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To describe the process of validating a short pictorial diet quality assessment tool to be used with low-income Spanish-speakers.
Latinos are disproportionally affected by nutrition-related conditions. A proportion of Spanish speakers in the US have limited ability to speak English. Linguistically and culturally appropriate evaluation tools are necessary to obtain valid and reliable dietary data from this population. Previous research has shown vegetable variety to be a proxy for diet quality and can serve as an alternative to the more burdensome 24-hour diet recall. A Spanish version of the tool was developed simultaneously with an English version. Bilingual and native Spanish speakers are involved in a multistage, iterative process that include face-validation through cognitive interviews, forward translation, and examination of conceptual consistency by subject-matter experts.
Text and pictures in the tool are examined for clarity, understanding, and relevance through cognitive interviews with a convenience sample of Spanish-speaking parents of 2-5 year old children at three Head Start sites in northern California. The tool is modified after interviewees’ feedback and content fidelity appraisal by experts in the research team. The process is iterated until satisfaction is achieved and no further changes are desirable.
Conclusions and Implications
Linguistic and cultural considerations are part of the process of achieving content and face validity of a short pictorial diet quality assessment tool to be used with low-income Spanish-speakers.