General measure of perceived diabetes and dietary competence (PDDC) was developed to assess a person's sense of confidence and perceived behavioral control in diabetes and dietary self-management. Internal structure, reliability, and construct validity were evaluated.
METHODS
There were 2 samples of African American women with type 2 diabetes; 226 patients in the development sample and 225 patients in the validation sample. Factor analysis, Cronbach's coefficient alpha, and correlation analysis were used to assess reliability and validity of the PDDC measure.
RESULTS
Three subscales were empirically determined by factor analysis: positive competence, negative dietary competence, and negative control. Cronbach's alphas for all subscales were good. Predicted relationships with measures of perceived health competence, self-efficacy, social support, and perceived dietary barriers were largely supported in construct validation.
CONCLUSIONS
This study provides initial support for the internal reliability and validity of a perceived diabetes and dietary competence measure. Further research is needed to determine its validity in other samples of African Americans with type 2 diabetes and its clinical utility in evaluating diabetes self-management training.
Get full access to this article
View all access options for this article.
References
1.
1. Feuerstein BL, Weinstock RS. Diet and exercise in type 2 diabetes mellitus. Nutrition. 1997;13:95-99.
2.
2. Bell RA, Summerson JH, Konen JC. Dietary intakes by levels of glycemic control for black and white adults with non-insulin dependent diabetes mellitus (NIDDM). J Am Coll Nutr. 1995;14:144-151.
3.
3. Fitzgerald JT, Anderson RM, Funnell MM, et al. Differences in the impact of dietary restrictions of African Americans and Caucasians with NIDDM. Diabetes Educ. 1997;23:41-47.
4.
4. Weatherspoon W, Kumanyika SK, Ludlow R, Schatz D.Glycemic control in a sample of black and white clinic patients with NIDDM. Diabetes Care. 1994;17: 1148-1153.
5.
5. Harris ML, Flegal KM, Cowie CC, et al. Prevalence of diabetes, impaired fasting glucose, and impaired glucose tolerance in U.S. adults. Diabetes Care. 1998;21:518-524.
6.
6. Keyserling TA, Ammerman AS, Samuel-Hodge, CD, et al. A diabetes management program for African American women with type 2 diabetes. Diabetes Educ. 2000;26:796-805.
7.
7. Wing RR, Anglin K.Effectiveness of a behavioral weight control program for blacks and whites with NIDDM. Diabetes Care. 1996;19:409-413.
8.
8. Carter JS, Pugh JA, Monterrosa A.Non-insulin-dependent diabetes mellitus in minorities in the United States. Ann Intern Med.1996;125: 221-232.
9.
9. UK Prospective Diabetes Study (UKPDS) Group. Effect of intensive blood-glucose control with metformin on complications in overweight patients with type 2 diabetes (UKPDS 34). Lancet. 1998;352:854-865.
10.
10. Sussman JL, Helseth LD. Reducing the complications of type 2 diabetes: a patient-centered approach. Am Fam Physician. 1997;56:471-478.
11.
11. Blaum CS, Velez L, Hiss RG, Halter JB. Characteristics related to poor glycemic control in NIDDM patients in community practice. Diabetes Care. 1997;20:7-11.
12.
12. Glasgow RE, Osteen VL. Evaluating diabetes education: are we measuring the most important outcomes?Diabetes Care. 1992;15:1423-1432.
13.
13. Fitzgerald JT, Davis WK, Connell CM, Hess GE, Funnell MM, Hiss RG. Development and validation of the Diabetes Care Profile. Eval Health Profile. 1996;19:208-230.
14.
14. Anderson RM, Funnell M, Fitzgerald J, Marrero DG. The Diabetes Empowerment Scale: a measure of psychosocial self-efficacy. Diabetes Care. 2000;23:739-743.
15.
15. Grossman HY, Brink S, Hauser S.Self-efficacy in adolescent girls and boys with insulin dependent diabetes mellitus. Diabetes Care. 1993;10:324-329.
16.
16. Skelly AS, Marshall JR, Haughley BP, Davis PJ, Dunford RG. Self-efficacy and confidence in outcomes as determinants of self-care practices in inner-city African-American women with non-insulin-dependent diabetes. Diabetes Educ. 1995;21:38-46.
17.
17. Bradley C, Brewin CR, Gamsu DS, Moses JL. Development of scales to measure perceived control of diabetes mellitus and diabetes-related health beliefs. Diabetic Med.1984;1:213-218.
18.
18. Ferraro LA, Price JH, Desmond SM, Roberts SM. Development of the Diabetes Locus of Control Scale. Psychol Rep.1987;61:763-770.
19.
19. Rubin RR, Peyrot M.Psychosocial problems and interventions in diabetes. Diabetes Care. 1992;15:1640-1657.
20.
20. Tillotson LM, Sheldon-Smith M.Locus of control, social support, and adherence to the diabetes regimen. Diabetes Educ. 1996;22:133-138.
21.
21. Smith MS, Wallston KA, Smith CA. The development and validation of the Perceived Health Competence Scale. Health Educ Res.1995;10: 51-64.
22.
22. Samuel-Hodge CD, Ammerman AS, Skelly AS, Headen S.Diabetes-related attitudes, beliefs, and barriers to dietary adherence among African Americans with NIDDM [abstract]. Diabetes. 1997;46: A376-A376.
23.
23. Samuel-Hodge CD, Headen SW, Skelly AH, et al. Influences on day-to-day selfmanagement of type 2 diabetes among African American women. Spirituality, the multicaregiver role, and other social context factors. Diabetes Care. 2000;23:928-933.
24.
24. Skelly AH, Samuel-Hodge C, Elasy T, Ammerman AS, Headen SW, Keyserling TC. Development and testing of culturally sensitive instruments for African American women with type 2 diabetes. Diabetes Educ. 2000;26:769-777.
25.
25. Jobe JB, Mingay DJ. Cognitive research improves questionnaires. Am J Public Health. 1989;79:1053-1055.
26.
26. McCaul KD, Glasgow RE, Schafer LC. Diabetes regimen behaviors: predicting adherence. Med Care. 1987;25: 868-881.
27.
27. DeVellis RF. Factor analytic strategies. In: Scale Development: Theory and Applications. Newbury Park, Calif: Sage Publications; 1991: 91-109.
28.
28. Schwarz N.Self-reports: how the questions shape the answers. Am Psychol. 1999; 54:93-105.
29.
29. Lewis FM, Daltroy LH. How causal explanations influence health behaviors: attribution theory. In: Glanz K, Lewis FM, Rimer BK, eds. Health Behavior and Health Education-Theory, Research and Practice. 1 st ed.San Francisco: Jossey-Bass Publishers; 1990: 92-114.
30.
30. Ford ME, Tilley BC, McDonald PE. Social support among African American adults with diabetes, part 2: review. J Natl Med Assoc. 1998;90: 425-432.
31.
31. Bailey BJ, LherissonCedeno D.Diabetes outcomes and practices: comparison of African Americans and Caucasians. J Natl Black Nurses Assoc. 1997;9:66-75.
