Development and Psychometric Testing of the Thai-Nutrition Literacy Assessment Tool for Adolescents

Main Article Content

Suhong Deesamer
Noppawan Piaseu
Wantana Maneesriwongul
Pisamai Orathai
Karen G. Schepp

Abstract

                 Nutrition literacy is a major component contributing to healthy food consumption behaviors and prevention of diet-related non-communicable diseases; however, existing nutrition literacy assessment tools are limited in their ability to assess Thai adolescents. We report in part the findings of a larger study that used qualitative and quantitative methods to develop and test the psychometric properties of Thai-Nutritional Literacy Assessment Tool for Adolescents. A descriptive design consisting of two phases and six steps was used.


                  A literature review and in-depth interviews (n=30) were employed to clarify the concept of nutrition literacy in Thai adolescents and generate the items, and in-depth findings regarding these will be reported elsewhere. Content validity was reviewed by a panel of seven experts, whereas face validity was conducted in 10 Thai adolescents. Then, preliminary testing was undertaken with 275 Thai adolescents, and item analysis performed. The final version of this instrument consisted of 61 items. Psychometric testing used concurrent validity to examine the association with the Thai Healthy Eating index as a gold standard. Analysis of the discrimination index revealed that baseline criteria were met. Construct validity using the known-group technique was employed, revealing that nutrition literacy score on energy balance was higher in the healthy group than the unhealthy group.


         This is the first instrument aiming to measure nutrition literacy among Thai adolescents, that focuses on understanding the functional, interactive and critical nutrition literacy in various situations. Our instrument has sufficient reliability and validity, and nurses and other health professionals can apply it for nutrition literacy screening and determine suitable interventions for Thai adolescents. Further testing of the instrument warranted with other populations in Thailand.

Article Details

How to Cite
1.
Deesamer S, Piaseu N, Maneesriwongul W, Orathai P, Schepp KG. Development and Psychometric Testing of the Thai-Nutrition Literacy Assessment Tool for Adolescents. PRIJNR [Internet]. 2020 Jan. 2 [cited 2022 Aug. 16];24(1):5-19. Available from: https://he02.tci-thaijo.org/index.php/PRIJNR/article/view/157958
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References

1. Joulaei H, Keshani P, Kaveh MH. Nutrition literacy as a determinant for diet quality amongst young adolescents: a cross-sectional study. Prog Nutr. 2018 20:455-64.

2. Corkins MR, Daniels SR, De Ferranti SD, et al. Nutrition in children and adolescents. Med Clin North Am. 2016 100:1217-35. doi: 10.1016/j.mcna.2016.06.005.

3. Driessnack M, Chung S, Perkhounkova E, Hein M. Using the “Newest Vital Sign” to assess health literacy in children. J Pediatr Health Care. 2014 28:165-71. doi:10.1016/j.pedhc.2013.05.005.

4. United Nations. The Sustainable Development Goals Report 2017. New York: United Nations. 2017 [cited 2017October 31]. Available from https://unstats.un.org/sdgs/files/ report/2017thesustainabledevelopmentgoalsreport2017.pdf

5. Borges CA, Marchioni DML, Levy RB, Slater B. Dietary patterns associated with overweight among Brazilian adolescents. Appetite. 2018 123:402-9. doi: 10.1016/j. appet.2018.01.001.

6. Joshi HA, Jethva VJ, Patel N. Changing food pattern in adolescents and impact on health. Int J Med Sci Public Health. 2014 3:1442-5.

7. Hess JM, Jonnalagadda SS, Slavin JL. What Is a Snack, Why Do We Snack, and How Can We Choose Better Snacks? A Review of the definitions of snacking, motivations to snack, contributions to dietary intake, and recommendations for improvement. Adv Nutr. 2016 7:466-75. doi: 10.3945/an.115.009571.

8. Grimes CA, Riddell LJ, Campbell KJ, Nowson CA. Dietary salt intake, sugar-sweetened beverage consumption, and obesity risk. Pediatrics. 2013 131:14-21. doi: 10.1542/peds.2012-1628.

9. Verstraeten R, Leroy JL, Pieniak Z, et al. Individual and environmental factors influencing adolescents’ dietary behavior in low- and middle-income settings. PLoS ONE. 2016 11:e0157744. doi: 10.1371/journal.pone.0157744.

10. Malloy-Weir L, Cooper M. Health literacy, literacy, numeracy and nutrition label understanding and use: a scoping review of the literature. J Hum Nutr Diet. 2017 30:309-25. doi: 10.1111/jhn.12428.

11. Editorial. Adolescence: A second chance to tackle inequities. Lancet. 2013 382:1535. doi: 10.1016/S0140-6736(13)62308-9.

12. Bastable SB, Dart MA. Developmental stages of the learner. In Bastable SB, Gramet P, Jacobs K, Sopczyk DL. Health professional as an educator: Principles of teaching and learning Sudbury: Jones & Bartlett Learning; 2011.

13. Yuen EYN, Thomson M, Gardiner H. Measuring nutrition and food literacy in adults: A systematic review and appraisal of existing measurement tools. Health Lit Res Pract. 2018 2:e134-e60.

14. Intarakamhang U, Kwanchuen Y. The Development and application of ABCDE-Health Literacy Scale for Thais. Asian Biomed. 2016 10:587-94.

15. Intarakamhang U, Intarakamhang P. Health literacy scale and causal model of childhood overweight. J Res Health Sci. 2017 17:e00368.

16. Nutbeam D. Health literacy as a public health goal: A challenge for contemporary health education and communication strategies into the 21st century. Health Promot Int. 2000 15:259-67.

17. Nutbeam D. The evolving concept of health literacy. Soc Sci Med. 2008 67:2072-8. doi: 10.1016/j.socscimed. 2008.09.050.

18. Velardo S. The nuances of health literacy, nutrition literacy, and food literacy. J Nutr Educ Behav. 2015 47:385-9. e1. doi: 10.1016/j.jneb.2015.04.328.

19. Tabbakh T, Freeland-graves JH. The home environment: A mediator of nutrition knowledge and diet quality in adolescents. Appetite. 2016 105:46-52. doi: 10.1016/j. appet.2016.05.002.

20. Sanders LM, Federico S, Klass P, Abrams MA, Dreyer B. Literacy and child health: a systematic review. Arch Pediatr Adolesc Med. 2009 163:131-40. doi: 10.1001/archpediatrics.2008.539.

21. Waltz CF, Strickland OL, Lenz ER. editors. Measurement in nursing and health research. New York: Springer; 2010.

22. Miles MB, Huberman AM, Saldana J. editors. Qualitative data analysis: A methods sourcebook. California: SAGE; 2014.

23. Grove SK, Burns N, Gray JR. Measurement concepts. In Grove SK, Burns N, Gray JR. The practice of nursing research: Appraisal, synthesis, and generation of evidence. St.Louis: Saunders; 2013, pp. 382-410.

24. Ferketich S. Focus on psychometrics: Aspects of item analysis. Res Nurs Health. 1991 14:165-8.

25. Drost EA. Validity and reliability in social science research. Educ Res Perspect. 2011 38:105-23.

26. Kimberlin CL, Winterstein AG. Validity and reliability of measurement instruments used in research. Am J Health Syst Pharm. 2008 65:2276-84. doi: 10.2146/ajhp070364.

27. Hair JF, Black WC, Babin BJ, Anderson RE. Exploratory Factor Analysis. In: Hair JF, Black WC, Babin BJ, Anderson RE. Multivariate Data Analysis: A global perspective. London: Pearson; 2010, pp. 91-151.

28. Capkova H, Kroupova J, Young K. An analysis of gap fill items in achievement tests. Procedia Soc Behav Sci. 2015 192:547-53.

29. Haidar A, Carey FR, Ranjit N, Archer N, Hoelscher D. Self-reported use of nutrition labels to make food choices is associated with healthier dietary behaviors in adolescents. Public Health Nutr. 2017 20:2329-39. doi: 10.1017/S1368980017001252.

30. Netemeyer RG, Bearden WO, Sharma S. editors. Scaling Procedures: Issues and Applications. California: Sage;2003.

31. Riera-crichton D, Tefft N. Macronutrients and obesity: revisiting the calories in, calories out framework. Econ Hum Biol. 2014 14:33-49. doi: 10.1016/j.ehb. 2014.04.002.

32. Sukumaltrakul K. Food and nutrition for adolescents. In: Kriengsinyod W, Yamborisut U, Sukumaltrakul K, Tangsuphoom N, Jittinandana S, Chailimpamontree W. Food and nutrition knowledge for everyone. Food and Drug Administration; 2016.

33. Chung LMY. Food literacy of adolescents as a predictor of their healthy eating and dietary quality. J Child Adolesc Behav. 2017 5:1000e117.

34. Bas M, Turker P, Koseler E, Saka M. Adolescents as a consumer: The food safety knowledge and practices. Health Med. 2012 6:2973-82.

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