Validation of the General Nutrition Knowledge Questionnaire in an Australian community sample

Aim:  To validate the General Nutrition Knowledge Questionnaire developed by Parmenter and Wardle (1999) in an Australian community sample. This questionnaire differs from previous assessments of knowledge because it incorporates a broad range of nutrition concepts, including knowledge of dietary recommendations, healthy food choices, nutrient sources and some diet–disease relationships.
Methods:  The original questionnaire was developed in the UK, and thus modified to suit the current Dietary Guidelines for Australians and current public health nutrition recommendations. A total of 156 people, of which 116 were community members, completed the questionnaire (113 items). As an indication of concurrent validity, a subsample of nutrition and dietetic students were included (n = 40). As a measure of test–retest reliability, a subsample (n = 57), including students and community members, answered the questionnaire on two occasions, two weeks apart.
Results:  Both overall internal reliability of the questionnaire items (Cronbach's alpha = 0.92) and test–retest reliability (r = 0.87) were high. The nutrition and dietetic students, hypothesised to have higher knowledge levels, scored consistently higher than the general community sample, indicating good concurrent validity.
Conclusion:  A test of a modified version of the General Nutrition Knowledge Questionnaire found it to be a valid and reliable measure of nutrition knowledge, appropriate for use in a section of the Australian community. The validated tool may be used in the future for the comprehensive assessment of general nutrition knowledge; however, further testing in differing sections of Australian society may be warranted.     

Validation of a Youth/Adolescent Food Frequency Questionnaire

Background.To address limited longitudinal nutrition data on children and adolescents, a self-administered food frequency questionnaire was designed for older children and adolescents. Initially, the Youth/Adolescent Questionnaire (YAQ) was developed and demonstrated to be reproducible. This study was conducted to evaluate its validity.Methods.The form was administered twice to a sample of 261 youths (ages 9 to 18) at an approximate interval of 1 year (1993–1994), and three 24-hr dietary recalls were collected during this period. Pearson correlation coefficients were calculated on nutrient data.Results.Validity was first evaluated by comparing the average of the three 24-hr recalls to the average of the two YAQs. Similar mean nutrients were found by both methods. Correlation coefficients between the mean energy-adjusted nutrients computed by the two methods ranged from 0.21 for sodium to 0.58 for folate. After correction for within-person error, the average correlation coefficient was 0.54, similar to that found among adults.Conclusion.A simple self-administered questionnaire completed by older children and adolescents can provide nutritional information about this age group.     

Validation of the General and Sport Nutrition Knowledge Questionnaire (GeSNK) in Spanish Adolescents

The General and Sport Nutrition Knowledge Questionnaire (GeSNK) is an instrument that has been developed and validated to assess the level of nutrition knowledge in adolescents and young adults. The aim of the present study was to validate the GeSNK questionnaire in a group of Spanish adolescents in the framework of a Nutrition Education Programme in Secondary Schools in Andalusia, Spain. This cross-sectional questionnaire validation study was developed in two phases: translation-cultural adaptation and validation. A total of 305 adolescents aged 11 to 17 years, studying from the first to the third year of compulsory secondary education, participated on a voluntary basis. The GeSNK questionnaire consists of 62 items: 29 items for the General Nutrition section and 33 items for the Sports Nutrition section. Cronbach’s alpha coefficient for the complete questionnaire (GeSNK Total) was: 0.934; for the GeSNK General Nutrition section it was 0.918; and for the GeSNK Sports Nutrition section it was 0.856. The stability measured by the correlation coefficient for the General Nutrition section was 0.406 (p = 0.000); for the Sports Nutrition section it was 0.198 (p = 0.017); and for GeSNK Total the stability was 0.545 (p = 0.000). The questionnaire also demonstrated adequate construct validity. We therefore conclude that the Spanish version of the GeSNK questionnaire is a valid instrument to measure the level of knowledge in general nutrition and sports nutrition in adolescents.     

Development and Validation of a Food and Nutrition Literacy Questionnaire for Chinese Adults

The purpose of this study aimed to develop and validate the Food and Nutrition Literacy Questionnaire for Chinese adults (FNLQ). The dimensions and core components of Food and Nutrition Literacy were constructed though literature review and qualitative consensus study. A cross-sectional survey of 8510 participants was conducted. The reliability of the questionnaire was determined by internal consistency, the construct validity was assessed by exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), and the content validity was assessed by the Pearson correlation coefficient. From the literature review and qualitative methods, 20 core components and 50 questions of the FNLQ were developed, including 1 dimension of knowledge and 3 practice dimensions (ability of selection, preparing food and eating). The overall FNLQ questionnaire had good reliability and validity (Cronbach’s α = 0.893, χ2/DF = 4.750, RMSEA = 0.048, GFI = 0.891 and AGFI = 0.876). The average FNLQ score of all participants was (64.08 ± 12.77), and the score for the knowledge and understanding dimension was higher than that for the practice dimensions. In addition, 80 was set as the nutritional literacy threshold, and only 12.2% met this threshold in this survey. Sociodemographic and health status characteristics were predictors of FNLQ (R² = 0.287, F = 244.132, p < 0.01). In conclusion, the FNLQ built in this study had good validity and reliability. It could be considered as a reliable tool to assess Food and Nutrition Literacy of Chinese adults.     

Adaptation and Validation of a Questionnaire to Evaluate Knowledge of the Low Phe Diet in PKU

Phenylketonuria (PKU) is an autosomal recessive disorder of phenylalanine (Phe) metabolism, causing a build-up of Phe in the body. Treatment consists of a Phe-restricted diet for life and regular determination of blood Phe levels to monitor the intake of Phe. Despite the fact that diet is the cornerstone of treatment, there are no studies examining common knowledge about food items and whether they are allowed as part of the PKU diet. Improving parents’ and patients’ knowledge and competence about the diet enables them to make appropriate food choices. This study validates a food-knowledge questionnaire first developed in Spanish and modified for English speaking populations. The questionnaire potentially helps parents to prepare appropriate meals and healthcare providers to create individualized educational programs about PKU for children and adolescents with this disorder.     

Development and Validity of a General Nutrition Knowledge Questionnaire (GNKQ) for Chinese Adults

Nutrition knowledge refers to understanding concepts and processes related to nutrition and health, proven to be an essential determinant of healthy eating. However, partially due to the lack of nutrition knowledge and unhealthy eating patterns, more and more Chinese people face overweight, obesity, and a high risk of suffering from various chronic diseases. This study aimed to develop a general nutritional knowledge questionnaire (GNKQ) in a Chinese context to diagnose and improve nutrition knowledge education for Chinese people. The newly adapted questionnaire was based on the Turkey version of GNKQ, and absorbed dietary recommendations in a Chinese context. It was first validated by four nutrition experts, then tested by eleven volunteers (one public nutritionist, one preventive medicine graduate student, and nine psychology graduate students). Finally, the questionnaire was tested by 278 participants, including 175 adults, to determine internal consistency, content validity, and convergent validity. Moreover, the construct validity was evaluated by comparing the differences between 50 students in nutrition-related majors and 53 students in nutrition-unrelated majors. The final Chinese version of GNKQ kept 32 questions with 68 items after deleting some questions based on item difficulty and discrimination. The data showed that the overall internal consistency coefficient was 0.885, and the test-retest reliability was 0.769, p < 0.001. Students majoring in nutrition had larger scores than in nutrition-unrelated majors. The convergent validity for each demographic variable was consistent with previous studies, such as larger nutrition knowledge scores for females and those with a higher education. Therefore, the revised Chinese version of GNKQ showed good reliability and validity, indicating that it could be an effective tool to assess the nutrition knowledge of Chinese adults.     

Development and Validation of Nutrition Literacy Questionnaire for the Chinese Elderly

(1) Background: Improving nutrition literacy is crucial for maintaining a healthier state of the elderly to achieve healthy ageing. Therefore, it is necessary to develop a Nutrition Literacy Questionnaire for the Chinese Elderly (NLQ-E). (2) Methods: an NLQ-E was developed according to the core components of nutrition literacy for the elderly. Internal consistency, exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to validate the reliability and validity of the NLQ-E. A cross-sectional study of 1490 elderly people was used to analyze the application of the NLQ-E. (3) Results: The NLQ-E was constructed with 3 domains (knowledge and understanding, healthy lifestyle and dietary behavior and skill), with a total of 25 questions. The overall NLQ-E had acceptable reliability and validity (Cronbach’s α = 0.678, χ²/DF = 4.750, RMSEA = 0.045, PCFI = 0.776 and PNFI = 0.759). The average nutrition literacy score of the subjects in this cross-sectional study was 65.95 (65.95 ± 10.93). The OR between the nutrition literacy score and multimorbidity was 0.965 (95% CI: 0.954, 0.976); (4) Conclusions: We developed and validated the NLQ-E and found that the nutrition literacy level of the Chinese elderly was generally low. This study is of great value to improve the nutrition literacy of the elderly and effectively prevent nutrition-related chronic diseases and multimorbidity.     

Validity and Reliability of a Nutrition Knowledge Questionnaire in an Adult Student Population

Objective

To assess the validity and reliability of the Kuwait Adult Nutrition Knowledge Questionnaire (KANKQ) in adult students as an initial step to validation in the general adult population.

Development and Validation of a Short Sport Nutrition Knowledge Questionnaire for Athletes

Weak evidence exists on the relationship between nutritional knowledge and diet quality. Many researchers claim that this could be in part because of inadequate validation of the questionnaires used. The aim of this study was to develop a compact reliable questionnaire on nutrition knowledge for young and adult athletes (NUKYA). Researchers and the sport clubs medical staff developed the questionnaire by taking into consideration the latest athlete dietary guidelines. The questionnaire content was validated by a panel of 12 nutrition experts, and finally tested by 445 participants including athletes (n = 264), nutrition students (n = 49) and non-athletes with no formal nutrition knowledge (n = 132). After consulting the experts, 59 of the 64 initial items remained in the questionnaire. To collect the evaluation of experts, we used the content validity index, obtaining high indices for relevance and ambiguity (0.99) as well as for clarity and simplicity (0.98). The final questionnaire included 24 questions with 59 items. We ensured construct validity and reliability through psychometric validation based on the Classical Test Theory and the Item–Response Theory (Rasch model). We found significant statistical differences comparing the groups of nutrition knowledgeable participants with the rest of the groups (ANOVA p < 0.001). We verified the questionnaire for test–retest reliability (R = 0.895, p < 0.001) and internal consistency (Cronbach’s α=0.849). We successfully fit the questionnaire data to a rating scale model (global separation reliability of 0.861) and examined discrimination and difficulty indices for items. Finally, we validated the NUKYA questionnaire as an effective tool to appraise nutrition knowledge in athletes. This questionnaire can be used for guiding in educational interventions, studying the influence of nutrition knowledge on nutrient intake and assessing/monitoring sport nutritional knowledge in large groups.     

Nutrition knowledge assessed by a structured questionnaire in a group of medical in-patients

A short questionnaire to test understanding of the principles of nutrition was designed and administered to 128 patients in a general medical ward.
The questionnaire was based on three components: familiarity with nutrition terms, knowledge of the principles of current recommendations, and understanding of the practical application of these recommendations. Although scores for each of the three components of nutrition knowledge correlated strongly with the overall understanding of individuals, there was rather poor correlation between the components, the lowest correlation being between knowledge of theoretical principles and understanding of the practical measures needed to implement current recommendations.
Compared with the remainder of the sample, significantly better total scores were recorded by subjects in the age group 20–39 and significantly worse in the age group 60–79. Significantly better scores were also found in subjects who had received dietary advice from a dietitian.     

Content Validation of a Chrononutrition Questionnaire for the General and Shift Work Populations: A Delphi Study

Unusual meal timing has been associated with a higher prevalence of chronic disease. Those at greater risk include shift workers and evening chronotypes. This study aimed to validate the content of a Chrononutrition Questionnaire for shift and non-shift workers to identify temporal patterns of eating in relation to chronotype. Content validity was determined using a Delphi study of three rounds. Experts rated the relevance of, and provided feedback on, 46 items across seven outcomes: meal regularity, times of first eating occasion, last eating occasion, largest meal, main meals/snacks, wake, and sleep, which were edited in response. Items with greater than 70% consensus of relevance were accepted. Rounds one, two, and three had 28, 26, and 24 experts, respectively. Across three rounds, no outcomes were irrelevant, but seven were merged into three for ease of usage, and two sections were added for experts to rate and comment on. In the final round, all but one of 29 items achieved greater than 70% consensus of relevance with no further changes. The Chrononutrition Questionnaire was deemed relevant to experts in circadian biology and chrononutrition, and could represent a convenient tool to assess temporal patterns of eating in relation to chronotype in future studies.     

Nutrition Knowledge and Dietary Intake of Adolescents in Cofimvaba,Eastern Cape,South Africa

The aim of the study was to assess the nutrition knowledge, nutrient intakes, and association between nutrition knowledge and dietary intakes of 98 adolescents attending five schools in rural Cofimvaba, South Africa. Measures included a socioeconomic questionnaire, two 24-hour-recall questionnaires, and food-frequency and nutrition knowledge questionnaires. The overall score for the multiple-choice section on general nutrition and the South African Food-Based Dietary Guidelines was 72.9%; 75.4% for correct identification of food groups; and 41.3% for correct identification of food portions/serving sizes. Median nutrient intakes, measured by 24-hour recall, failed to meet average requirements, with the exception of protein, carbohydrates, chromium, riboflavin, pantothenate, and vitamin K among girls. A similar trend was observed for boys. Lower total carbohydrate and fat and higher protein intakes were associated with a higher quartile score for nutrition knowledge. The study provided a valuable understanding of the association between nutrition knowledge and dietary intakes of adolescents.     

Exploring Sports Nutrition Knowledge in Elite Gaelic Footballers

Nutrition intake plays a crucial role in improving athletic performance, enhancing adaptations to training, and augmenting recovery from exercise. However, research has reported that Gaelic footballers consistently fail to meet energy and carbohydrate recommendations. Sports nutrition knowledge (SNK) can influence the dietary intake of athletes, and therefore has the potential to have a significant impact on athletic performance. The aim of this study was to investigate the current level of SNK in elite Gaelic footballers (n = 100). An online version of the Nutrition for Sport Knowledge Questionnaire (NSKQ) was used to assess sports SNK. The overall mean SNK scores for Gaelic footballers and practitioners were 47.6 ± 12.3% and 78.1 ± 8.3%, respectively. There were no differences in knowledge between age groups, education level or divisional status. The top three sources of nutrition information identified by participants were team dietitian/nutritionists (84.0%), athletic trainers/strength and conditioning coaches (73%), and social media (37%). The results show that there is a major gap in the SNK of Gaelic footballers, while practitioners demonstrated a promising SNK, that could support Gaelic footballers. There is a need for development of interventions and knowledge transfer partnerships, including more effective methods of educating Gaelic footballers and translating sports nutrition principles to players. Developing appropriate nutritional education strategies using online resources and mobile applications could help to improve nutritional knowledge and practice of Gaelic footballers.     

Validation and reproducibility of an Australian caffeine food frequency questionnaire

The aim of this study was to measure validity and reproducibility of a caffeine food frequency questionnaire (C-FFQ) developed for the Australian population. The C-FFQ was designed to assess average daily caffeine consumption using four categories of food and beverages including; energy drinks; soft drinks/soda; coffee and tea and chocolate (food and drink). Participants completed a seven-day food diary immediately followed by the C-FFQ on two consecutive days. The questionnaire was first piloted in 20 adults, and then, a validity/reproducibility study was conducted (n?=?90 adults). The C-FFQ showed moderate correlations (r?=?.60), fair agreement (mean difference 63?mg) and reasonable quintile rankings indicating fair to moderate agreement with the seven-day food diary. To test reproducibility, the C-FFQ was compared to itself and showed strong correlations (r?=?.90), good quintile rankings and strong kappa values (κ?=?0.65), indicating strong reproducibility. The C-FFQ shows adequate validity and reproducibility and will aid researchers in Australia to quantify caffeine consumption.     

Repeatability and Validation of a Short,Semi-Quantitative Food Frequency Questionnaire Designed for Older Adults Living in Mediterranean Areas: The MEDIS-FFQ

The aim of the present work was to evaluate the repeatability and the validity of a short food frequency questionnaire (FFQ) that could be used for older people living in Mediterranean areas. The semi-quantitative FFQ included questions regarding the frequency of consumption of the main food groups and beverages typically consumed in the Mediterranean areas as well as some questions regarding eating habits of older persons. During 2006–2007, for the repeatability assessment (within 10–30 days), 150 individuals (51 ± 17 yrs, 40% males) were studied, while another 190 individuals (74 ± 9 yrs, 52% males) were enrolled for the validation purposes. Agreement of the FFQ with the 3-day food records was evaluated using the Bland–Altman method and the Kendall's tau-b coefficient. Repeatability was tested using the Cohen's kappa coefficient. Between 3-day food records and the FFQ, good agreement for alcohol (tau-b = 0.64, p < 0.001) was found, while moderate agreement for food and beverage groups of greens (tau-b = 0.32, p < 0.001), fruits (tau-b = 0.35, p < 0.001), cereals (tau-b = 0.61, p < 0.001), sweets (tau-b = 0.51, p < 0.001), and coffee (tau-b = 0.58, p < 0.001) was observed. Low, but still significant, agreement for fish (tau-b = 0.21, p = 0.001), legumes (tau-b = 0.23, p < 0.001), vegetables (tau-b = 0.23, p < 0.001), pasta (tau-b = 0.25, p < 0.001), potatoes (tau-b = 0.17, p = 0.006) and meat consumption (tau-b = 0.14, p < 0.001) were also found. The FFQ was also valid regarding the estimation of macronutrients and energy intake. Sensitivity analyses by sex, age category (≤ or > 75 yrs), and education status showed similar validity of the FFQ in each subgroup, except for elders older than 75 years. The repeatability of the FFQ was fair in all foods tested (Cohen's kappa coefficients varied between 0.15–0.39, p-values < 0.05). The suggested FFQ seems to be a reasonably valid and repeatable measure of dietary intake and can be used in older persons living in the Mediterranean areas.     

Studying a Population Undergoing Nutrition Transition: A Practical Case Study of Dietary Assessment in Urban South African Adolescents

The South African Medical Research Council food frequency questionnaire (FFQ) and protocol was used to determine food intake in 83 adolescents from the Birth To Twenty study. The FFQ was piloted on a small group (n = 8). Specific problems which resulted in overestimation of energy intake were identified. The protocol was modified and administered to the remainder of the adolescents and their caregivers. Reasonable energy intakes were obtained, and time spent completing the FFQ was reduced. The modified protocol was more successful in determining habitual food intake although it would benefit from validation against other dietary intake techniques.     

Validation of Occupational Zoonotic Disease Questionnaire Using Fuzzy Delphi Method

ABSTRACT

Objective: The Fuzzy Delphi Method (FDM) is one of the phases in Design and Development Research (DDR). It is a systematic method for tool development and validation. This article aims to validate an occupational zoonotic disease questionnaire using this technique. DDR is applied going through phase 1 (needs analysis), phase 2 (development and design), and phase 3 (usability).

Method: In phase 1, information about safe work practices and occupational zoonotic exposure was obtained from discussions to verify predetermined domains as stated in The National Park Service survey on zoonotic disease exposure and risk. In phase 2, agreement from 14 experts about the domains was obtained using the FDM. In phase 3, a cognitive debriefing was performed to determine its usability for future studies. A total of five superior domains were verified, and their items were adapted. All domains and their items were submitted to experts to obtain consensus agreement.

Results: A total of 31 (96.9%) passed the Triangle of Fuzzy Numbers and Defuzzification process with acceptable consensus agreement (78.8–91.9%) and threshold d value (0.07–0.14). Only four veterinarians were needed for cognitive debriefing to achieve the point of saturation.

Conclusion: FDM in DDR is suitable to be applied by various professions for tool validation, as it is doable and cost and time effective. The Occupational Zoonotic Disease Questionnaire is now ready to be used for future studies in Malaysia.     

The Prader-Willi Syndrome Anxiousness and Distress Behaviors Questionnaire: Development and Psychometric Validation

ObjectivesTo facilitate the development of new therapies for Prader-Willi syndrome (PWS), we sought to develop a reliable and valid assessment of anxiousness and distress, common characteristics that have a significant negative impact on individuals with PWS and their families.MethodsThe PWS Anxiousness and Distress Behaviors Questionnaire (PADQ) was developed with extensive input from clinical experts, as well as caregivers of individuals with PWS, who participated in iterative sets of qualitative interviews. The psychometric properties of the PADQ were subsequently demonstrated in a cross-sectional evaluation using data from the Global PWS Registry provided by > 400 caregivers and confirmed using data from a phase 3 clinical trial of an oxytocin analogue (intranasal carbetocin, LV-101).ResultsQualitative interview participants consistently endorsed the content of the PADQ and were confident they could accurately respond to each item based on their observations of their child’s behavior. Analysis of cross-sectional data supported the computation of a total PADQ score, as well as the reliability and validity of the measure. The results of analyses using longitudinal clinical trial data confirmed these properties and provided evidence for the responsiveness of the PADQ, further supporting its appropriateness for the evaluation of new treatments targeting anxiousness and distress in PWS.ConclusionsThe current body of evidence supports the conclusion that the PADQ measures observable behaviors that are meaningful to patients and their families and provides a valid and reliable method to assess beneficial treatment effects for some of the most challenging behaviors associated with PWS.