Improving measurement in nutrition literacy research using Rasch modelling: examining construct validity of stage-specific ‘critical nutrition literacy’ scales

Abstract

Objective: Critical nutrition literacy (CNL), as an increasingly important area in public health nutrition, can be defined as the ability to critically analyse nutrition information, increase awareness and participate in action to address barriers to healthy eating behaviours. Far too little attention has been paid to establishing valid instruments for measuring CNL. The aim of the present study was to assess the appropriateness of utilizing the latent scales of a newly developed instrument assessing nursing students' 'engagement in dietary habits' (the 'engagement' scale) and their level of 'taking a critical stance towards nutrition claims and their sources' (the 'claims' scale). Design: Data were gathered by distributing a nineteen-item paper-and-pencil selfreport questionnaire to university colleges offering nursing education. The study had a cross-sectional design using Rasch analysis. Data management and analysis were performed using the software packages RUMM2030 and SPSS version 20. Setting: School personnel handed out the questionnaires. Subjects: Four hundred and seventy-three students at ten university colleges across Norway responded (52 % response rate). Results: Disordered thresholds were rescored, an under-discriminating item was discarded and one item showing uniform differential item functioning was split. The assumption of item locations being differentiated by stages was strengthened. The analyses demonstrated possible dimension violations of local independence in the 'claims' scale data and the 'engagement' scale could have been better targeted. Conclusions: The study demonstrates the usefulness of Rasch analysis in assessing the psychometric properties of scales developed to measure CNL. Qualitative research designs could further improve our understanding of CNL scales.

The Nuances of Health Literacy, Nutrition Literacy, and Food Literacy

“…Critical nutrition literacy should consequently encompass critical appraisal skills alongside increased awareness and critical/ emancipatory action to address barriers to good nutrition. 37 As Kickbusch 6 illustrated, a community that lobbies against the establishment of a fast-food restaurant opposite a local school may serve as an example of social action or citizenship that resonates with Nutbeam's notion of critical health literacy. Subsequently, challenging deeply engrained sociocultural norms regarding food and health is one such expression of critical nutrition literacy.…”

Helsesøstres oppfatninger av mødres interaktive ernæringsfremmende allmenndannelse

“…Denne NL-definisjonen er naert forbundet med HL-definisjonen til Nutbeam (10). De tre innholdsdimensjonene i HL; FHL, IHL og CHL er antatt å ha tilsvarende dimensjoner i NL; funksjonell NL (FNL), interaktiv NL (INL) og kritisk NL (CNL) (8,21,22). INL omfatter de kompetanser som er nød-vendige for å kunne søke etter relevant informasjon om ernaering og kosthold, samt å kunne kommunisere og drøfte ernaeringsrelatert helseinformasjon i lag med helsepersonell.…”

“…Dersom spedbarnsmødre har lav NL, så kan dette bli en barriere for å få til et sunt kosthold hos barna deres (26). Guttersrud et al og Guttersrud & Pettersen har nylig validert to spørre-skjemaer for CNL, henholdsvis til bruk overfor sykepleierstudenter og tiendeklasseelever i norsk skole (22,27). I øyeblik-ket foreligger det sannsynligvis ingen validerte spørreskjemaer som spesifikt måler INL, og for øvrig finnes det få som måler IHL (17,28).…”

Obesity Prevention in Children from Birth to Age 5

“…62 Adults with low health literacy have poorer understanding of preventive care information and lower access to services, and their children have poorer health. 131 There is a link between low health literacy with consumption of unhealthy foods, non-compliance with the US Dietary Guidelines, [132][133][134] and playing less with their infants (tummy time). 62 Higher health literacy of parents has been shown to increase effective communication with their child's providers.…”