Development and psychometric evaluation of the type 2 diabetes nutrition therapy adherence scale
Primary Care Diabetes, vol.20, no.4, pp.465-473, 2026 (SCI-Expanded, Scopus)
- Publication Type: Article / Article
- Volume: 20 Issue: 4
- Publication Date: 2026
- Doi Number: 10.1016/j.pcd.2026.06.003
- Journal Name: Primary Care Diabetes
- Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, EMBASE, MEDLINE
- Page Numbers: pp.465-473
- Keywords: Adherence, Medical nutrition therapy, Psychometric evaluation, Scale development, Type 2 diabetes
- Dokuz Eylül University Affiliated: Yes
Abstract
Aims Type 2 diabetes mellitus is a major global public health concern closely associated with unhealthy dietary patterns. Medical nutrition therapy plays a central role in its prevention and management; however, assessing adherence remains challenging. This study aimed to develop and psychometrically evaluate the Type 2 Diabetes Nutrition Therapy Adherence Scale (DNTA-S), a culturally appropriate instrument for assessing adherence to nutrition therapy among individuals with type 2 diabetes. Methods This methodological and cross-sectional study was conducted with 420 adults diagnosed with type 2 diabetes. Content validity was assessed using the Davis technique based on expert evaluations. Construct validity was examined through exploratory and confirmatory factor analyses. Reliability was evaluated using Cronbach’s alpha, split-half, and test–retest analyses. Results The final 20-item scale consisted of four dimensions. The four-factor structure explained 61.29% of the total variance, with acceptable factor loadings. Confirmatory factor analysis supported the structure and demonstrated good model fit (RMSEA=0.060; CFI=0.943). The overall Cronbach’s alpha was 0.915, and subdimension reliability coefficients were within acceptable ranges. Test–retest reliability indicated excellent stability (ICC=0.95). Conclusions The DNTA-S is a valid and reliable multidimensional instrument that captures key aspects of dietary adherence and may support both clinical practice and research.