1
|
Lemke S, de Andrade DF, de Fragas Hinnig P, da Silva SA, Vincenzi SL, Roberto DMT, Lobo AS, Vieira FGK, Di Pietro PF, de Assis MAA. Development and application of the Meal and Snack Assessment (MESA) quality scale for children and adolescents using item response theory. Nutr J 2024; 23:50. [PMID: 38745270 PMCID: PMC11092231 DOI: 10.1186/s12937-024-00948-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 04/10/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND Meals differ in terms of food items and nutritional quality. The aim of the present study was to propose a scale to measure the meals quality of schoolchildren according to food processing degree, perform a preliminary evaluation of the scale's validity and reliability and apply the scale to a representative sample of schoolchildren in a city in southern Brazil. METHODS A methodological study based on the generalized graded unfolding model (GGUM) of item response theory (IRT) with analysis of secondary data was carried out in 6,399 schoolchildren of 6-15y-old attending 2nd to 5th grades of public elementary schools in Florianópolis, Brazil, in 2013-2015 who answered the validated Food Intake and Physical Activities of Schoolchildren (WebCAAFE) questionnaire. Meal quality was the latent trait. The steps for the development of the scale included: latent trait definition; item generation; dimensionality analysis; estimation of item parameters; scale levels definition; assessment of validity and reliability; and assessment of the meal quality of a subsample of schoolchildren aged 7 to 12 years (n = 6,372). RESULTS Eleven out of eighteen items had adequate parameters, without differential item functioning for sex or age. Meal quality was categorized into three levels: healthy, mixed, and unhealthy. Higher scores indicate a greater prevalence of ultra-processed foods in daily meals. Most schoolchildren had mixed (40.6%) and unhealthy (41%) meal patterns. CONCLUSIONS IRT analysis allowed the development of the scale, which measures the quality of meals and snacks based on the degree of food processing. At all snack times, there was a higher frequency of ultra-processed foods consumption, therefore foods consumed as snacks are a potential focus for nutritional interventions.
Collapse
Affiliation(s)
- Stella Lemke
- Nutrition Postgraduate Program, Department of Nutrition, Health Sciences Center, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Dalton Francisco de Andrade
- Informatics and Statistics Department, Technological Center, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Patrícia de Fragas Hinnig
- Nutrition Postgraduate Program, Department of Nutrition, Health Sciences Center, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Silvio Aparecido da Silva
- Knowledge Management Department, Federal Institute of Education, Science and Technology of Santa Catarina, Florianópolis, Brazil
| | - Silvana Ligia Vincenzi
- Informatics and Statistics Department, Technological Center, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Denise Miguel Teixeira Roberto
- Nutrition Postgraduate Program, Department of Nutrition, Health Sciences Center, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Adriana Soares Lobo
- Nutrition Postgraduate Program, Department of Nutrition, Health Sciences Center, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Francilene Gracieli Kunradi Vieira
- Nutrition Postgraduate Program, Department of Nutrition, Health Sciences Center, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Patricia Faria Di Pietro
- Nutrition Postgraduate Program, Department of Nutrition, Health Sciences Center, Federal University of Santa Catarina, Florianópolis, Brazil.
- Federal University of Santa Catarina, Campus Trindade, Florianópolis, Santa Catarina, 88040-370, Brazil.
| | - Maria Alice Altenburg de Assis
- Nutrition Postgraduate Program, Department of Nutrition, Health Sciences Center, Federal University of Santa Catarina, Florianópolis, Brazil
| |
Collapse
|
2
|
Silveira VNDC, França AKTDC, Campelo CL, Machado PMA, dos Santos AM. Proposition of an Energy Intake Estimating Scale through Item Response Theory. Nutrients 2023; 15:4511. [PMID: 37960164 PMCID: PMC10650126 DOI: 10.3390/nu15214511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 10/10/2023] [Accepted: 10/14/2023] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND Traditional methods for assessing individual energy consumption often involve lengthy and intricate procedures. This study aims to introduce an Energy Consumption Estimation Scale, utilizing Item Response Theory (IRT) for adolescents aged 18-19 years. METHODS This psychometric investigation applies IRT to 93 items extracted from a validated food frequency questionnaire. The study encompasses a representative sample of 2515 adolescents from the São Luís birth cohort in Brazil. The latent trait, energy intake, is derived using IRT and subsequently validated through hierarchical multiple linear regression modeling. Significance was established at p < 0.05. RESULTS A Samejima's model was successfully fitted (CFI and TLI > 0.9 and RMSEA < 0.08), effectively capturing variations across all energy consumption levels. Factors associated with the latent trait demonstrate consistent behavioral patterns. Adolescents with higher energy intake exhibited increased consumption of dairy products, artificially sweetened beverages, and seasonal fruits and vegetables. CONCLUSIONS The proposed Energy Consumption Estimation Scale demonstrates a reliable measurement of energy intake and serves as a practical and concise alternative for assessing energy consumption among adolescents. These findings suggest the potential for adapting similar models for different age groups and incorporating diverse food items based on the obtained results.
Collapse
Affiliation(s)
- Victor Nogueira da Cruz Silveira
- Postgraduate Programme in Collective Health, Federal University of Maranhão, São Luís 65020-070, Brazil; (A.K.T.d.C.F.); (A.M.d.S.)
| | | | - Cleber Lopes Campelo
- Higher School of Health Sciences—Bachelor of Nursing, State University of Amazonas, Nurse at Brazilian Hospital Services Company (EBSERH), Manaus 69850-000, Brazil;
| | | | - Alcione Miranda dos Santos
- Postgraduate Programme in Collective Health, Federal University of Maranhão, São Luís 65020-070, Brazil; (A.K.T.d.C.F.); (A.M.d.S.)
| |
Collapse
|
3
|
Sosanya ME, Beamon I, Muhammad R, Freeland-Graves JH. Development and validation of the Teen Moms Child Feeding Questionnaire for Sub-Saharan Africa. BMC Public Health 2023; 23:1487. [PMID: 37542311 PMCID: PMC10401754 DOI: 10.1186/s12889-023-16365-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 07/21/2023] [Indexed: 08/06/2023] Open
Abstract
BACKGROUND In Sub-Saharan Africa, the nutritional status of children born to teenage mothers deserves critical attention. Maternal knowledge and attitudes concerning infant and young child feeding (IYCF) may predict actual practices and child nutritional status. This study created and validated the Teen Moms Child Feeding Questionnaire for Sub-Saharan Africa. METHODS A literature search on IYCF knowledge and attitude gaps in teenage mothers generated scale items. Ten nutrition experts and six teenage mothers assessed content validity and comprehensibility, respectively. Construct validation was conducted by item response theory (IRT) and confirmatory factor analysis (CFA), in 150 teenage mothers in rural communities of Abuja, Nigeria. Model fit parameters were estimated by standardized chi-square tests. Internal consistency reliability was determined by marginal reliability and Cronbach's alpha. In a sub-sample of 40 women who completed the questionnaire two weeks later, test-retest reliability was assessed via intraclass correlations. RESULTS The IRT analysis retained 23 knowledge items on infant food type, breastfeeding and complementary feeding, with acceptable discrimination and difficulty. CFA produced a six-factor solution (exclusive breastfeeding, breast milk expression, meal frequency, responsive feeding, dietary diversity, and barriers) with 17 attitude items. Confirmatory fit and Tucker Lewis indices > 0.9; Root Mean Square Errors of Approximation and Standardized Root Mean Square Residuals < 0.08, showed good model fit. Overall Cronbach's alpha of the attitude scale (0.843), subscales (≥ 0.6) and high intraclass correlation coefficients (> 0.75) indicated reliability. CONCLUSION The Teen Moms Child Feeding Questionnaire for Sub-Saharan Africa is a valid assessment tool for IYCF knowledge and attitudes of teenage mothers.
Collapse
Affiliation(s)
- Mercy E Sosanya
- Department of Nutritional Sciences, University of Texas at Austin, Austin, USA.
- Department of Nutrition and Dietetics, The Federal Polytechnic, Bauchi, Bauchi, Nigeria.
| | - Isaiah Beamon
- Department of Nutritional Sciences, University of Texas at Austin, Austin, USA
| | - Raza Muhammad
- Department of Nutritional Sciences, University of Texas at Austin, Austin, USA
| | | |
Collapse
|
4
|
Wang Y, Jia Q, Wang H, Zou K, Li L, Yu B, Wang L, Wang Y. Revised Chinese resident health literacy scale for the older adults in China: simplified version and initial validity testing. Front Public Health 2023; 11:1147862. [PMID: 37265518 PMCID: PMC10231683 DOI: 10.3389/fpubh.2023.1147862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 04/10/2023] [Indexed: 06/03/2023] Open
Abstract
Objective This study aimed to develop a short version of the Chinese Resident Health Literacy Scale focused on older adults in China, and further assess the reliability and validity of this short version. Methods The data was from a cross-sectional community-based older adults health survey conducted in 2020. The total of 5,829 older adults were randomly divided into two parts using for the simplification and assessment of the scale, respectively. Item Response Theory (IRT) and Differential Item Functioning (DIF) were used for item analysis and scale simplification. Cronbach's alpha and McDonald's omega were used to assess the reliability and three factors Confirmatory Factor Analysis (CFA) was used to assess the validity, which were compared to the original version. Moreover, Multi-group Confirmatory Factor Analysis (MCFA) was used to test the model invariance of the short version across groups of gender, age groups, level of education, and cognitive status. Results The simplified version consisted of 27 items taken from 50 original items, of them 11 items from the dimension of knowledge and attitudes, 9 items from the dimension of behavior and lifestyle, and 7 items from the dimension of health-related skills. The overall Cronbach's alpha and McDonald's omega were both 0.87 (95%CI: 0.86-0.88). The goodness-of-fits of CFA in simplified version were still acceptable in CFI, TLI, GFI, and RMSEA, even improved in CFI, TLI, and GFI compared to those of original version. Also, the model was stable and invariant in MCFA across gender, cognitive status, and educational level groups. Conclusion In this study, we formed a simplified instrument for measuring health literacy focused on older adults in China. This short version might be more suitable for the priority recommendation in extended tracking of the dynamic changes on the levels of health literacy in the whole life cycle in public health settings. Further research might be to identify the cut-off values to distinguish the older adults with different levels of health literacy.
Collapse
|
5
|
Oliveira GAL, Saldanha MP, Araújo GS, Barrio DOL, Gubert MB, Toral N. Validation of the illustrated questionnaire on eating and sedentary behaviors (QUICAS) for seven to ten-year-old children. Appetite 2023; 180:106359. [PMID: 36332848 DOI: 10.1016/j.appet.2022.106359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 10/20/2022] [Accepted: 10/26/2022] [Indexed: 11/09/2022]
Abstract
The Illustrated Questionnaire on Eating and Sedentary Behaviors (QUICAS) was developed and validated for schoolchildren seven to ten years old. It used previous day recall and was illustrated with ten eating behaviors (referring to the act of eating without distractions, with company, on a regular basis, the type of food eaten, and participation in tasks involved in meal preparation) and five sedentary behaviors (related to the use of television, computer, tablet, cell phone, and video game). The instrument was validated in four stages: (1) Its content was developed based on literature review and expert evaluation; (2) Items were validated by comparing the responses of children and their parents, through a questionnaire on Google Forms. At this stage, a convenience sample was adopted, consisting of 145 parent-child dyads. High sensitivity (average of 90.7%); high specificity (mean of 87.9%); low number of false positives (mean of 12.1%); low number of false negatives (mean of 9.3%); almost perfect agreement between the child's and the parent's reports (k = 0.81); and low disagreement (≤22%) were found. In addition, the child's gender and age did not significantly influence the child's report. (3) The illustrations were validated in a focus group with 18 children, who satisfactorily described all the eating and sedentary behaviors of the illustrations. (4) In the pretest of the questionnaire on Google Forms, with the participation of 15 children, the majority (86.7%) judged the questionnaire as excellent or good. Therefore, the QUICAS is valid to assess eating and sedentary behaviors in schoolchildren seven to ten years old.
Collapse
Affiliation(s)
- Giovanna Angela Leonel Oliveira
- University of Brasilia, Faculty of Health Science, Postgraduate Program in Human Nutrition, Center for Epidemiological Studies in Health and Nutrition - NESNUT, Brasilia, Distrito Federal, Campus Universitário Darcy Ribeiro, Asa Norte, CEP: 70910-900, Brazil.
| | - Marina Pimentel Saldanha
- University of Brasilia, Faculty of Health Science, Department of Nutrition, Center for Epidemiological Studies in Health and Nutrition - NESNUT, Brasilia, Distrito Federal, Campus Universitário Darcy Ribeiro, Asa Norte, CEP: 70910-900, Brazil.
| | - Giovanna Soutinho Araújo
- University of Brasilia, Faculty of Health Science, Postgraduate Program in Human Nutrition, Center for Epidemiological Studies in Health and Nutrition - NESNUT, Brasilia, Distrito Federal, Campus Universitário Darcy Ribeiro, Asa Norte, CEP: 70910-900, Brazil.
| | - Daniela Oliveira Llorente Barrio
- University of Brasilia, Faculty of Health Science, Department of Nutrition, Center for Epidemiological Studies in Health and Nutrition - NESNUT, Brasilia, Distrito Federal, Campus Universitário Darcy Ribeiro, Asa Norte, CEP: 70910-900, Brazil.
| | - Muriel Bauermann Gubert
- University of Brasilia, Faculty of Health Science, Postgraduate Program in Human Nutrition, Center for Epidemiological Studies in Health and Nutrition - NESNUT, Brasilia, Distrito Federal, Campus Universitário Darcy Ribeiro, Asa Norte, CEP: 70910-900, Brazil.
| | - Natacha Toral
- University of Brasilia, Faculty of Health Science, Postgraduate Program in Human Nutrition, Center for Epidemiological Studies in Health and Nutrition - NESNUT, Brasilia, Distrito Federal, Campus Universitário Darcy Ribeiro, Asa Norte, CEP: 70910-900, Brazil.
| |
Collapse
|
6
|
Roberto DMT, Kupek E, Assis MAA, Lobo AS, Belchor ALL, Spanholi MW, Cezimbra VG, Oliveira MT, Pereira LJ, Vieira FGK, Hinnig PDF. Most meal and snack patterns are stable over a 3‐year period in schoolchildren in southern Brazil. NUTR BULL 2022; 47:79-92. [DOI: 10.1111/nbu.12541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 01/05/2022] [Accepted: 01/06/2022] [Indexed: 11/30/2022]
Affiliation(s)
| | - Emil Kupek
- Department of Public Health Center for Health Sciences Federal University of Santa Catarina Florianópolis Brazil
| | | | - Adriana Soares Lobo
- Center for Health Sciences Federal University of Santa Catarina Florianópolis Brazil
| | - Ana Luisa Lages Belchor
- Department of Public Health Center for Health Sciences Federal University of Santa Catarina Florianópolis Brazil
| | | | - Vanessa Guimarães Cezimbra
- Department of Public Health Center for Health Sciences Federal University of Santa Catarina Florianópolis Brazil
| | | | | | | | | |
Collapse
|