Development and testing of a computerised 24-h recall questionnaire measuring fruit and snack consumption among 9–11 year olds

Abstract

Objective: To evaluate the validity, reliability and sensitivity of a computerised single day 24-h recall questionnaire designed for the comparison of children's fruit and snack consumption at the group (school) level. Design: Relative validity and reliability were assessed in relation to (i) intake at school and (ii) intake throughout the whole day, using diary-assisted 24-h recall interviews and a 7-day test-retest procedure. Sensitivity was assessed in relation to intake by comparing results from schools with differing food policies, and by sex. Subjects and setting: Eight schools took part in the validity and reliability assessments, with 78 children completing the 24-h recall interviews and 195 children completing the test-retest procedure. A total of 43 schools (1890 children) took part in the sensitivity analysis. All children were aged 9-11 y. All schools were in South Wales and South-west England. Results: For fruit intake at school, the questionnaire showed fair levels of validity at the individual level (kappa ¼ 0.29). At the group level, there were little or no differences in fruit intake at school between the two measures and two occasions. The questionnaire was sufficiently sensitive to identify statistically significant differences between girls and boys, and between schools with different food policies. For snack intake at school, validity at the individual level was slightly lower (kappa ¼ 0.22-0.25), but the data remained of value in analyses at the group level. For fruit and snack intake throughout the whole day there was little agreement at the individual level (kappa ¼ 0.00-0.06), and at the group level there tended to be substantial differences between the two measures and two occasions. Conclusions: The computerised questionnaire is a quick and cost-effective means of assessing children's consumption of fruit at school. While further development is required to improve validity and reliability, it has the potential to be particularly useful in randomised controlled trials of school-based dietary interventions.

Validation of a self-completion measure of breakfast foods, snacks and fruits and vegetables consumed by 9- to 11-year-old schoolchildren

“…This is consistent with the findings of Moore et al (2005), who found that reporting of foods during school time on a computerized 24-h recall measure was more accurate than reporting for the whole day. Although this appears to be in contrast to the aforementioned trend for reporting to become less accurate as the time point reported becomes progressively less recent, children may remember structured occasions such as school breaks more accurately than evening eating occasions, where eating behaviour may be more sporadic (Davidson et al, 1986).…”

“…However, such methods were not logistically viable in this instance due to the focus upon recording breakfast intakes in naturalistic settings. Furthermore, the assumption that if one section of the day is reported accurately that this can be generalized to the rest of the day is not upheld by previous research (Moore et al, 2005), or indeed by the findings of this study.…”

“…In recent years, efforts to facilitate change in dietary behaviours have been directed towards schoolchildren (James et al, 2004;Moore et al, 2005). Habitual behaviours developed in childhood may track into adulthood, with potential consequences for health later in life (Mikkila et al, 2004), and repeated exposure to healthier foods at an early age has been shown to increase the intrinsic rewards associated with their consumption (Birch and Marlin, 1982;Birch et al, 1987;Sullivan and Birch, 1990;Wardle et al, 2003).…”

“…Evaluations of school-based interventions typically take the form of cluster randomized controlled trials (James et al, 2004;Moore et al, 2005) as randomization at the individual level is not practicable. Large numbers of participants are therefore required in order for effects to be statistically detectable with appropriate validated measures of dietary behaviour.…”

Development of a scale to measure 9–11-year-olds' attitudes towards breakfast

“…Where there are nutritional goals, the obvious choice would be dietary assessment. However, dietary assessment in schools is far from simple, with many measures being either unsuitable for children or impractical for use on a large scale (Moore et al, 2005). Although measures have been developed in an attempt to address these difficulties (Edmunds and Ziebland, 2002;Moore et al, 2005), these generally assess intake during the course of just one day and therefore tend to be valid at the group level only.…”