Psychometric evaluation of the Persian version of the Heart Disease Fact Questionnaire (HDFQ) in people with diabetes in Iran

Background and aimsPublic health and clinic-based educational strategies are desperately needed to stem the tide of death from heart disease among people with diabetes in low and middle-income countries. This study translated the Heart Disease Fact Questionnaire into Persian and evaluated its reliability and validity for use in Iran.MethodsUsing rigorous translation methods, the 25-item scale was administered to Persian speakers with diabetes. The scale was evaluated for content validity, construct validity and reliability.ResultsParticipants were 268 patients with diabetes with mean age of 63.19 ± 16.61 years. The mean HDFQ score was 17.31 ± 5.11 (in the low range). Higher scores were associated with younger age, younger age of diabetes onset, higher education, higher employment position, family history of diabetes and hypertension, shorter diabetes duration, and adherence to home exercise regimens. Kuder–Richardson's reliability coefficient was good, i.e., 0.82. Confirmatory factor analysis showed that the factor loadings of all questions, except question number 25, were favorable, i.e., >0.3. Model fit indices were favorable: Chi-square statistic to degree of freedom ratio (χ²?df) = 1.82, Comparative fit index = 0.96, Tucker-Lewis Index = 0.96 and root mean square error = 0.06.ConclusionAfter removing item #25, the Persian heart disease fact questionnaire has good validity and reliability and can be used to inform and evaluate clinical and public health educational programs aimed at decreasing risk for heart disease among Persian speakers with diabetes.