Abstract
This study sought to develop and validate a general nutrition knowledge questionnaire (GNKQ) for Ugandan adults. The initial draft consisted of 133 items on five constructs associated with nutrition knowledge; expert recommendations (16 items), food groups (70 items), selecting food (10 items), nutrition and disease relationship (23 items), and food fortification in Uganda (14 items). The questionnaire validity was evaluated in three studies. For the content validity (study 1), a panel of five content matter nutrition experts reviewed the GNKQ draft before and after face validity. For the face validity (study 2), head teachers and health workers (n = 27) completed the questionnaire before attending one of three focus groups to review the clarity of the items. For the construct and test-rest reliability (study 3), head teachers (n = 40) from private and public primary schools and nutrition (n = 52) and engineering (n = 49) students from Makerere University took the questionnaire twice (two weeks apart). Experts agreed (content validity index, CVI > 0.9; reliability, Gwet’s AC1 > 0.85) that all constructs were relevant to evaluate nutrition knowledge. After the focus groups, 29 items were identified as unclear, requiring major (n = 5) and minor (n = 24) reviews. The final questionnaire had acceptable internal consistency (Cronbach α > 0.95), test-retest reliability (r = 0.89), and differentiated (p < 0.001) nutrition knowledge scores between nutrition (67 ± 5) and engineering (39 ± 11) students. Only the construct on nutrition recommendations was unreliable (Cronbach α = 0.51, test-retest r = 0.55), which requires further optimization. The final questionnaire included topics on food groups (41 items), selecting food (2 items), nutrition and disease relationship (14 items), and food fortification in Uganda (22 items) and had good content, construct, and test-retest reliability to evaluate nutrition knowledge among Ugandan adults.
Highlights
Malnutrition among school-aged children in Uganda remains high [1,2] as 22%–38% are considered stunted, 38% are anaemic, and 80% are iron-deficient, undermining national education efforts
The general nutrition knowledge questionnaire (GNKQ) for Uganda is available in supplementary materials
Five experts in nutrition-related disciplines reviewed the first GNKQ drafts resulting in high consensus on the relevance of constructs (CVI and Gwet’s AC1 > 0.96)
Summary
Malnutrition among school-aged children in Uganda remains high [1,2] as 22%–38% are considered stunted, 38% are anaemic, and 80% are iron-deficient, undermining national education efforts. This is partly due to poor feeding practices at homes and at schools [3]. Head teachers’ actions are among the many interpersonal factors that can influence the school environment for children and, potentially, for their parents and other teachers. The ability of teachers and heads to influence healthy behaviours at schools might be limited by their knowledge of and attitudes towards nutrition [7]
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