Cross-cultural adaptation, validation, and measurement invariance of the Italian version of the diabetes health literacy scale among Italian-born and foreign-born adults with type 2 diabetes mellitus
Authors' conclusion
The DHLS-IT is a valid and reliable instrument for assessing diabetes HL in Italian adults with T2DM. Partial metric invariance cautions against direct latent score comparisons between Italian-born and foreign-born patients.
Study context
- Population
- Adults with T2D from two outpatient diabetology clinics in Florence, Italy
- Participants
- 300 adults
- Comparison
- Italian-born vs foreign-born adults
- Outcome
- Structural validity, internal consistency, construct validity and measurement invariance of the Italian Diabetes Health Literacy Scale (DHLS) (14-item)
Methodological detailscross-cultural adaptation, ISPOR guidelines with cognitive debriefing, COSMIN recommendations, two outpatient clinics
- Cross-cultural adaptation
- ISPOR guidelines with cognitive debriefing
- COSMIN recommendations
- Two outpatient clinics
Performance
As reported in the abstract
Psychometric properties of the DHLS-IT
- Confirmatory factor analysis (CFA) three-factor second-order structure: CFI
- 0.921
- CFA three-factor second-order structure: RMSEA
- 0.077
- Internal consistency across domains (ω)
- 0.759-0.868
- Internal consistency, total scale (ω)
- 0.940
- Total scale ωH
- 0.770
Original publication
Cross-cultural adaptation, validation, and measurement invariance of the Italian version of the diabetes health literacy scale among Italian-born and foreign-born adults with type 2 diabetes mellitus. Diabetes Res Clin Pract. Published 24 July 2026. doi:10.
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