Advertisement

Development and Evaluation of the Infant Feeding Education Questionnaire for the Expanded Food and Nutrition Education Program

Published:October 09, 2019DOI:https://doi.org/10.1016/j.jneb.2019.09.006

      ABSTRACT

      Objective

      Develop and evaluate the Infant Feeding Education Questionnaire (IFEQ) to measure the impact of the Expanded Food and Nutrition Education Program (EFNEP) infant-feeding education on knowledge, attitudes, and behavioral intent.

      Methods

      Evaluation included content validity testing through expert reviews and cognitive interviews with low-income mothers (n = 37); construct validity using the known-groups technique (n = 679); convergent validity testing using the Infant Feeding Practices Study II questionnaire (n = 66); and test-retest reliability (n = 66).

      Results

      The IFEQ had strong construct validity for knowledge and attitudes; IFEQ scores were significantly higher for the high-knowledge/attitude group (29.6 ± 3.08) than the low-knowledge/attitude group (14.5 ± 5.81; P < .001). The IFEQ failed to show convergent validity. The percent agreement between baseline and retest questions was moderate to high, indicating reliability over time.

      Conclusions and Implications

      This study represents the first steps in the development of the IFEQ. There's a need to perform further testing to establish convergent validity and pilot-test the questions following EFNEP infant-feeding education.

      Key Words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic and Personal

      SNEB Member Login

      SNEB Members, full access to the journal is a member benefit. Login via the SNEB Website to access all journal content and features.
      Join SNEB today online

      Subscribe:

      Subscribe to Journal of Nutrition Education and Behavior
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      REFERENCES

        • Rose CM
        • Birch LL
        • Savage JS
        Dietary patterns in infancy are associated with child diet and weight outcomes at 6 years.
        Int J Obes (Lond). 2017; 41: 783-788
        • Gross RS
        • Mendelsohn AL
        • Fierman AH
        • Hauser NR
        • Messito MJ
        Maternal infant feeding behaviors and disparities in early child obesity.
        Child Obes. 2014; 10: 145-152
        • Öhlund I
        • Hernell O
        • Hörnell A
        • Stenlund H
        • Lind T
        BMI at 4 years of age is associated with previous and current protein intake and with paternal BMI.
        Eur J Clin Nutr. 2010; 64: 138-145
        • Goodell LS
        • Wakefield DB
        • Ferris AM
        Rapid weight gain during the first year of life predicts obesity in 2-3 year olds from a low-income, minority population.
        J Community Health. 2009; 34: 370-375
        • Flegal KM
        • Carroll MD
        • Kit BK
        • Ogden CL
        Prevalence of obesity and trends in the distribution of body mass index among US adults, 1999-2010.
        JAMA. 2012; 307: 491-497
        • Finkelstein EA
        • Graham WCK
        • Malhotra R
        Lifetime direct medical costs of childhood obesity.
        Pediatrics. 2014; 133: 854-862
        • Savage JS
        • Birch LL
        • Marini M
        • Anzman-Frasca S
        • Paul IM
        Effect of the INSIGHT responsive parenting intervention on rapid infant weight gain and overweight status at age 1 year: a randomized clinical trial.
        JAMA Pediatr. 2016; 170: 742-749
        • Wen LM
        • Baur LA
        • Simpson JM
        • Rissel C
        • Wardle K
        • Flood VM
        Effectiveness of home based early intervention on children's BMI at age 2: randomised controlled trial.
        BMJ. 2012; 344: e3732
      1. US Department of Agriculture, National Institute of Food and Agriculture. 2016 Impacts: the Expanded Food and Nutrition Education Program (EFNEP).https://nifa.usda.gov/sites/default/files/resource/EFNEP%20Impact%20Data% 20Report%202016%20FINAL.pdf. Accessed February 8, 2019.

      2. US Department of Agriculture, National Institute of Food and Agriculture. Expanded Food and Nutrition Education Program (EFNEP).https://nifa.usda.gov/program/expanded-food-and-nutrition-education-program-efnep. Accessed February 8, 2019.

        • Colorado State Extension
        Eating Smart Being Active.
        2015 (Accessed February 11, 2019)
      3. University of Wyoming Extension. Cent$ible Nutrition Program: Lessons in Action. http://www.uwyo.edu/cnp/. Accessed September 30, 2019.

        • Thompson AL
        • Mendez MA
        • Borja JB
        • Adair LS
        • Zimmer CR
        • Bentley ME
        Development and validation of the Infant Feeding Style Questionnaire.
        Appetite. 2009; 53: 210-221
        • de Lauzon-Guillain B
        • Oliveira A
        • Charles MA
        • et al.
        A review of methods to assess parental feeding practices and preschool children's eating behavior: the need for further development of tools.
        J Acad Nutr Diet. 2012; 112 (, 1602e1-8): 1578-1602
        • Contento IR
        • Randell JS
        • Basch CE
        Review and analysis of evaluation measures used in nutrition education intervention research.
        J Nutr Educ Behav. 2002; 34: 2-25
        • Price LR.
        Psychometric Methods: Theory Into Practice.
        The Guilford Press, New York, NY2016
      4. US Department of Agriculture. Expanded Food and Nutrition Education Program (EFNEP) FY2017 National Reports.https://nifa.usda.gov/sites/default/files/resource/2017_NationalDataReports.pdf. Accessed February 20, 2019.

      5. Mullen PD, Iverson DC. Qualitative methods. In: Green LW, Lewis FM, eds. Measurement and Evaluation in Health Education and Health Promotion. Palo Alto, CA: Mayfield Publishing Co; 1986:149–170.

      6. United States Department of Agriculture. WIC Works Resource System: infancy.https://wicworks.fns.usda.gov/explore-resources?f[0]=topic:37. Accessed September 30, 2019.

        • Baughcum AE
        • Powers SW
        • Johnson SB
        • et al.
        Maternal feeding practices and beliefs and their relationships to overweight in early childhood.
        J Dev Behav Pediatr. 2001; 22: 391-408
        • Saied H
        • Mohamed A
        • Suliman A
        • Al Anazi W
        Breastfeeding knowledge, attitude and barriers among Saudi women in Riyadh.
        J Nat Sci Res. 2013; 3: 6-13
        • Tengku Ismail TA
        • Sulaiman Z
        Reliability and validity of a Malay-version questionnaire assessing knowledge of breastfeeding.
        Malays J Med Sci. 2010; 17: 32-39
        • Horodynski MA
        • Baker S
        • Van Egeren L
        • Olson B
        • Brophy-Herb H
        • Auld G
        The healthy babies curriculum.
        J Nutr Educ Behav. 2014; 46: 151-152
        • Miller K
        • Willson S
        • Chepp V
        • Padilla JL
        Cognitive Interviewing Methodology.
        John Wiley & Sons, Inc, Hoboken, NJ2014
        • Portney LG.
        Foundations of Clinical Research: Applications to Practice.
        3rd ed. Pearson/Prentice Hall, Upper Saddle River, NJ2009
      7. Centers for Disease Control and Prevention. Breastfeeding and infant feeding practices. 2017.http://www.cdc.gov/breastfeeding/data/ifps/index.htm. Accessed September 30, 2019.

        • Grummer-Strawn LM
        • Li R
        • Perrine CG
        • Scanlon KS
        • Fein SB
        Infant feeding and long-term outcomes: results from the year 6 follow-up of children in the Infant Feeding Practices Study II.
        Pediatrics. 2014; 134: S1-S3
        • Hartmann DP.
        Considerations in the choice of interobserver reliability estimates.
        J Appl Behav Anal. 1977; 10: 103-116
        • Stemler SE.
        A comparison of consensus, consistency, and measurement approaches to estimating interrater reliability.
        Pract Assess Res Eval. 2004; 9: 1-11
        • Heyman MB
        • Abrams SA
        Section on Gastroenterology, Hepatology, and Nutrition Committee on Nutrition. Fruit juice in infants, children, and adolescents: current recommendations.
        Pediatrics. 2017; 139e20170967
        • Fein SB
        • Labiner-Wolfe J
        • Shealy KR
        • Li R
        • Chen J
        • Grummer-Strawn LM
        Infant Feeding Practices Study II: study methods.
        Pediatrics. 2008; 122: S28-S35
        • Al-Tayyib AA
        • Rogers SM
        • Gribble JN
        • Villarroel M
        • Turner CF
        Effect of low medical literacy on health survey measurements.
        Am J Public Health. 2002; 92: 1478-1480
        • Drost EA.
        Validity and reliability in social science research.
        Educ Res Perspect. 2011; 38: 105-123
        • Krumpal I.
        Determinants of social desirability bias in sensitive surveys: a literature review.
        Qual Quant. 2013; 47: 2025-2047
        • Lee EJ.
        Living with risk in the age of “intensive motherhood”: maternal identity and infant feeding.
        Health Risk Soc. 2008; 10: 467-477