Department of Public Health Sciences, Division of Social Medicine, Karolinska Institutet, Norrbacka, level 3, 17176 Stockholm, Sweden.
Public Health Nutr. 2013 Jun;16(6):1028-36. doi: 10.1017/S1368980012004211. Epub 2012 Sep 25.
To develop a feasible, valid, reliable web-based instrument to objectively evaluate school meal quality in Swedish primary schools.
The construct 'school meal quality' was operationalized by an expert panel into six domains, one of which was nutritional quality. An instrument was drafted and pilot-tested. Face validity was evaluated by the panel. Feasibility was established via a large national study. Food-based criteria to predict the nutritional adequacy of school meals in terms of fat quality, iron, vitamin D and fibre content were developed. Predictive validity was evaluated by comparing the nutritional adequacy of school menus based on these criteria with the results from a nutritional analysis. Inter-rater reliability was also assessed.
The instrument was developed between 2010 and 2012. It is designed for use in all primary schools by school catering and/or management representatives.
A pilot-test of eighty schools in Stockholm (autumn 2010) and a further test of feasibility in 191 schools nationally (spring 2011).
The four nutrient-specific food-based criteria predicted nutritional adequacy with sensitivity ranging from 0.85 to 1.0, specificity from 0.45 to 1.0 and accuracy from 0.67 to 1.0. The sample in the national study was statistically representative and the majority of users rated the questionnaire positively, suggesting the instrument is feasible. The inter-rater reliability was fair to almost perfect for continuous variables and agreement was ≥ 67 % for categorical variables.
An innovative web-based system to comprehensively monitor school meal quality across several domains, with validated questions in the nutritional domain, is available in Sweden for the first time.
开发一种可行、有效、可靠的基于网络的工具，客观评估瑞典小学的学校膳食质量。
“学校膳食质量”这一概念由专家小组具体化为六个领域，其中之一是营养质量。起草了一份工具并进行了试点测试。小组评估了表面效度。通过一项大型全国性研究确定了可行性。制定了基于食物的标准，以预测学校膳食在脂肪质量、铁、维生素 D 和纤维含量方面的营养充足程度。通过将这些标准应用于学校菜单的营养充足程度与营养分析结果进行比较，评估了预测有效性。还评估了组内信度。
该工具于 2010 年至 2012 年开发。它旨在供所有小学的学校餐饮和/或管理人员使用。
在斯德哥尔摩进行了 80 所学校的试点测试（2010 年秋季），并在全国范围内进一步进行了可行性测试（2011 年春季），共有 191 所学校参与。
四个特定营养素的基于食物的标准以 0.85 到 1.0 的灵敏度、0.45 到 1.0 的特异性和 0.67 到 1.0 的准确性预测了营养充足性。全国性研究中的样本具有统计学代表性，大多数用户对问卷给予了积极评价，表明该工具具有可行性。组内信度对于连续变量为良好到几乎完美，对于分类变量为一致性≥67%。
瑞典首次提供了一种创新的基于网络的系统，可全面监测多个领域的学校膳食质量，营养领域的问题经过验证。
