Department of Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.
Department of Health Education and Promotion, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran.
Nutr Diet. 2017 Nov;74(5):529-535. doi: 10.1111/1747-0080.12383. Epub 2017 Oct 13.
To develop a nutritional screening tool and examine its reliability and validity in elementary school children with malnutrition based on PRECEDE-PROCEED model, in Shiraz, Iran.
A questionnaire was designed and its reproducibility was analysed via test-retest design among students with malnutrition. The students were in the fourth to sixth grades. Validity was assessed using face validity, content validity, construct validity, item difficulty and item discrimination. Reliability was measured by Cronbach's alpha (internal consistency), the intra-class correlation coefficient (ICC) and κ statistics (test-retest reliability).
A total of 165 primary school students (mean age of 11.21 ± 1.08 years, 65.5% females) participated in the study. The PRECEDE-PROCEED theoretical model for health education was adapted for this questionnaire. The questionnaire was divided into four main sections: predisposing, reinforcing, enabling factors and behaviour. Coefficient α reliability estimate was above 0.9 for most scales. The ICCs for different scales of the questionnaire were within the range of 0.402-0.800. Values for κ ranged from 0.412 to 0.785 for most scales.
The results showed reasonable validity, excellent reliability and moderate to substantial reproducibility for all scales of the questionnaire except two questions for κ statistics. The present study is of great importance, as there are no psychometrically evaluated tools (based on health behaviour models) with accepted validity and reliability for the evaluation of such factors in children with malnutrition. The questionnaire developed in the present study can be used to assess the effect of intervention among primary school students with malnutrition.
基于 PRECEDE-PROCEED 模式，开发一种适用于伊朗设拉子营养不良小学生的营养筛查工具，并检验其信度和效度。
设计问卷，并通过对营养不良学生的重测设计分析其可重复性。学生的年级在四至六年级。采用表面效度、内容效度、结构效度、项目难度和项目区分度评估有效性。通过 Cronbach's alpha（内部一致性）、组内相关系数（ICC）和κ 统计量（重测信度）衡量可靠性。
共有 165 名小学生（平均年龄为 11.21 ± 1.08 岁，65.5%为女性）参与了研究。对健康教育的 PRECEDE-PROCEED 理论模型进行了改编，形成了该问卷。问卷分为四个主要部分：倾向因素、促成因素、强化因素和行为。大多数量表的系数α可靠性估计值均高于 0.9。问卷不同量表的 ICC 值在 0.402-0.800 之间。大多数量表的κ值在 0.412-0.785 之间。
除了κ统计量的两个问题外，该问卷的所有量表均具有合理的有效性、极好的可靠性和中等至较大的可重复性。本研究具有重要意义，因为目前尚无经过心理计量学评估（基于健康行为模型）、具有公认有效性和可靠性的工具可用于评估营养不良儿童的此类因素。本研究开发的问卷可用于评估对营养不良小学生进行干预的效果。
