Translation and psychometric evaluation of the Diabetes Education Questionnaire (DATE-Q) from English to Marathi – assessing reliability, validity, and cross-cultural equivalence
DOI:
https://doi.org/10.15584/ejcem.2025.2.15Keywords:
cross cultural evaluation, diabetes mellitus, health education, psychometric evaluation, reliability, validityAbstract
Introduction and aim. The DiAbeTes Education Questionnaire (DATE-Q) is a self-administered tool created to evaluate disease-related knowledge and knowledge of five core components of rehabilitation: exercise, diet, psychological well-being, self-management and complications. The aim was to translate and adapt the DATE-Q into Marathi language and to evaluate the validity and reliability among diabetes and prediabetic patients.
Material and methods. The study was carried out following standard stepwise Beaton and COSMIN guidelines to complete the translation and psychometric validation of the questionnaire. The pre-final version was evaluated in 30 individuals with diabetes or prediabetes. Test-retest reliability and internal consistency were assessed among 200 individuals with type 2 diabetes using Cronbach’s alpha and intraclass correlation coefficients respectively.
Results. The original and translated versions did not conceptually differ from each other. DATE-Q has ten elements that were culturally adjusted. Based on suggestions from the expert group and the results of the pilot tests, cross-cultural modifications were made. The value of 0.935 for Cronbach’s alpha shows a very high level of internal consistency. For single and average measures, the intraclass correlation coefficient is 0.985 and 0.993 resp. which indicates an excellent level of reliability.
Conclusion. The DiAbeTes Education Questionnaire is a reliable and valid tool for evaluating knowledge among Marathi-speaking patients.
Downloads
References
Powers MA, Bardsley J, Cypress M, et al. Diabetes Self-Management Education and Support in Type 2 Diabetes: A Joint Position Statement of the American Diabetes Association, the American Association of Diabetes Educators, and the Academy of Nutrition and Dietetics. J Acad Nutr Diet. 2015;115(8):1323-1334. doi: 10.1016/j.jand.2015.05.012
Beck J, Greenwood DA, Blanton L, et al. 2017 National Standards for Diabetes Self-Management Education and Support. Diabetes Educ. 2017;43(5):449-464. doi: 10.1177/0145721717722968
Chatterjee S, Khunti K, Davies MJ. Type 2 diabetes. Lancet. 2017;389(10085):2239-2251. doi: 10.1016/S0140-6736(17)30058-2
Marciano L, Camerini AL, Schulz PJ. The Role of Health Literacy in Diabetes Knowledge, Self-Care, and Glycemic Control: a Meta-analysis. J Gen Intern Med. 2019;34(6):1007-1017. doi: 10.1007/s11606-019-04832-y
Sahadevan P, Kamal VK, Sasidharan A, Bagepally BS, Kumari D, Pal A. Prevalence and risk factors associated with undiagnosed diabetes in India: Insights from NFHS-5 national survey. J Glob Health. 2023;13:04135. doi: 10.7189/jogh.13.04135
Schiborn C, Schulze MB. Precision prognostics for the development of complications in diabetes. Diabetologia. 2022;65(11):1867-1882. doi: 10.1007/s00125-022-05731-4
Zuñiga JA, Huang YC, Bang SH, et al. Revision and Psychometric Evaluation of the Diabetes Knowledge Questionnaire for People With Type 2 Diabetes. Diabetes Spectrum. 2023;36(4):345-353. doi: 10.2337/ds22-0079
Low awareness of diabetes among poorer people in India. https://www.nature.com/articles/d44151-023-00028-w. Doi: 10.1038/d44151-023-00028-w. Accessed October 20, 2024.
Felix CM de M, Ghisi GL de M, Seixas MB, et al. Translation, cross-cultural adaptation, and psychometric properties of the Brazilian Portuguese version of the DiAbeTes Education Questionnaire (DATE-Q). Braz J Phys Ther. 2021;25(5):583-592. doi: 10.1016/j.bjpt.2021.03.003
Hsieh MH, Chen YC, Ho CH, Lin CY. Validation of Diabetes Knowledge Questionnaire (DKQ) in the Taiwanese Population - Concurrent Validity with Diabetes-Specific Quality of Life Questionnaire Module. Diabetes Metab Syndr Obes. 2022;15:2391-2403. doi: 10.2147/DMSO. S369552
Mathur P, Leburu S, Kulothungan V. Prevalence, Awareness, Treatment and Control of Diabetes in India From the Countrywide National NCD Monitoring Survey. Front Public Health. 2022;10:748157. doi: 10.3389/fpubh.2022.748157
Ghisi GLDM, Aultman C, Konidis R, et al. Development and Validation of the DiAbeTes Education Questionnaire (DATE-Q) to Measure Knowledge Among Diabetes and Prediabetes Patients Attending Cardiac Rehabilitation Programs. J Cardiopulm Rehabil Prev. 2021;41(4):224-229. doi: 10.1097/HCR.0000000000000546
Beaton DE, Bombardier C, Guillemin F, Ferraz MB. Guidelines for the Process of Cross-Cultural Adaptation of Self-Report Measures. Spine. 2000;25(24):3186-3191. doi: 10.1097/00007632-200012150-00014
Mokkink LB, Prinsen CA, Patrick DL, et al. COSMIN Study Design checklist for Patient-reported outcome measurement instruments. https://www.cosmin.nl/wp-content/uploads/COSMIN-study-designing-checklist_final.pdf. Accessed October 20, 2024.
Hair Jr JF, Anderson RE, Tatham RL, Black WC. Multivariate Data Analysis (5th ed.). Upper Saddle River, NJ Prentice Hall. - References - Scientific Research Publishing. https://www.scirp.org/reference/ReferencesPapers?ReferenceID=1519308. Accessed August 17, 2024.
CDC. Testing for Diabetes and Prediabetes: A1C. Diabetes. August 29, 2024. https://www.cdc.gov/diabetes/diabetes-testing/prediabetes-a1c-test.html. Accessed January 7, 2025.
Tavakol M, Dennick R. Making Sense of Cronbach’s Alpha. International Journal of Medical Education. 2011;2:53-55. doi: 10.5116/ijme.4dfb.8dfd
Fitzgerald JT, Davis WK, Connell CM, Hess GE, Funnell MM, Hiss RG. Development and validation of the Diabetes Care Profile. Eval Health Prof. 1996;19(2):208-230. doi: 10.1177/016327879601900205
Standards of Medical Care in Diabetes-2021 Abridged for Primary Care Providers. Clin Diabetes. 2021;39(1):14-43. doi: 10.2337/cd21-as01
Heise M, Heidemann C, Baumert J, et al. Structured diabetes self-management education and its association with perceived diabetes knowledge, information, and disease distress: Results of a nationwide population-based study. Prim Care Diabetes. 2022;16(3):387-394. doi: 10.1016/j.pcd.2022.03.016
Gordon EM, Laumann TO, Gilmore AW, et al. Precision Functional Mapping of Individual Human Brains. Neuron. 2017;95(4):791-807.e7. doi: 10.1016/j.neuron.2017.07.011
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 European Journal of Clinical and Experimental Medicine

This work is licensed under a Creative Commons Attribution 4.0 International License.
Our open access policy is in accordance with the Budapest Open Access Initiative (BOAI) definition: this means that articles have free availability on the public Internet, permitting any users to read, download, copy, distribute, print, search, or link to the full texts of these articles, crawl them for indexing, pass them as data to software, or use them for any other lawful purpose, without financial, legal, or technical barriers other than those inseparable from having access to the Internet itself.
All articles are published with free open access under the CC-BY Creative Commons attribution license (the current version is CC-BY, version 4.0). If you submit your paper for publication by the Eur J Clin Exp Med, you agree to have the CC-BY license applied to your work. Under this Open Access license, you, as the author, agree that anyone may download and read the paper for free. In addition, the article may be reused and quoted provided that the original published version is cited. This facilitates freedom in re-use and also ensures that Eur J Clin Exp Med content can be mined without barriers for the research needs.




