title: [Development of the scale of knowledge, attitude, and behavior of lifestyle intervention in a diabetes high-risk population].
abstract: OBJECTIVE
  To establish a scale of knowledge, attitude, and behavior of lifestyle interventions among a population at high risk of diabetes with good cultural adaptability, validity, and reliability.
  
  
  METHODS
  The original item pool was formed based on a literature review, group discussions, and interviews with experts. We used the Delphi method to determine core items of the scale (30 cases in the first round and 26 cases in the second round, respectively). We invited 30 experts from clinical medicine, nursing, preventive medicine, health education, and community diabetes prevention and control to completed expert consultation tables. For each item, experts were asked to provide an importance score, the judgment basis, and a familiarity score. We analyzed the positive coefficient, authoritative coefficient, degree of concentration, and harmonious coefficient, to determine the selected items. Using face-to-face questionnaire surveys, 31 participants at high risk of diabetes were selected for the pilot study. We analyzed understanding of the scale's content and presentation and corrected the scale based on the analysis.
  
  
  RESULTS
  We received 26 and 23 inquiry forms, respectively, in two rounds of consultation. Responses rates of the two rounds were 87% and 88%. The scores of authoritative coefficients were 0.79 ± 0.14 and 0.87 ± 0.10. The score of total scale in the first consultation was 4.32±0.25, the coefficient of variation was 0.06, and the coefficient of concordance was 0.163; in the second consultation, these were 4.58±0.21, 0.05, 0.150, respectively. In the first consultation, 22 experts proposed amendments and made suggestions, a rate of 85% (22/26). After the second round, 30 items were included in the final scale. In the pilot study, 13 males and 18 females with high risk of diabetes were interviewed. Average age of the population was (62.24 ± 10.23) years. The time to complete the survey was (9.35 ± 2.71) minutes. After the pilot study was completed, the order of the items was adjusted to ensure a reasonable and logical scale.
  
  
  CONCLUSIONS
  We developed the scale of knowledge, attitude, and behavior of lifestyle intervention in a diabetes high-risk population, using the Delphi method and a pilot study. Overall, the findings indicate that input from experts during development facilitates achievement of satisfactory concentration and coordination levels, and the use of this scale will produce credible results.
authors.affiliation: National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China.
authors.forename: W J
authors.initials: WJ
authors.lastname: Wang
authors.forename: J
authors.initials: J
authors.lastname: Dong
mesh_terms: D003697:Delphi Technique; D003920:Diabetes Mellitus / Q000628:therapy*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007407:Interviews as Topic; D008019:Life Style; D008297:Male; D010865:Pilot Projects; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires