Spanish Adaptation of a Pictorial Assessment of Diet Quality

Abstract

for low-literacy Spanish speakers. Validation will be done by comparing MCMT item responses to behaviors observed during mealtime interactions with the target child (final target N ¼ 80). Content of the tool and mealtime coding system was based on previous validation results of the English MCMT version. The process described here will be used to assess whether parent responses accurately capture their mealtime behaviors. Evaluation: Videotaping of mealtimes is underway (current n¼22). Coder reliability has been established and final coding is complete for one quarter of the collected videos. Approximately 35 videos will be finalized by the time of the report. Development of the coding system and preliminary descriptive data of the observed parent mealtime behaviors will be reported. Preliminary associations between behaviors and MCMT responses will be shared. Conclusion and Implications: Development of a valid Spanish language self-assessment tool with low-literacy demands to capture feeding style would be an effective tool for federally funded nutrition education programs. Such tools enable programs to tailor their messaging to key barriers specific to each group.Objective: To describe the process of validating a short pictorial diet quality assessment tool to be used with lowincome Spanish-speakers. Description: Latinos are disproportionally affected by nutrition-related conditions. A proportion of Spanish speakers in the US have limited ability to speak English. Linguistically and culturally appropriate evaluation tools are necessary to obtain valid and reliable dietary data from this population. Previous research has shown vegetable variety to be a proxy for diet quality and can serve as an alternative to the more burdensome 24-hour diet recall. A Spanish version of the tool was developed simultaneously with an English version. Bilingual and native Spanish speakers are involved in a multistage, iterative process that include face-validation through cognitive interviews, forward translation, and examination of conceptual consistency by subject-matter experts. Evaluation: Text and pictures in the tool are examined for clarity, understanding, and relevance through cogni-tive interviews with a convenience sample of Spanishspeaking parents of 2-5 year old children at three Head Start sites in northern California. The tool is modified after interviewees' feedback and content fidelity appraisal by experts in the research team. The process is iterated until satisfaction is achieved and no further changes are desirable. Conclusions and Implications: Linguistic and cultural considerations are part of the process of achieving content and face validity of a short pictorial diet quality assessment tool to be used with low-income Spanishspeakers.Objective: In year four, the research objective was to test the impact of implementing fewer Smarter Lunchrooms protocol items, and food service ownership of Smarter Lunchrooms intervention, on the selection and consumption of fruits, vegetables, and while milk in middle schools. T...