Developing and validating a nutrition knowledge questionnaire: key methods and considerations

Objective: To outline key statistical considerations and detailed methodologies for the development and evaluation of a valid and reliable nutrition knowledge questionnaire.

Design: Literature on questionnaire development in a range of fields was reviewed and a set of evidence-based guidelines specific to the creation of a nutrition knowledge questionnaire have been developed. The recommendations describe key qualitative methods and statistical considerations, and include relevant examples from previous papers and existing nutrition knowledge questionnaires. Where details have been omitted for the sake of brevity, the reader has been directed to suitable references.

Results: We recommend an eight-step methodology for nutrition knowledge questionnaire development as follows: (i) definition of the construct and development of a test plan; (ii) generation of the item pool; (iii) choice of the scoring system and response format; (iv) assessment of content validity; (v) assessment of face validity; (vi) purification of the scale using item analysis, including item characteristics, difficulty and discrimination; (vii) evaluation of the scale including its factor structure and internal reliability, or Rasch analysis, including assessment of dimensionality and internal reliability; and (viii) gathering of data to re-examine the questionnaire's properties, assess temporal stability and confirm construct validity. Several of these methods have previously been overlooked.

Conclusions: The measurement of nutrition knowledge is an important consideration for individuals working in the nutrition field. Improved methods in the development of nutrition knowledge questionnaires, such as the use of factor analysis or Rasch analysis, will enable more confidence in reported measures of nutrition knowledge.

Keywords: Factor analysis; Nutrition knowledge; Questionnaire; Rasch analysis.

Comment in

Balparda K, Herrera-Chalarca T, Cardozo-Dávila X, Pacheco MA, Godin F, Nicholls-Molina MA. Balparda K, et al. Indian J Ophthalmol. 2023 Apr;71(4):1432-1440. doi: 10.4103/IJO.IJO_2993_22. Indian J Ophthalmol. 2023. PMID: 37026277 Free PMC article.

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References

    1. Sudman S & Bradburn NM (1982) Asking Questions: A Practical Guide to Questionnaire Design. New York: John Wiley & Sons, Inc.
    1. Parmenter K & Wardle J (2000) Evaluation and design of nutrition knowledge measures. J Nutr Educ 32, 269–277.
    1. Frary RB (2003) A brief guide to questionnaire development. Virginia Polytechnic Institute State University. http://medrescon.tripod.com/questionnaire.pdf (accessed June 2015).
    1. Kouvelioti R & Vagenas G (2015) Methodological and statistical quality in research evaluating nutritional attitudes in sports. Int J Sport Nutr Exerc Metab 25, 624–635. - PubMed
    1. Trakman G, Forsyth A, Devlin B et al.. (2016) A systematic review of athletes’ and coaches’ nutrition knowledge and reflections on the quality of current nutrition knowledge measures. Nutrients 8, 570–593. - PMC - PubMed