Cultural adaptation and preliminary psychometric assessment of the IMEVID questionnaire for assessing lifestyle in adults with type 2 diabetes in Peru.
Multidomain patient-reported and self-reported instruments are often summarized using total scores, even when their domains represent conceptually distinct aspects of health behavior, emotional functioning, or self-management. Such scoring practices may obscure clinically meaningful domain-specific information if the instrument has not been shown to behave as a unidimensional reflective scale. This study culturally adapted the IMEVID questionnaire for use in Peru and evaluated its psychometric properties and score interpretation in adults with type 2 diabetes.
We conducted a cross-sectional methodological study in 180 adults with self-reported type 2 diabetes in Peru. IMEVID underwent cross-cultural adaptation and expert-based content validity assessment. Psychometric evaluation included expert agreement for content validity, item and domain descriptive statistics, floor and ceiling effects, internal consistency estimates, Kaiser-Meyer-Olkin measures and Bartlett's tests based on Pearson and polychoric correlation matrices, exploratory factor analysis, confirmatory factor analysis, and hypothesis-driven Spearman correlations among domains. Cronbach's alpha was used for domains with three or more items, while inter-item Spearman correlations were used for two-item domains.
The adapted IMEVID showed high expert-based content validity agreement across clarity, coherence, relevance, and sufficiency criteria, with an overall mean agreement of 0.96 and acceptable overall internal consistency (α = 0.82). Domain-level internal consistency varied across the instrument, with Cronbach's alpha ranging from 0.43 to 0.78 and two-item domain correlations ranging from 0.26 to 0.74. Factorability assessment differed according to the correlation matrix: the Pearson matrix showed acceptable sampling adequacy (KMO = 0.757), whereas the polychoric matrix yielded a very low KMO value (KMO = 0.14), likely influenced by sparse response patterns and marked ceiling effects in selected domains. Exploratory factor analysis was more consistent with a seven-factor solution aligned with the original IMEVID domains. Confirmatory factor analysis showed poor fit for the one-factor model (CFI = 0.677; TLI = 0.648; RMSEA = 0.104; SRMR = 0.151) and substantially better fit for the seven-domain model (CFI = 0.946; TLI = 0.936; RMSEA = 0.044; SRMR = 0.093). All standardized factor loadings in the seven-domain model were statistically significant.
The Peruvian adaptation of IMEVID showed high content validity agreement, acceptable overall reliability, and preliminary structural support for the original seven-domain organization. The findings were more consistent with a multidomain lifestyle assessment tool than with a strictly unidimensional reflective scale. Domain scores may provide complementary information about distinct aspects of lifestyle and self-management. However, the structural findings should be considered preliminary, particularly given the very low polychoric KMO and the moderate sample size. Further validation is needed in larger clinically characterized samples.
We conducted a cross-sectional methodological study in 180 adults with self-reported type 2 diabetes in Peru. IMEVID underwent cross-cultural adaptation and expert-based content validity assessment. Psychometric evaluation included expert agreement for content validity, item and domain descriptive statistics, floor and ceiling effects, internal consistency estimates, Kaiser-Meyer-Olkin measures and Bartlett's tests based on Pearson and polychoric correlation matrices, exploratory factor analysis, confirmatory factor analysis, and hypothesis-driven Spearman correlations among domains. Cronbach's alpha was used for domains with three or more items, while inter-item Spearman correlations were used for two-item domains.
The adapted IMEVID showed high expert-based content validity agreement across clarity, coherence, relevance, and sufficiency criteria, with an overall mean agreement of 0.96 and acceptable overall internal consistency (α = 0.82). Domain-level internal consistency varied across the instrument, with Cronbach's alpha ranging from 0.43 to 0.78 and two-item domain correlations ranging from 0.26 to 0.74. Factorability assessment differed according to the correlation matrix: the Pearson matrix showed acceptable sampling adequacy (KMO = 0.757), whereas the polychoric matrix yielded a very low KMO value (KMO = 0.14), likely influenced by sparse response patterns and marked ceiling effects in selected domains. Exploratory factor analysis was more consistent with a seven-factor solution aligned with the original IMEVID domains. Confirmatory factor analysis showed poor fit for the one-factor model (CFI = 0.677; TLI = 0.648; RMSEA = 0.104; SRMR = 0.151) and substantially better fit for the seven-domain model (CFI = 0.946; TLI = 0.936; RMSEA = 0.044; SRMR = 0.093). All standardized factor loadings in the seven-domain model were statistically significant.
The Peruvian adaptation of IMEVID showed high content validity agreement, acceptable overall reliability, and preliminary structural support for the original seven-domain organization. The findings were more consistent with a multidomain lifestyle assessment tool than with a strictly unidimensional reflective scale. Domain scores may provide complementary information about distinct aspects of lifestyle and self-management. However, the structural findings should be considered preliminary, particularly given the very low polychoric KMO and the moderate sample size. Further validation is needed in larger clinically characterized samples.
Authors
Carcausto Huamaní Carcausto Huamaní, Nieto Olivera Nieto Olivera, Diaz Reyes Diaz Reyes
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