Validation of a diabetes numeracy test in Arabic

BACKGROUND: The prevalence of diabetes Mellitus in Saudi Arabia is 24%, ranking it among the top ten Worldwide. Diabetes education focuses on self-management and relies on numeracy skills. Poor numeracy may go unrecognized and it is important to have an assessment tool in Arabic to measure such a skill in diabetes care. OBJECTIVES: To validate a 15-item Diabetes Numeracy Test (DNT-15) in the Arabic Language as a tool to assess the numeracy skills of patients with diabetes and to test its properties among Saudi patients with diabetes. METHODS: A 15-question Arabic-language test to assess diabetes numeracy among patients with diabetes on the basis of the diabetes numeracy test (DNT-15) was validated among a sample Arabic speaking Saudi patients with diabetes. Data collection included patients’ demographics, long-term glycemic control, diabetes type, duration, co-morbidities, and diabetes related knowledge questions. Internal reliability was assessed using Kuder-Richardson Formula 20 (KR-20). RESULTS: The average score of Arabic DNT-15 was 53.3% and took an average of 30 minutes to complete. The scores significantly correlated with education, income, HbA1c, and diabetes knowledge (p<0.05). Content Validity Ratio (CVR) of 0.75 and Content Validity Index (CVI) of 0.89 supported good content validity. The Arabic DNT-15 also had good internal reliability (KR20 = 0.90). CONCLUSION: Patients with diabetes need numeracy skills to manage their disease. Level of education does not reflect level of numeracy, and low numeracy skills might be unnoticed by health care providers. The Arabic DNT-15 is a valid and reliable scale to identify Arabic speaking patients with difficulties in certain diabetes-related numeracy skills.