AVACARD – Menu evaluation index: Construction and validation

Abstract

IntroductionFood Services are leading actors in the promotion of healthy eating, and menus are tools that provide access to an adequate food supply. Thus, proper menu planning offers healthy food and consecutively healthy food choices. While there is broad recognition of the importance of nutrition, diet, and menu planning for preventing NCDs and other comorbidities, the existing tools for menu analysis mostly lack a validation process. ObjectiveTo develop and validate (content and criteria) the AVACARD - Menu Evaluation Index to measure the instrument's validity, reliability, and reproducibility. MethodologyThe AVACARD was developed from a literature review with five dimensions, including the food laws proposed by Pedro Escudero and a Sustainability/Food Culture dimension. Content validation, internal consistency, reliability, and criteria were performed. The Delphi Technique was used for content validation, using a five-point Likert scale that verified the pertinence and understanding of the items. The instrument was applied to 32 menus practiced in Food Services in the Federal District/Brazil by two independent evaluators and compared to the results obtained by the expert evaluator to verify the reliability, internal consistency, and criterion validation. Internal consistency was analyzed using Cronbach's Alpha, and test-retest reliability between evaluators used the Intraclass Correlation Coefficient (ICC). Criterion validation was performed based on the correlation (Pearson) between the evaluation of the menus and theoretical definitions of the five dimensions that compose the instrument. ResultsThe final instrument (AVACARD) has 59 items and five dimensions (Quantity, Quality, Harmony, Adequacy, and Sustainability/Food Culture). The items obtained CVI> 0.80 for relevance and semantics for all dimensions in content validation. For the other stages of the validation process, AVACARD showed good reproducibility - reliability (ICC >0.90) and excellent internal consistency (α = 0.89), and criterion validation presented a strong correlation (r = 0.98). ConclusionThe analysis offered strong evidence of AVACARD's quality in evaluating menus, thus contributing to better planning of menus in Food Service and offering a healthier and more sustainable diet.