Abstract
BackgroundThe rapid increase in non-communicable chronic diseases in people of working age has had a major effect on health care utilization, productivity and economy. Lifestyle and diet are recognized as being major risk determinants involved. Disease prevention strategies need to be based on people’s understanding of nutritional knowledge, attitudes and practice. This study evaluates the validity of a new nutritional knowledge and practice questionnaire specifically developed for assessing individuals of working age in a Thai population.MethodsThe questionnaire was constructed and based on previous relevant literature and its content validity was scrutinized by an expert panel. An exploratory factor analysis (EFA) was performed to reduce the number of questions included. Subsequently, data from a cross-sectional study of 1,032 participants were used to evaluate the reliability and validity of this questionnaire. The validity of the questionnaire constructed for assessing knowledge and attitude was evaluated using Confirmatory Factor Analysis (CFA). For the practice component, set criteria were applied to determine the final variables used.ResultsCFA of the nutritional knowledge component suggested that all the variables in the model fitted with the data (χ2 = 80.17, df = 66, p > 0.05, CFI = 0.99, RMSEA = 0.01, SRMR = 0.02). The CFA final model for the nutritional knowledge included three factors (food recommendation, nutrients related to diseases, and healthy diet) with a total of 14 questions. For nutrition attitude, CFA also revealed a good fit (χ2 = 178.14, df = 93, p < 0.001, CFI = 0.99, RMSEA = 0.03, SRMR = 0.03). The final CFA model for nutritional attitude included three factors (food choice, healthy diet and food recommendation) with a total of 16 questions. For practice items, the number of questions was reduced from 76 to 60.ConclusionsQuestionnaire development should use a logical, systematic and structured approach. Results from our evaluation process demonstrates the construction validity of the nutritional knowledge and practice questionnaire developed. This questionnaire can be further modified for use in other countries within the region.
Highlights
The rapid increase in non-communicable chronic diseases in people of working age has had a major effect on health care utilization, productivity and economy
Changes in society and the global economy during the past two to three decades have resulted in significant changes in the nutritional status and health of populations, in developing countries [1]
Given a changing and increasing trend of western lifestyle in Thailand, it is important to gain a clear insight into the population-based knowledge of diet and the changing patterns of behavior, both increasing risk of chronic disease development, especially in those of working age [4]
Summary
The rapid increase in non-communicable chronic diseases in people of working age has had a major effect on health care utilization, productivity and economy. Given a changing and increasing trend of western lifestyle in Thailand, it is important to gain a clear insight into the population-based knowledge of diet and the changing patterns of behavior, both increasing risk of chronic disease development, especially in those of working age [4] This knowledge will facilitate the introduction of interventions that prevent or reduce future disease development. Epidemiological studies into the relationship between chronic disease development and nutritional risk exposures can only be achieved through the appropriate collection of robust information on the factors that determine our knowledge, attitudes, practices and preferences relating to food and nutrition Such data can only be generated by the development of appropriate questionnaires and these have to be validated and assessed within the social context of the populations they are designed for. This study evaluates a questionnaire constructed to assess nutritional knowledge, attitude, and practice in a working Thai population
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