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A Validation Study of the Spoken Knowledge in Low Literacy in Diabetes Scale (SKILLD)

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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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Acknowledgements

The authors would like to thank Mark Stevens, Charlie Pizanis, Stephen Wilkes, Scott Gspandl, Laura Holzer, Patrick Ellsworth, Joan Allen, and the very helpful staff at The Ohio State University Rardin Family Practice Center.

This research was funded by The Ohio State University Crisafi -Monte Primary Care Cardiopulmonary Endowment, and by grant T32RR023260 from the National Center for Research Resources (NCRR), a component of the National Institutes of Health (NIH).

Conflict of Interest

KMJ, BPH, and MR report no conflicts of interest. WFM has received research funding from Abbott Laboratories, Centocor Ortho Biotech, Inc., Bristol-Myers Squibb, Daiichi Sankyo Co., LTD, Eli Lilly and Company, Forest Research Institute, GlaxoSmithKline, Merck & Co., Inc., Novartis, Novo Nordisk, Pfizer Inc., Sanofi Pasteur, and Wyeth-Ayerst.

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Authors and Affiliations

  1. Department of Family Medicine, McKay-Dee Hospital Center, 4401 Harrison Blvd, Ogden, UT, 84403, USA

    Kelly Marvin Jeppesen MD, MPH

  2. Department of Family Medicine, The Ohio State University College of Medicine, Columbus, OH, USA

    Benjamin P. Hull BS, Matthew Raines BS & William F. Miser MD, MA

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  1. Kelly Marvin Jeppesen MD, MPH
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  2. Benjamin P. Hull BS
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  3. Matthew Raines BS
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  4. William F. Miser MD, MA
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Corresponding author

Correspondence to Kelly Marvin Jeppesen MD, MPH.

Appendix

Appendix

Table 3 shows Fliess Kappa statistics for each item and the total score.

Table 3 Fleiss Kappa Statistics for Each Item and Total Score
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Jeppesen, K.M., Hull, B.P., Raines, M. et al. A Validation Study of the Spoken Knowledge in Low Literacy in Diabetes Scale (SKILLD). J GEN INTERN MED 27, 207–212 (2012). https://doi.org/10.1007/s11606-011-1900-9

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  • DOI: https://doi.org/10.1007/s11606-011-1900-9

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