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Questionnaire Development Research Methods| Volume 52, ISSUE 12, P1088-1099, December 2020

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Development of a National Dietary Behaviors Questionnaire for EFNEP Adult Participants

Published:August 04, 2020DOI:https://doi.org/10.1016/j.jneb.2020.06.003

      Abstract

      Objective

      Develop and establish the reliability and validity of dietary behavior evaluation questions for the Expanded Food and Nutrition Education Program (EFNEP).

      Design

      A mixed-methods study using cognitive interviews, expert panels, test/retest reliability, and pretests/posttests.

      Setting

      14 states across the US.

      Participants

      A convenience sample of low-income EFNEP or EFNEP-eligible participants for cognitive interviews (n = 111), reliability testing (n = 181), and sensitivity to change testing (n = 382).

      Main Outcomes Measures

      Indicators of face and content validity, temporal reliability, and sensitivity to change.

      Analysis

      Questions interpreted as intended in cognitive interviews, intraclass correlation coefficient and Spearman rank-order correlation for reliability testing; paired t tests or Wilcoxon signed-rank tests for sensitivity to change; and exploratory factor analyses to identify possible scales.

      Results

      Cognitive interviews resulted in 3 rounds of question revisions; reliability value ranges were 0.48–0.77 for intraclass correlation coefficient and 0.43–0.77 for Spearman rank-order correlation. For sensitivity to change, 9 items had evidence of change (P < 0.05) between pretests and posttests, whereas 5 items had evidence for change after removing those with little room to change. Two scales were identified: diet quality and non-cheese dairy.

      Conclusions and Implications

      The EFNEP's new dietary behavior evaluation questions demonstrated face and content validity, moderate to strong reliability, and sensitivity to detect self-reported behavior changes among low-income, diverse populations (culturally, racially/ethnically, and level of education) across 14 states. Nutrition education programs targeting similar behaviors with English speaking clients could consider this dietary behavior questionnaire.

      Key Words

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