Reliability and Validity of Diabetes Nutrition Self-Efficacy and Behavior Measures for the "What Can I Eat" Diabetes Nutrition Education Program for American Indian and Alaska Native Adults With Type 2 Diabetes.

IF 3.5 2区 医学 Q2 NUTRITION & DIETETICS Journal of the Academy of Nutrition and Dietetics Pub Date : 2025-01-01 Epub Date: 2024-05-10 DOI:10.1016/j.jand.2024.05.004
Angela G Brega, Sarah A Stotz, Kelly R Moore, Monica C McNulty, Luohua Jiang
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Abstract

Background: American Indian and Alaska Native (AI/AN) people have high rates of diabetes and limited access to nutrition education. The "What Can I Eat? Healthy Choices for People With Type 2 Diabetes" (WCIE) diabetes nutrition education program was culturally adapted for AI/AN adults.

Objective: This analysis was designed to evaluate the reliability and validity of items developed to measure diabetes nutrition self-efficacy (ie, confidence one can engage in specific behaviors) and diabetes nutrition behavior among participants in the WCIE program for AI/AN adults.

Design: This study was a secondary analysis of data from a randomized controlled trial designed to evaluate the WCIE program for AI/AN adults. Baseline data were used to assess the reliability and validity of the self-efficacy and behavior items, which were collected via survey. Due to COVID-19 safety protocols, the intervention was conducted via Zoom (Zoom Video Communications), and both survey and clinical data were collected at home by participants.

Participants/setting: The study was conducted from January to December 2021 with 5 AI/AN-serving health care programs in Oklahoma, Illinois, North Carolina, California, and New York. AI/AN adults with type 2 diabetes who spoke English and had internet access were eligible. Sixty people participated.

Main outcome measures: Analyses examined validity and reliability of diabetes nutrition self-efficacy and behavior items.

Statistical analysis performed: To test reliability, internal consistency and factor structures of the scales were examined. To evaluate convergent validity, Pearson correlations were computed to examine the association of the self-efficacy and behavior measures with each other and with clinical indicators (ie, body mass index, blood pressure, and hemoglobin A1c).

Results: Two self-efficacy factors were identified. Each showed strong internal consistency (Cronbach α ≥ 0.85; McDonald ω ≥ 0.88) and was directly associated with diabetes nutrition behavior (P < .001). The factor assessing Confidence in Using the Diabetes Plate was inversely associated with hemoglobin A1c (Pearson correlation = -0.32, P = .0243). The behavior measure capturing Healthy Nutrition Behavior showed strong internal consistency (α = 0.89; ω = 0.92) and was inversely associated with hemoglobin A1c (Pearson correlation = -0.38, P = .0057).

Conclusions: Diabetes nutrition self-efficacy and behavior items developed for the WCIE program for AI/AN adults are valid and reliable. These items can facilitate rigorous and consistent evaluation of the AI/AN WCIE program.

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针对患有 2 型糖尿病的美国印第安人和阿拉斯加原住民成年人的 "我能吃什么 "糖尿病营养教育计划的糖尿病营养自我效能和行为测量的可靠性和有效性。
背景:美国印第安人和阿拉斯加原住民(AI/AN)的糖尿病发病率很高,但接受营养教育的机会却很有限。我可以吃什么?(WCIE) 糖尿病营养教育计划针对美国印第安人和阿拉斯加原住民成年人进行了文化调整:本分析旨在评估为衡量糖尿病营养自我效能(即对自己能够从事特定行为的信心)和糖尿病营养行为而开发的项目的可靠性和有效性:本研究是对一项随机对照试验数据的二次分析,该试验旨在评估针对亚裔美国人/印第安人成人的 WCIE 计划。基线数据用于评估通过调查收集的自我效能和行为项目的可靠性和有效性。根据 COVID-19 安全协议,干预是通过 Zoom 进行的,调查和临床数据都是由参与者在家中收集的:该研究于 2021 年 1 月至 12 月在俄克拉荷马州、伊利诺伊州、北卡罗来纳州、加利福尼亚州和纽约州的五个为亚裔美国人/印第安人服务的医疗保健项目中进行。会说英语并能上网的 2 型糖尿病亚裔/非裔成人符合条件。有 60 人参与:对糖尿病营养自我效能和行为项目的有效性和可靠性进行了分析:为测试信度,研究了量表的内部一致性和因子结构。为评估收敛效度,计算了皮尔逊相关性,以检查自我效能和行为测量之间以及与临床指标(即体重指数、血压、血红蛋白 A1C)之间的关联:结果:确定了两个自我效能因子。每个因子都显示出很强的内部一致性(Cronbach alphas ≥ 0.85;McDonald omegas ≥ 0.88),并与糖尿病营养行为直接相关(Ps < 0.001)。评估使用糖尿病餐盘信心的因子与 A1C 成反比(Pearson Correlation = -0.32,P = 0.0243)。捕捉健康营养行为的行为测量显示出很强的内部一致性(α = 0.89;Ω = 0.92),并且与 A1C 呈反比关系(Pearson Correlation = - 0.38,P = 0.0057):结论:为美国印第安人/美洲印第安人成人 WCIE 计划开发的糖尿病营养自我效能和行为项目是有效和可靠的。这些项目有助于对阿拉斯加原住民/印第安人 WCIE 计划进行严格、一致的评估。
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来源期刊
CiteScore
7.20
自引率
10.40%
发文量
649
审稿时长
68 days
期刊介绍: The Journal of the Academy of Nutrition and Dietetics is the premier source for the practice and science of food, nutrition, and dietetics. The monthly, peer-reviewed journal presents original articles prepared by scholars and practitioners and is the most widely read professional publication in the field. The Journal focuses on advancing professional knowledge across the range of research and practice issues such as: nutritional science, medical nutrition therapy, public health nutrition, food science and biotechnology, foodservice systems, leadership and management, and dietetics education.
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