MedStar Investigators Evaluate Validity and Reliability of Diabetes Survival Skills Knowledge Test

Man sitting on couch, testing blood glucose with monitor

MedStar Health investigators examined the validity and reliability of the KNOW Diabetes test, a survival skill knowledge test used to evaluate the impact of diabetes education and research interventions in their study “Validity and Reliability of a (Brief) Diabetes ‘Survival Skills’ Knowledge Test.” Diabetes self-management education support (DSMES) may be defined as essential education that facilitates the knowledge, skills, and abilities necessary for safe and effective sort-term diabetes self-care.

In the United States, there is a low rate of participation in diabetes self-management education support and lack of availability of short, easy-to-administer diabetes knowledge tests. This presents a need for a tool that can easily identify knowledge deficits to ensure the safety and effectiveness of diabetes self-care management among adults with type 2 diabetes mellitus where traditional diabetes self-management education support is not available. Managing diabetes is an important part of positive patient outcomes. The KNOW Diabetes knowledge test was developed with input from endocrinologists, certified diabetes educators, and patients in a US regional health care system. The test consists of questions from seven domains: nutrition and meal plan basics, blood glucose monitoring, glycemic targets, taking medications as prescribed, hyper- and hypoglycemia recognition and treatment, and when to seek medical help.

This study recruited 280 adults with T2DM for a two-phase research study. In phase one, the 19-question diabetes knowledge test was administered to assess feasibility. Following analysis of phase one data, three questions were removed from the knowledge test due to high difficulty and two questions on insulin storage were combined into a single question. The revised KNOW Diabetes survey contained 15 questions and was completed by 227 participants. Most participants were older than 65 years, and 65% reported having diabetes for more than five years. 70% of participants were African American.

The study results showed that patients who are older and have a lower level of education, have Medicaid or Medicare, and are without pain or numbness in the feet, scored significantly lower on the KNOW Diabetes test.  Test scores were higher among those who were younger, had a higher education level had a longer duration of diabetes and were non-Medicare or Medicaid insured.

The KNOW Diabetes knowledge test is intended to identify knowledge deficits in diabetes self-management survival skills and the study results prove the validity and reliability of the test for use in a variety of nondiabetic specialty care settings as well as in the clinical care setting.

The collaborative research team included Gretchen Youssef, MS, RD, CDE; Edward H. Ip, PhD; Michelle Magee, MD, MBBCh, BAO, LRCPSI; Shyh-Huei Chen, PhD; Amisha Wallia, MD, MS; Teresa Pollack, MS; Emilie Touma; Clayton Bourges, MS; Lynne Brecker, BSN, RN, CDE from the MedStar Diabetes Institute.

The Diabetes Educator, DOI: 10.1177/0145721719828064