Abstract
Assessment of nutrition-related behaviors is dependent on the development of reliable instruments. The objective of this study was to assess the reliability of a School-Based Nutrition Monitoring (SBNM) Questionnaire for 4th grade elementary school students using a test-retest study design. The study population included 322 fourth grade students from 2 school districts in the Houston area. To assess test-retest reproducibility, the entire questionnaire (43 questions) was administered to students during a morning class. Questions from the instrument that assessed “yesterday” behaviors (21 of 43) were administered that same afternoon (>2 hours later). Questions that assessed usual behaviors, nutrition knowledge, and attitudes (22 of 43) were administered to the students two weeks later. Spearman rank order correlation, percent agreement, and Kappa statistic were calculated for each individual questions. Correlations were 0.70 or greater for 24 of the 43 test-retest questions, while percent agreement was 75% or greater for 28 of the questions. Items with computable Kappa values (21 of 43) resulted in 3 almost perfect (0.81–1.00), 9 substantial (0.61–0.80), 7 moderate (0.41–0.60), 1 fair (0.21–0.40), and 1 slight (0.00–0.20) reproducibility. The SBNM fourth grade questionnaire showed good reproducibility for nutrition behavior questions which addressed food and meal choice “yesterday” behaviors, physical activity, weight behavior, and food selection skills in fourth grade students. However, questions that assess nutrition knowledge and attitudes were not as reliable, probably due to learning effects over time and volatility of the construct. Results from the study indicate that this questionnaire can be administered quickly and easily by teachers in an elementary classroom and can be used as a reliable tool for public health nutritionists to measure nutrition behaviors, knowledge, and attitudes among school children.
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