BackgroundInformation and communication technology (ICT) has been used with increasing frequency for the assessment of diet and physical activity in health surveys. A number of Web-based questionnaires have been developed for children and adolescents. However, their usability characteristics have scarcely been reported, despite their potential importance for improving the feasibility and validity of ICT-based methods.ObjectiveThe objective of this study was to describe the usability evaluation of the Consumo Alimentar e Atividade Física de Escolares (CAAFE) questionnaire (Food Consumption and Physical Activity Questionnaire for schoolchildren), a new Web-based survey tool for the self-assessment of diet and physical activity by schoolchildren.MethodsA total of 114 schoolchildren aged 6 to 12 years took part in questionnaire usability testing carried out in computer classrooms at five elementary schools in the city of Florianopolis, Brazil. Schoolchildren used a personal computer (PC) equipped with software for recording what is on the computer screen and the children’s speech during usability testing. Quantitative and qualitative analyses took into account objective usability metrics such as error counts and time to complete a task. Data on the main difficulties in accomplishing the task and the level of satisfaction expressed by the children were assessed by the observers using a standardized form and interviews with the children. Descriptive statistics and content analysis were used to summarize both the quantitative and the qualitative aspects of the data obtained.ResultsThe mean time for completing the questionnaire was 13.7 minutes (SD 3.68). Compared to the children in 2nd or 3rd grades, those in 4th or 5th grades spent less time completing the questionnaire (median 12.4 vs 13.3 minutes, P=.022), asked for help less frequently (median 0 vs 1.0 count, P=.005), had a lower error count (median 2.0 vs 8.0 count, P<.001), and obtained a higher overall performance score (median 73.0 vs 68.0, P=.005). Children with a PC at home spent less time completing the questionnaire (median 12.3 vs 14.9 minutes, P<.001), had a lower overall error count (median 2.0 vs 9.0 count, P=.03), and had a higher performance score (median 72.0 vs 64.0, P=.005) compared to the children without a PC at home. The most common difficulty in completing the questionnaire was in using the scroll bar. The majority of children reported a positive evaluation (liked a lot or liked) for the four design elements, which were evaluated.ConclusionsThe results of the present study provided feedback to improve the final version of the CAAFE questionnaire. Quantitative data showed minor errors and system failures, while qualitative data indicated that, overall, the children enjoyed the CAAFE questionnaire. Grade levels and PC use must be taken into account in Web-based tools designed for children.

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A qualitative evaluation of the diet of a probabilistic sample of 7-10 year old schoolchildren (n = 1,232) from Florianópolis (southern Brazil) was carried out by analyzing compliance with recommendations from the Brazilian Food Guidelines. The strengths and limitations of the Previous Day Food Questionnaire (PDFQ) are also presented. Frequencies of intake were defined as how many times per day the food group was reported on the PDFQ. The percentages of schoolchildren who met the minimum recommendations and who ate foods that were not recommended in the guidelines were compared for boys versus girls, private versus public school and by family income level. Although most of the children complied with the guidelines regarding consumption of meat/fish, dry beans, sweets, and eating three meals and two snacks, only 6.5% of the children met the recommendations for cereals, and 15% for fruit and vegetables. The PDFQ was confirmed as a practical and cost-effective method for the evaluation of compliance with health promotion targets.

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Objective: To investigate clustering patterns of health risk behaviors for non communicable diseases and its associated factors. Methods: a Random telephone survey with 1,996 adults from Florianopolis, SC, was conducted in 2005. Tobacco use, high alcoholic intake episodes, fruit consumption and physical inactivity were investigated. Clustering was examined by the ratio between observed and expected prevalence of each of the 16 possible combinations. These clustered risk factors comprised the main outcome and binomial and multinomial logistic regression was conducted to examine socio-demographic correlates. Results: 43% of men and 36.6% of women clustered at least two health risk factors. Three (19.2%; CI 95% 16.7 -21.7) and five (9.8%; CI 95% 8.0 -11.6) specific combinations exceed the expected prevalence, respectively, in men and women. Women with low schooling level and older were more likely to cluster health risk behaviors. Conclusion: although men showed higher prevalence of single health risk behavior and its combinations, women presented more specific combinations that clustered above the expected. Knowledge on the clustering pattern of these health risk behaviors may guide the design of more effective health promotion initiatives.