Development and validation of a questionnaire investigating endurance athletes practices to manage gastrointestinal symptoms around exercise

Abstract

AimTo develop and validate a questionnaire investigating endurance athletes' carbohydrate beliefs, knowledge, information sources, and other dietary and non‐dietary practices related to exercise‐associated gastrointestinal symptoms.MethodsA questionnaire was developed by a review of relevant literature and sports‐related questionnaires, and input from five experienced sports dietitians. Item construct and format was adapted and modified from a previous questionnaire. The modified questionnaire sought information on demographics, nutrition knowledge, beliefs, intended practices, information sources and exercise‐associated gastrointestinal symptoms. A five‐phase validity process was conducted to determine content, face and construct validity, item difficulty and internal reliability of the questionnaire. The Delphi technique was applied with experts over three anonymous rounds. Items were reviewed to determine whether to keep, modify, or delete, rate the relevance of each item using a content validity index (CVI), and provide comments. A content analysis was conducted on all comments after each round. Online interviews were conducted with a pilot group of endurance athletes (n = 15) to assess item difficulty and feasibility. Nutrition knowledge was compared between pilot group of athletes and experts to determine construct validity and internal consistency. A test‐retest process was applied to a second pilot group (n = 8) to verify questionnaire reliability.ResultsHigh CVI (≥.83) and agreement scores were obtained through the Delphi technique. High reliability (r = .942) and acceptable internal consistency (α = .53‐.78) of the questionnaire were obtained.ConclusionsThe questionnaire was shown to be a valid and reliable tool that will be of use for clinicians and research purposes.

Carbohydrate knowledge, beliefs, and intended practices, of endurance athletes who report exercise-associated gastrointestinal symptoms

“…This exploratory study applied a validated online questionnaire investigating endurance athletes who report Ex-GIS and their CHO knowledge, beliefs, and intended practices ( 25 ) ( Supplementary file 1 ), compared to a subgroup of athletes without Ex-GIS. Convenience sampling was used for athlete recruitment given researchers had associations with endurance athlete groups or professional contacts who support endurance athletes.…”

“…Only questions related to CHO knowledge, beliefs, intended practices and sports nutrition strategies were included in this study. Specific questions regarding nutritional strategies for managing Ex-GIS, including the use of nutritional supplements were excluded, as this has been previously reported ( 26 ).…”

An exploratory study of the management strategies reported by endurance athletes with exercise-associated gastrointestinal symptoms

“…This exploratory study used a previously established validated online questionnaire to investigate self-reported Ex-GIS, management strategies, and information sources (38). Inclusion criteria were endurance athletes ≥ 18 years of age, training and competing at any level in events ≥ 60 min, who experience Ex-GIS.…”

“…The questionnaire included participant information (e.g., biological sex, age, main endurance sport, participation level, and event characteristics, i.e., single-day or multiday), Ex-GIS (including the onset of symptoms, symptom incidence and severity, and information sources for Ex-GIS) (1-21 items), intended practices for Ex-GIS (9 items), and diseases or disorders of the gastrointestinal tract (3 items). The questionnaire included 43 items depending on dichotomous, Likert scales, or descriptive responses (38) (Supplementary material 1).…”

Factors associated with high-level endurance performance: An expert consensus derived via the Delphi technique

“…Therefore, the aim of this study was to reach consensus about the key factors that are considered important for high-level endurance performance among international experts. The Delphi technique allows a comprehensive and structured group communication process aiming to achieve convergence of expert opinions by employing iterative data collection [19][20][21][22][23][24].…”