Reproducibility and validity of the secondary level School-Based Nutrition Monitoring student questionnaire

https://doi.org/10.1053/jada.2003.50031Get rights and content

Abstract

Objective To evaluate the reproducibility and validity of the School-Based Nutrition Monitoring (SBNM) secondary level student questionnaire. Design Reproducibility was evaluated using a test-retest study design by administering the questionnaire on the same day (morning and afternoon, n=254) and, when appropriate, 9 to 14 days apart (n=259). Validity was assessed by comparing foods selected on the questionnaire with foods reported from a single 24-hour recall covering the same referent period (yesterday) in 209 students. Subjects/setting Eighth grade students in middle schools from central Texas were used: male and female, approximately 75% white, for the reproducibility study, with 15% Hispanic, 6% African American; for the validation study, approximately 38% white, 41% Hispanic, and 17% African American. Statistical analysis Spearman rank order correlation, κ statistic, and percentage agreement were used for both reproducibility and the validation. Results For the reproducibility study, agreement for questions about food intake ″yesterday” were 70% to 98%, with κ statistics ranging from 0.54 to 0.93 and correlations between 0.66 and 0.97. Questions on recent physical activity had high agreement (66% to 89%) as did ″usual” physical activity items, weight loss, and food selection behaviors. Nutrition knowledge items showed relatively weaker reliability: agreements ranged from 47% to 92%, with κ statistics between 0.30 and 0.56. Attitude questions had weaker agreement (50% to 87%), κ statistics (0.27 to 0.52), and correlations (0.33 to 0.63). For the validation study, correlation coefficients ranged from 0.32 for breads to 0.68 for milk and beans. Percentage agreement ranged from 38% for breads to 89% for gravy. Applications/conclusions Most questions on the SBNM secondary questionnaire were found to have acceptable reproducibility, whereas validation of food choice behaviors showed results similar to or better than other dietary assessment instruments for this age group. This questionnaire is a useful epidemiologic tool for surveillance, assessing broad intervention effects among groups or providing needs assessment data on selected nutrition and physical activity-related constructs. J Am Diet Assoc. 2003;103:186-194.

Section snippets

Instrument development

The development of the survey was an iterative process [11], [12] that included the following: needs assessment; development of a Rationale, Goals, and Scope statement; development of questionnaire items; review by an expert panel; focus group testing; and cognitive interview testing of questionnaire items. The initial needs assessment data were collected by an interagency work group assembled by the two lead agencies: the CDC and the USDA. The University of Texas-Houston investigators

Reproducibility

A demographic profile of the students who participated in the reproducibility test is shown in Table 2.Approximately three-fourths of the students were white, although there was also significant Hispanic student representation.

Reproducibility data for each of the survey questions are listed in Table 3. No significant gender differences were detected for any survey questions in terms of reproducibility (data not shown), so only overall data are presented. Agreement for questions on food or meal

Discussion

Overall, the reproducibility of most items on the SBNM secondary questionnaire was found to be similar to that of other questionnaires for school-aged children [3], [4], [6]. For example, questions on weight behaviors from the YRBS questionnaire have been found to have κ statistic values of 67.2% or higher in students in grades 7 to 12 ((3)). Reproducibility of ″usual” food behavior and physical activity questions was, in general, acceptable but not as high or consistent as those obtained for

Applications

  • The School-Based Nutrition Monitoring (SBNM) questionnaires are brief assessments of nutrition and physical activity that can be used at the state and local level. These questionnaires are useful epidemiologic tools for monitoring group trends in selected nutrition and physical activity-related behaviors (Table 1), assessing the effects of nutrition-related interventions or providing information for needs assessments among school-aged students. These instruments are relatively inexpensive and

Acknowledgements

The authors thank Sarah Kuester, Jill Randell, and Jay Hirschmann for their contributions to the project, as well as the schools and students from Austin Independent School District in Austin, Tex; Goliad Independent School District in Goliad, Tex; Round Rock Independent School District, Round Rock, Tex; Lake Travis Independent School District, Austin, Tex; and Houston Independent School District, Houston, Tex. We also thank Jennifer Richardson for technical assistance with preparation of this

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