Adaptation of the Diabetes Health Profile (DHP-1) for use with patients with Type 2 diabetes mellitus: psychometric evaluation and cross-cultural comparison

Aims To adapt the Diabetes Health Profile (DHP-1) for use with English spea king patients with Type 2 diabetes mellitus and to evaluate the psychometri c properties of the adapted measure in a UK; and Danish sample of insulin, tablet and diet-treated patients with Type 2 diabetes. Methods Following linguistic adaptation using the forward-backward translat ion procedure, the 32-item DHP-1 was sent to 650 and 800 consecutively sele cted UK and Danish patients with Type 2 diabetes. Construct validity was as sessed using principal axis factoring. Factor stability was assessed across language groups using the coefficient of congruence. Reliability was evalu ated using Cronbach's alpha and multi-trait analysis, including item conver gent/discriminant validity. Subscale discriminant validity was assessed thr ough known groups with one-way ANOVA and post hoc Scheffe tests for multipl e comparisons. Results Eighteen items (56.25%) were retained following initial item analys is. A three-factor solution accounting for 45.6% and 40.3% of the total exp lained variance was identified in the UK and Danish samples, respectively. Factors were interpreted as psychological distress (PD), barriers to activi ty (BA and disinhibited eating (DE). Factor congruence between language gro ups ranged from 0.98 to 0.99 and Cronbach's alpha ranged between 0.70 and 0 .88. Item scaling success for both language versions was 88.9%. BA scores d iscriminated between treatment groups in both language groups (F = 24.24, P < 0.001; F = 7.68, P < 0.001) and PD scores in the UK sample (F = 20.97, P < 0.001). Conclusions The DHP-18 developed for use with patients with Type 2 diabetes has been shown to have satisfactory internal reliability and validity and measurement equivalence across language groups.