Psychometric Properties of Persian Version of Diabetes Health Literacy Scale (DHLS) in Patients with Type 2 Diabetes

Background: The purpose of this study was to investigate the psychometric properties of the Persian version of Diabetes Health Literacy Scale in type 2 diabetic patients.

Method: This cross-sectional study was conducted in 2021 in 1040 patients with type 2 diabetes in eastern Iran. Participants was selected by proportional stratified sampling method. The validity of DHLS was investigated through qualitative face validity, qualitative content validity, and structural validity (exploratory factor analysis and confirmatory factor analysis). The reliability of DHLS was checked by Cronbach's alpha coefficient, McDonald omega coefficient, and test-retest.

Results: In exploratory factor analysis, 3 factors with eigenvalues greater than 1 were extracted, explaining 68.57% of the variance. These factors entered the confirmatory factor analysis, none of the questions were removed, and all questions had factor loading above 0.4. Cronbach's alpha coefficient and McDonald omega coefficient of DHLS were 0.919 and 0.922. Also, the Intraclass correlation coefficient of DHLS was 0.957. Finally, the DHLS was approved with 14 questions and the three subscales of Informational Health Literacy (6 items), Numerate Health Literacy (5 items), and Communicative Health Literacy (3 items).

Conclusions: DHLS with 14 questions and the three subscales is a valid and reliable tool for examining diabetes health literacy in people with type 2 diabetes.