title: Development and validation of a Spanish diabetes-specific numeracy measure: DNT-15 Latino.
abstract: BACKGROUND
  Although deficits in health literacy and numeracy have been described among Latinos, the impact of low numeracy on diabetes outcomes has not been studied. Study objectives were (1) to establish the reliability and validity of a 15-item Spanish, diabetes-specific numeracy measure (Diabetes Numeracy Test [DNT]-15 Latino) and (2) to examine the relationship between diabetes-specific numeracy and diabetes-related outcomes among a sample of Latino adults with diabetes.
  
  
  METHODS
  Data collection included patient demographics, health literacy, general numeracy, diabetes-specific numeracy, acculturation, self-efficacy, self-care behaviors, and most recent glycosylated hemoglobin (HbA1c).
  
  
  RESULTS
  Participants (n=144) were on average 47.8 years old (SD=12.1). The majority were female (62%), uninsured (81%), and of Mexican nationality (78%) and reported low levels of acculturation (96%). The DNT-15 Latino had high internal reliability (Kruder-Richardson 20=0.78). The DNT-15 Latino demonstrated construct validity, correlating with measures of health literacy (ρ=0.291), general numeracy (ρ=0.500), education (ρ=0.361), and income (ρ=0.270) (P<0.001 for each). The DNT-15 Latino was significantly associated with acculturation but unrelated to self-efficacy, self-care behaviors, insulin use, and HbA1c.
  
  
  CONCLUSIONS
  The DNT-15 Latino is a reliable and valid measure of diabetes-specific numeracy for Latino patients with diabetes; however, additional studies are needed to further explore the association between diabetes-specific numeracy and acculturation and their impact on diabetes-related outcomes for Latinos.
authors.affiliation: Department of Internal Medicine, Meharry Medical College, Nashville, Tennessee 37208, USA. rwhite@mmc.edu
authors.forename: Richard O
authors.initials: RO
authors.lastname: White
authors.forename: Chandra Y
authors.initials: CY
authors.lastname: Osborn
authors.forename: Tebeb
authors.initials: T
authors.lastname: Gebretsadik
authors.forename: Sunil
authors.initials: S
authors.lastname: Kripalani
authors.forename: Russell L
authors.initials: RL
authors.lastname: Rothman
mesh_terms: D000069:Acculturation; D000328:Adult; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000208:ethnology* / Q000503:physiopathology / Q000523:psychology / Q000628:therapy; D004522:Educational Status; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D057220:Health Literacy; D006630:Hispanic or Latino; D006801:Humans; D007802:Language; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D015203:Reproducibility of Results; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires