Development and reliability of questionnaires for the assessment of diet and physical activity behaviors in a multi-country sample in Europe the Feel4Diabetes Study

Abstract

Background: Assessment of diet and physical activity and their determinants still remains a demanding task, especially when the objective is to evaluate the efficacy of lifestyle interventions. In the context of the Feel4Diabetes study (a European community based intervention study in families with school aged children and at high risk of developing diabetes), we aimed to develop questionnaires for the assessment of food-frequency and eating behaviors, and physical activity and sedentary behaviors in both parents and school-aged children and a questionnaire for overall family's energy balance-related behaviors. Methods: Questionnaires were developed to be used in 6 countries under standardized harmonization procedures and included questions regarding not only food intake and physical activity, but also questions of their determinants. A reliability study was conducted in 191 pairs of parents and their children (N = 191). Parents completed the questionnaires on two occasions, within a 1-2 week interval. Reliability was tested by the intra-class correlation coefficients (ICC) of testretest. Results: Most of the questions in all questionnaires had excellent reliability, assessed as an ICC of > 0.810. Mean ICCs for food-frequency and eating behaviors questionnaires were 0.838 and 0.787, and for physical activity and sedentary behaviors questionnaires were 0.734 and 0.793, in adults and children respectively. Mean ICC for overall family's energy balance-related behaviors and their determinants was 0.659. Conclusion: The developed questionnaires showed acceptable reliability and may be valuable tools in the assessment of children's and parents' behaviors related to diet, physical activity, sedentary behavior and overall energy balance in school-and community-based interventions.

Nutritional Status Measurement Instruments for Diabetes: A Systematic Psychometric Review

“…Of these, 2195 articles were excluded after evaluation. Subsequently, 22 full-text articles were evaluated, and 8 articles were excluded after reviewing the full text [ 11 , 23 , 24 , 25 , 26 , 27 , 28 , 29 ]. Thus, a total of 14 studies were included in this systematic review.…”

Cross-Sectional Associations between Mothers and Children’s Breakfast Routine—The Feel4Diabetes-Study

“…Also, the aim of the study was not to compare the results between countries; however, the major strength of our study is the large sample of children and its geographical distribution across Europe. Moreover, questionnaires have been designed under standardized procedures for a multi-country population, and these have been tested for their reliability in European countries [32].…”

“…The family's energy balance-related behaviors questionnaire was developed in order to assess habits related to diet and physical activity (total time devoted to physical activity and screen activities). This questionnaire has previously been validated for its use in European countries [32]. The questionnaire was developed to be filled in by one of the parents or caregivers, who completed it both for him/herself and their child.…”

Lifestyle Changes Observed among Adults Participating in a Family- and Community-Based Intervention for Diabetes Prevention in Europe: The 1st Year Results of the Feel4Diabetes-Study

“…Parents' behavioral indices were assessed by self-reported questionnaires on drinking, eating, physical activity and sedentary behaviors. The reliability of these questionnaires was evaluated prior to the study execution and was found to be acceptable [13].…”