Crush Diabetes Knowledge, Attitudes, and Beliefs Survey (CDKA)

Abstract

The Crush Diabetes Knowledge, Attitudes, and Beliefs Survey (CDKA; Mokhtari et al., 2023) was developed to assess middle school students’ knowledge of diabetes, the benefits of exercise, a healthy lifestyle, and diabetes risk. It also measures their attitudes, beliefs, and intent to change behaviors related to diabetes prevention. The content of this 25-item scale was developed by a team of registered dietitians with extensive experience in adolescent diabetes. The CDKA was evaluated in a sample of middle school students, and its factor analysis, reliability, and validity results have been reported.

Keywords

Knowledge, Diabetes, Adolescents, Attitudes, Beliefs, Intent to Change, Health Attitudes, Health Knowledge, Physical Illness (Attitudes Toward), Readiness to Change, Health Attitude Measures, Adolescent Health

Authors

Mokhtari, Pari; Jordan, Kristine C.; Wilson, Andrew; Sisco-Taylor, Brittany; Metos, Julie M.

---

Purpose

The purpose of this survey is to assess diabetes knowledge, attitudes, beliefs, and intent to change among middle school students.

Validity

Content Validity: The overall content validity index for the questionnaire items was 0.95.

Reliability

Internal Consistency: The Cronbach’s alpha coefficients were 0.70 for the knowledge section and 0.7 for the attitudes, beliefs, and intent to change sections.
Test-Retest Reliability: The questionnaire exhibited good reliability for the person-average measures for knowledge (Rkf = 0.8) and attitudes, beliefs, and intent to change (Rkf = 0.7) sections.

Factor Analysis

Exploratory Factor Analysis: After conducting a scree plot analysis (eigenvalues > 1), 4 components were extracted for each questionnaire section. The factor loading of the questionnaire items for the knowledge section was < 0.8 and > 0.5. The factor loadings for the attitudes, beliefs, and intent to change section were between 0.9 and 0.4. All factor loadings were >0.4.
Confirmatory Factor Analysis: In the CFA, the model fit for the 4-factor model was acceptable (for knowledge section: Chi-squared = 79.4, P < 0.001, RMSEA = 0.04; for attitudes, beliefs, and intent to change, Chi-squared = 165.7, P < 0.001, RMSEA = 0.07).

Instrument: Crush Diabetes Knowledge, Attitudes, and Beliefs Survey (CDKA)

Test Type: Original
Format: The Knowledge section consists of 12 True/False items. The Attitudes, Beliefs, and Intent to Change section is comprised of 13 items answered using five response categories (from strongly disagree to strongly agree). For the knowledge section, the maximum possible score is 12, and the minimum score is 0. The answer, “I do not know,” is added to prevent subjects from guessing. Correct responses are allocated a score of 1, whereas incorrect and “do not know” responses are allocated a score of 0.
Language Available: English
Population Group: Human (Male, Female)
Age Group: Childhood (birth-12 yrs), School Age (6-12 yrs), Adolescence (13-17 yrs)
Population Details: Respondents were middle school students aged 12-14 from the United States.
Test Methodology: Test Validity, Content Validity, Test Reliability, Internal Consistency, Test-Retest Reliability, Factor Analysis, Confirmatory Factor Analysis, Exploratory Factor Analysis.

Keywords

Knowledge, Diabetes, Adolescents, Attitudes, Beliefs, Intent to Change

Authors

Mokhtari, Pari
Author ORCID Identifier: http://orcid.org/0000-0003-0451-1580
Affiliation: University of Utah, College of Health, Department of Nutrition and Integrative Physiology
Email address: [email protected]
Correspondence Address: University of Utah, College of Health, Department of Nutrition and Integrative Physiology, Salt Lake City, Utah, United States, 84112.

Jordan, Kristine C.
Affiliation: University of Utah, College of Health, Department of Nutrition and Integrative Physiology

Wilson, Andrew
Author ORCID Identifier: http://orcid.org/0000-0003-3679-9232
Affiliation: University of Utah, College of Nursing

Sisco-Taylor, Brittany
Author ORCID Identifier: http://orcid.org/0000-0001-7028-2953
Affiliation: University of Utah, School of Medicine, Department of Population Health Sciences

Metos, Julie M.
Affiliation: University of Utah, College of Health, Department of Nutrition and Integrative Physiology

Permissions & Fee and Test Year

Permissions: May be used for Research/Teaching.
Commercial: No
Fee: No
Test Year: 2023

References

Mokhtari, P., Jordan, K. C., Wilson, A., Sisco-Taylor, B., & Metos, J. M. (2023). Development and validation of a diabetes questionnaire for middle school students. Journal of Nutrition Education and Behavior, 55(2), 135–144. https://doi.org/10.1016/j.jneb.2022.11.004

Items of the Crush Diabetes Knowledge, Attitudes, and Beliefs Survey (CDKA)

Number of items: This measure consists of 25 items.
Test Items Available: Yes
Test Location: 2023-46605-010, Table 3, Page 139; 2023-46605-010, Table 4, Page 140
Factors and Subscales:

• Subscales: Knowledge; Attitudes, Beliefs, and Intent to Change.

• Factors: Insulin; General Information; Prevention; Untrue Definition; Intent to Change; Attitudes and Beliefs: Lifestyle; Attitudes and Beliefs: Psychosocial; Attitudes and Beliefs: Emotional.

Knowledge Section

• You get diabetes when your body cannot make or use insulin

• Insulin is a hormone in the blood that controls blood sugar

• The pancreas makes insulin

• Diabetes occurs only in adults

• There are 2 main types of diabetes: type 1 and type 2

• Eating too much sugar and other sweet foods and drinks may lead to excess body weight

• Kids with diabetes should exercise regularly

• Type 1 diabetes can be prevented by eating healthy foods and exercising

• If you are overweight, you are more likely to get type 1 diabetes

• A family history of diabetes is a risk factor for developing diabetes

• Diabetes is when you have low sugar in your blood

• Type 1 diabetes is the most common form of diabetes

Note. Knowledge items are rated as True or False, with an added I do not know option.

Attitudes, Beliefs, and Intent to Change Section

• I plan to eat less food that contains sugar in the next wk

• I plan to drink less soda, energy drinks, and other sugary drinks next wk

• I plan to exercise more in the next wk

• I believe exercise can help prevent type 2 diabetes

• I believe eating healthy food can prevent type 2 diabetes

• I understand what diabetes is

• I believe if you get diabetes, it will affect almost every part of your life

• I believe diabetes is hard because you never get a break from this disease

• I believe everyone with diabetes should keep their blood sugar close to normal

• I believe type 2 diabetes is a very serious disease

• I believe type 2 diabetes is not as serious as type 1 diabetes

• I believe the emotional effects of diabetes are small

• I believe a person with diabetes can control diabetes and lead a normal life

Note. Items are rated on a 5-point scale (from strongly disagree to strongly agree).