Development of the Diabetes Index for Social Determinants of Health (DISDOH)
Authors' conclusion
DISDOH is the first validated, diabetes-specific SDoH assessment designed for brief, practical use in clinical and community settings. Unlike existing instruments, which are often lengthy and not tailored to diabetes management, DISDOH offers a concise yet comprehensive approach to identifying social risk factors that impact diabetes self-care and outcomes.
Study context
- Population
- Participants with T1D and T2D recruited from the regional Health Extension for Diabetes (HED) programme and a national crowdsourcing platform
- Outcome
- Internal consistency of the five DISDOH domains
Methodological detailsprincipal component analysis, confirmatory factor analysis, 16-item pool from diabetes expert stakeholder group, refined by piloting with individuals living with diabetes, Principal component analysis in 440 HED participants identified a 5-factor solution, Confirmatory factor analysis in 215 individuals with T1D and T2D supported the 5-factor solution
- Principal component analysis
- Confirmatory factor analysis
- 16-item pool from diabetes expert stakeholder group, refined by piloting with individuals living with diabetes
- Principal component analysis in 440 HED participants identified a 5-factor solution
- Confirmatory factor analysis in 215 individuals with T1D and T2D supported the 5-factor solution
Performance
As reported in the abstract
- Domain 1, socioeconomic status (a)
- 0.660
- Domain 2, neighborhood and physical environment (a)
- 0.812
- Domain 3, food environment (a)
- 0.801
- Domain 4, health context (a)
- 0.812
- Domain 5, social context (a)
- 0.708
Further findings
- Strong convergent validity with related social determinants of health (SDoH) measures
- Divergent validity supported by weak or non-significant correlations with distinct constructs
Original publication
Development of the Diabetes Index for Social Determinants of Health (DISDOH). BMJ Open Diabetes Res Care. Published 27 July 2025. doi:10.
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