and behavior assessment scale showed good acceptability, validity, and reliability, to responsibly evaluate self-management KAB among patients with diabetes.

Objective To evaluate the validity, reliability, and acceptability of the brief version of the self-management knowledge, attitude, and behavior (KAB) assessment scale for diabetes patients. Methods Diabetes patients who were managed at the Xinkaipu Community Health Service Center of Tianxin in Changsha, Hunan Province were selected for survey by cluster sampling. A total of 350 diabetes patients were surveyed using the brief scale to collect data on knowledge, attitudes, and behaviors of self-management. Content validity was evaluated by Pearson correlation coefficient between the brief scale and subscales of knowledge, attitude, and behavior. Structure validity was evaluated by factor analysis, and discrimination validity was evaluated by an independent sample t-test between the high-score and low-score groups. Reliability was tested by internal consistency reliability and split-half reliability. The evaluation indexes of internal consistency reliability were Cronbach's α coefficients, θ coefficient, and Ω coefficient. Acceptability was evaluated by valid response rate and completion time of the brief scale. Results A total of 346(98.9%) valid questionnaires were returned, with average survey time of (11.43±3.4) minutes. Average score of the brief scale was 78.85 ± 11.22; scores of the knowledge, attitude, and behavior subscales were 16.45 ± 4.42, 21.33 ± 2.03, and 41.07 ± 8.34, respectively. Pearson correlation coefficients between the brief scale and the knowledge, attitude, and behavior subscales were 0.92, 0.42, and 0.60, respectively;P-values were all less than 0.01, indicating that the face validity and content validity of the brief scale were achieved to a good level. The common factor cumulative variance contribution rate of the brief scale and three subscales was from 53.66%to 61.75%, which achieved more than 50%of the approved standard. There were 11 common factors;41 of the total 42 items had factor loadings above 0.40 in their relevant common factor, indicating that the brief scale and three subscales had good construct validity. Patients were divided into a high-score group and a low-score group, then scores of the brief scale and three subscales were compared between the groups using a t-test. The results were all significant, indicating that the brief scale and three subscales had good discriminate validity. Mean scores of the brief scale and three subscales of the high-score group were 91.55±6.81, 19.51±2.17, 22.74±1.88, and 49.30±6.20, respectively;these were higher than the low-score group (65.89 ± 5.79, 12.29 ± 4.76, 20.22 ± 1.88, and 33.39 ± 6.17, respectively) with t-values 27.76, 13.31, 9.20, and 17.56 (P-values were less than 0.001). The Cronbach's α coefficient, θ coefficient,Ω coefficient, and split-half reliability of the brief scale were 0.83, 0.87, 0.96, and 0.84, respectively. These values for the three subscales were all above 0.70, except for theθcoefficient of the attitude subscale with 0.64, indicating that the brief scale and three subscales had acceptable internal consistency reliability. Conclusion The brief version of the diabetes self-management knowledge, attitude, and behavior assessment scale showed good acceptability, validity, and reliability, to responsibly evaluate self-management KAB among patients with diabetes.