Moore Graham F, Tapper Katy, Moore Laurence, Murphy Simon
Cardiff Institute of Society, Health and Ethics, Cardiff University, 53 Park Place, Cardiff, Wales, UK CF10 3AT.
J Am Diet Assoc. 2008 Nov;108(11):1865-73. doi: 10.1016/j.jada.2008.08.012.
Measuring children's dietary behavior is central to evaluating interventions and identifying predictors and outcomes of dietary behaviors. Systematic biases may obscure or inflate associations with self-reported intakes.
To identify cognitive, behavioral, and social correlates of bias in children's reporting of breakfast items on a self-completion questionnaire.
Cross-sectional survey. Children completed standardized tests of episodic memory, working memory, and attention, and a questionnaire assessing attitudes toward breakfast. Teachers completed a classroom behavior measure. Associations between measures and children's underreporting of breakfast foods (ie, cereals, bread, milk, fruits, sweet items, and potato chips) on a self-completion questionnaire relative to validated 24-hour recall were examined.
Subjects were aged 9 to 11 years (n=678). Data were collected from 111 schools throughout Wales in 2005.
A larger percentage of less-healthful breakfast items (ie, sweet snacks and potato chips) than more healthful items (ie, fruit, cereals, bread, and milk) were omitted from questionnaire self-reports. Children from lower socioeconomic status schools omitted more items than those from wealthier schools (Kruskal-Wallis H=12.51, P<0.01), with omissions twice as high for less-healthful items than for more-healthful items within the lowest socioeconomic status schools. Those with positive attitudes (H=23.85, P<0.001), better classroom behavior (H=6.26, P<0.05), and better episodic memory (H=8.42, P<0.05) omitted fewer items than those with negative attitudes, poorer behavior, and poorer episodic memory. Children who ate more items omitted more than those who ate fewer (H=47.65, P<0.001). No differences were observed in terms of attention and working memory.
Episodic memory, classroom behavior, attitudes, socioeconomic status, and total items consumed are associated with bias in questionnaire self reports. Such biases have implications for examination of associations between breakfast eating and cognitive and behavioral factors, examination of effect modification by socioeconomic status in intervention trials, and for the sensitivity of measures to detect intervention effects.
测量儿童的饮食行为是评估干预措施以及确定饮食行为的预测因素和结果的核心。系统偏差可能会模糊或夸大与自我报告摄入量的关联。
在一份自填式问卷中，确定儿童报告早餐项目时偏差的认知、行为和社会相关因素。
横断面调查。儿童完成情景记忆、工作记忆和注意力的标准化测试，以及一份评估对早餐态度的问卷。教师完成一项课堂行为测评。研究了这些测评与儿童在自填式问卷中相对于经过验证的24小时回忆法少报早餐食物（即谷类食品、面包、牛奶、水果、甜食和薯片）之间的关联。
研究对象为9至11岁的儿童（n = 678）。2005年从威尔士的111所学校收集数据。
与更健康的食物（即水果、谷类食品、面包和牛奶）相比，问卷自我报告中遗漏的不健康早餐食物（即甜零食和薯片）的比例更高。社会经济地位较低学校的儿童比富裕学校的儿童遗漏的项目更多（Kruskal-Wallis H = 12.51，P < 0.01），在社会经济地位最低的学校中，不健康食物的遗漏量是健康食物的两倍。态度积极（H = 23.85，P < 0.001）、课堂行为较好（H = 6.26，P < 0.05）和情景记忆较好（H = 8.42，P < 0.05）的儿童比态度消极、行为较差和情景记忆较差的儿童遗漏的项目更少。吃的项目较多的儿童比吃的项目较少的儿童遗漏的更多（H = 47.65，P < 0.001）。在注意力和工作记忆方面未观察到差异。
情景记忆、课堂行为、态度、社会经济地位以及所消费食物的总数与问卷自我报告中的偏差有关。这种偏差对研究早餐摄入与认知和行为因素之间的关联、干预试验中社会经济地位对效应修正的检验以及检测干预效果的测量方法的敏感性均有影响。
