None listed
Conditions
Brief summary
Childhood obesity is a global health problem, affecting one in five Australian children by age five. Given the persistence of obesity from childhood into adulthood, it is essential to establish healthy eating habits from a young age. Monitoring obesity trends, evaluating scaled-up obesity intervention programs and making informed policy and practice decisions depends on the availability of suitable assessment tools. However, research and evaluation in this area is limited by the lack of validated and ‘fit-for-purpose’ tools for measuring food intake of young children. Short food questionnaires have the capacity for rapid reporting of food intake, are quick to administer in a variety of formats and have low respondent burden, making them an appealing and viable approach to monitor population dietary intake and evaluate intervention programs. However, a recent review of short questions assessing child food intake found that no single set of short questions provided reliable and valid estimates of intake across a range of food groups. Better understanding of the thought processes and recall strategies used by parents when responding to questions about their children’s food intake can improve the validity and reliability of short food questions. Cognitive interviewing approaches are used to study the way people understand, mentally process and respond to questionnaires, and can therefore provide novel insights for improving short food questions. The aim of this study is to use cognitive interviewing to improve understanding of how parents of 3-7 year old children report what, how often and how much their children eat to improve the measurement accuracy and acceptability of questionnaires measuring young children’s food intake. A secondary aim is to understand why certain food groups perform worse than others in measuring children’s food intake. This study will use semi-structured cognitive interviews, combining think-aloud and retrospective probing question approaches to evaluate question comprehension and recall strategies used by parents when reporting their children’s intake of discretionary foods, cereals and grains, meat and proteins and vegetables. Interviews will be audio-recorded, transcribed verbatim, and analysed for themes related to understanding and interpretation of short food questions and recall strategies used. The findings of this study will used to improve the design of short questions measuring young children’s food intake.
Interventions
This study will use semi-structured cognitive interviews, combining think-aloud and retrospective probing question approaches to evaluate question comprehension and recall strategies used by parents of 3-7 year old children when responding to questions about their child’s dietary intake. The length of the interview will be approximately 60 minutes.
The measurement of four food groups will be evaluated: discretionary foods, grains and cereals, meat and vegetables. To reduce interview length and
This study will use semi-structured cognitive interviews, combining think-aloud and retrospective probing question approaches to evaluate question comprehension and recall strategies used by parents of 3-7 year old children when responding to questions about their child’s dietary intake. The length of the interview will be approximately 60 minutes. The measurement of four food groups will be evaluated: discretionary foods, grains and cereals, meat and vegetables. To reduce interview length and participant burden, not all food groups will be evaluated in all interviews. All participants will answer questions about discretionary foods. The remaining food groups will be randomised, so that each participant will answer a question about two of the three other food groups. The order in which the food groups are presented will also be randomised. Firstly, participants will ‘think-aloud’ as they answer a selection of short food questions for one food group. They will be encouraged by the interviewer to vocalise all of their thoughts as they complete the questions about their child’s dietary intake. Secondly, retrospective probing questions will be asked to gain further understanding of areas of interest, for example: - Was the question understood as intended? - What recall strategies were employed to come to an answer? - What specific foods, meal occasions, other factors were considered? - Were portion size and/or serving size considered, and if so how? This process will be repeated for the other two food groups allocated to the participant. At the completion of the think-aloud and probing for all three food groups, the participant will be presented with different approaches for asking questions about one food group and asked to indicate their preference and provide feedback. Selected questions from three dietary instruments will be evaluated: (1) Short Food Survey (38-item questionnaire measuring usual food intake, variety and behaviours), (2) Child Diet Questionnaire (28-item questionnaire measuring obesity-related food intake over the previous 7-days), and (3) Pre-schooler dietary questionnaire (19-item questionnaire measuring dietary intake over the previous seven days). The format of questions from these instruments differs according to whether portion size is included in the question, completeness of foods listed within questions for each food group, and time frame (usual intake versus specified 7-day period). The ‘type’ of question presented will also be randomised, so that the interviewee receives one question from each of the food groups from each of the questionnaires.
Sponsors
Dr Dorota Zarnowiecki
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
- Parents or primary caregiver (responsible for child feeding) with one or more children aged 3-7 years. - Parents of vegetarians/vegans will be included, and will not be asked questions about meat intake. - Sufficient English fluency to undertake an interview.
Exclusion criteria
Parents of children with conditions which effect their eating will be excluded. For example food intolerances or allergies, Coeliac Disease, Type 1 Diabetes, Cystic Fibrosis.
Outcome results
None listed