Reliability and validity of Arabic version of revised general nutrition knowledge questionnaire on university students

Effect of nutrition-related infodemics and social media on maternal experience: A nationwide survey in a low/middle income country

BACKGROUND

Undernutrition is a crucial cause of morbidity and mortality among children in low- or middle-income countries (LMICs). A better understanding of maternal general healthy nutrition knowledge, as well as misbeliefs, is highly essential, especially in such settings. In the current era of infodemics, it is very strenuous for mothers to select not only the right source for maternal nutrition information but the correct information as well.

AIM

To assess maternal healthy nutritional knowledge and nutrition-related misbeliefs and misinformation in an LMIC, and to determine the sources of such information and their assessment methods.

METHODS

This cross-sectional analytical observational study enrolled 5148 randomly selected Egyptian mothers who had one or more children less than 15 years old. The data were collected through online questionnaire forms: One was for the general nutrition knowledge assessment, and the other was for the nutritional myth score. Sources of information and ways of evaluating internet sources using the Currency, Relevance, Authority, Accuracy, and Purpose test were additionally analyzed.

RESULTS

The mean general nutrition knowledge score was 29 ± 9, with a percent score of 70.8% ± 12.1% (total score: 41). The median myth score was 9 (interquartile range: 6, 12; total score: 18). The primary sources of nutrition knowledge for the enrolled mothers were social media platforms (55%). Half of the mothers managed information for currency and authority, except for considering the author's contact information. More than 60% regularly checked information for accuracy and purpose. The mothers with significant nutrition knowledge checked periodically for the author's contact information (P = 0.012). The nutrition myth score was significantly lower among mothers who periodically checked the evidence of the information (P = 0.016). Mothers dependent on their healthcare providers as the primary source of their general nutritional knowledge were less likely to hold myths by 13% (P = 0.044). However, using social media increased the likelihood of having myths among mothers by approximately 1.2 (P = 0.001).

CONCLUSION

Social media platforms were found to be the primary source of maternal nutrition information in the current era of infodemics. However, healthcare providers were the only source for decreasing the incidence of maternal myths among the surveyed mothers.

A Cross-Sectional Study of General Nutrition Knowledge among Nursing Students in the UAE

Background

Adolescence is a crucial time for establishing long-lasting healthy habits, but many university students often engage in unhealthy eating behaviors. Increased independence, social influences, and mental stress all play a role in leading to poor dietary choices that can impact overall health and well-being. It is important to have a good grasp of nutrition to make informed food choices and avoid the development of chronic illnesses.

Purpose

To assess the nutrition knowledge of nursing students and examine the interconnections between participants' beliefs about diet, disease, and weight management.

Methods

: A total of 100 nursing students participated in this descriptive cross-sectional study. Data gathering was conducted from March 2023 to May 2023 at a nursing college in the UAE. Participating students completed a self-reported validated revised general nutrition knowledge questionnaire (GNKQ-R). Descriptive statistics and Pearson's correlation were used for analysis, along with univariate and multivariate analyses as a statistical methodology to examine individual variables within the dataset independently. Cronbach's alpha coefficient of the scale in this study is 0.880. A cut-off point of 50 percent correctness was employed to signify a high level of knowledge.

Results

All participating students were female, with the majority (94%) being single. Most students (68%) had a normal mass index of 23.6, whereas 32% were overweight. The analysis showed that more than half of the students (57%) rated their overall health condition as good. The analysis also found that the only variable detected to predict the good nutrition knowledge level among studied students was having children less than 18 in the same family.

Conclusion

The results of the current study indicate that future wellness actions should prioritize increasing students' general nutrition knowledge while also considering individual and academic factors impacting NK in college.

Food literacy and diet quality in young vegans, lacto-ovo vegetarians, pescatarians, flexitarians and omnivores

OBJECTIVE

To investigate whether food literacy competencies and diet quality vary between 16-to-24-year-olds vegans, lacto-ovo vegetarians, pescatarians, flexitarians and omnivores and to assess whether food literacy is associated with diet quality.

DESIGN

Cross-sectional study. Food literacy (general nutrition knowledge, critical nutrition literacy and food skills) and diet quality were measured using an electronic questionnaire.

SETTING

Southern Norway, September 2021 - March 2022.

PARTICIPANTS

Healthy 16-24-year-olds (n 165).

RESULTS

Overall, the mean general nutrition knowledge score was moderate (48·0 out of 67·0); the lowest mean score was found in omnivores and the highest in flexitarians (45·6 v. 51·5) (P = 0·034). The mean score of critical nutrition literacy was also moderate (3·7 out of 5·0); vegans showed higher scores compared to other dietary practices (P = 0·018). No difference was observed in food skills between the different dietary practices. The overall median diet quality score was 46·0 out of 80·0, lowest in omnivores and highest in vegans (42·0 v. 56·0) (P =< 0·001). In multivariate regression analyses, general nutrition knowledge, food skills and vegan dietary practice were significantly associated with higher diet quality.

CONCLUSIONS

We found moderate levels of food literacy across all dietary practices. The food literacy competencies, general nutrition knowledge and food skills were associated with higher diet quality in our sample. Omnivores showed both the lowest general nutrition knowledge level and lowest diet quality scores. In contrast, both flexitarians and vegans scored highest on general nutrition knowledge and diet quality scores, despite being one of the less restrictive and one of the strictest plant-based dietary practices, respectively.

Validation of the General and Sport Nutrition Knowledge Questionnaire (GeSNK) in Spanish Adolescents

The General and Sport Nutrition Knowledge Questionnaire (GeSNK) is an instrument that has been developed and validated to assess the level of nutrition knowledge in adolescents and young adults. The aim of the present study was to validate the GeSNK questionnaire in a group of Spanish adolescents in the framework of a Nutrition Education Programme in Secondary Schools in Andalusia, Spain. This cross-sectional questionnaire validation study was developed in two phases: translation-cultural adaptation and validation. A total of 305 adolescents aged 11 to 17 years, studying from the first to the third year of compulsory secondary education, participated on a voluntary basis. The GeSNK questionnaire consists of 62 items: 29 items for the General Nutrition section and 33 items for the Sports Nutrition section. Cronbach's alpha coefficient for the complete questionnaire (GeSNK Total) was: 0.934; for the GeSNK General Nutrition section it was 0.918; and for the GeSNK Sports Nutrition section it was 0.856. The stability measured by the correlation coefficient for the General Nutrition section was 0.406 (p = 0.000); for the Sports Nutrition section it was 0.198 (p = 0.017); and for GeSNK Total the stability was 0.545 (p = 0.000). The questionnaire also demonstrated adequate construct validity. We therefore conclude that the Spanish version of the GeSNK questionnaire is a valid instrument to measure the level of knowledge in general nutrition and sports nutrition in adolescents.

What Do People Know about Food, Nutrition and Health?-General Nutrition Knowledge in the Austrian Population

BACKGROUND

Only limited information is available on the nutrition knowledge of the general Austrian population and how this relates to the nutrition knowledge of health professionals (medical doctors, pharmacists, nutritionist, dieticians) and school teachers.

METHODS

Adolescents and adults at the age of 14-75 years (n = 1000), medical doctors (n = 307), pharmacists (n = 295), nutritionists (n = 124), dieticians (n = 160) and school teachers (n = 873) completed an online survey using a German version of the General Nutrition Knowledge Questionnaire-Revised (GNKQ-R) including self-reported data on sex, age, BMI, and health status. Adolescent and adult participants were recruited by a research agency to be representative for the Austrian population for age, sex, and education. A convenience sample was used for health professionals (medical doctors, pharmacists, nutritionist, dieticians) and school teachers. All participants completed a computer-assisted web-based interviewing (CAWI) survey.

RESULTS

Total scores for nutrition knowledge of the general population (61.4%) were significantly lower than scores from all other groups (medical doctors 81.3%, pharmacists 83.0%, dieticians 87.5%, nutritionists 85.6%, school teachers 74.5%). The main drivers for better nutritional knowledge were female sex, higher age, and higher level of education, while BMI classification and self-reported health status had no impact. In regard to single questions, the most striking result was the misclassification of sugar as the nutrient with the most calories by 41.4% of the general population while only 29.0% correctly identified fat to be the nutrient with the most calories.

CONCLUSIONS

The nutritional knowledge of the general population should be significantly improved in order to lay a basis for better dietary behavior. In view of the relatively low scores of teachers, their nutrition education should be improved in order to enable transfer of sound education in schools.

Nutrition Knowledge as a Driver of Adherence to the Mediterranean Diet in Italy

Background

An optimal Nutrition knowledge (NK) among the population could result in greater Adherence to the Mediterranean Diet (AMD), a recognized dietary pattern capable of preventing chronic food-related diseases. This study aimed to evaluate the association between NK and AMD in Italy.

Methods

A national representative sample of 2,869 adults took part in an assessment that was carried out through a self-administrated questionnaire including sections relating to NK and AMD. AMD was evaluated following the PREDIMED PLUS methodology. Descriptive statistics were provided, and ordinal measures of NK score and AMD were calculated based on quartiles of the quantitative scores. A contingency analysis was performed to check associations between variables.

Results

In Italy, the average NK score was 50 ± 13.3, equivalent to 56.8% of correct answers. The average value of AMD was 6.8, corresponding to 40% of the maximum score with 31.4% of the population demonstrating low AMD, 31.3% in the lower-middle range, 24% in the medium-high range, and only 13.3% reporting a high AMD. A significant association between NK and AMD was found; respondents who reported the lowest AMD corresponded to those with the lowest NK (36.7%; p < 0.05) and similarly, those with the highest level of adherence to MD also achieved the highest NK scores (41.7%; p < 0.05).

Conclusion

This study showed that AMD in Italy is generally low, and the strong association between NK and AMD demonstrated that there is a clear connection between a healthy dietary pattern and the nutrition literacy of the population. Those with the highest AMD corresponded to the highest NK and, conversely, those with the lowest AMD displayed the lowest NK. The study also highlighted that socioeconomic aspects were strong determinants of both AMD and NK.

Cross-cultural adaptation and validation of the PedsQL™ stem cell transplant module in China: A methodological and cross-sectional study

BACKGROUND

Hematopoietic stem cell transplantation (HSCT), as a mature technology, has significantly improved the survival rate of children. However, there lack efficient scales to assess the quality of life (QoL) of children with HSCT in China, which has important implications in the care of this population. This study aimed to translate the original English Pediatric Quality of Life Inventory™ (PedsQL™) Stem Cell Transplant Module into a Chinese mandarin version, and evaluate its reliability.

METHODS

Children of ages 2-18 years who had received HSCT at Children's Hospital of Nanjing Medical University and Children's Hospital of Fudan University were recruited. Children or their parents were asked to fill the PedsQL™ 4.0 Generic Core Scales, PedsQL™ Stem Cell Transplant Module, and PedsQL™ Family Information Form. Feasibility was evaluated by completion rate and the percentage of missing items, reliability by the internal consistency and test-retest reliability, and validity by factor analysis and correlation analysis between the scores of total scale and each dimension.

RESULTS

A total of 120 children (mean age 6.37, SD = 3.674) and some parents were included. A low percentage of items were missed in returned reports. Cronbach's alpha coefficient reached 0.70 in the majority of dimensions of both child self-report and parent proxy-report. Test-retest reliability was 0.685 in parents' forms and 0.765 in child's forms. Eight factors were extracted, with a cumulative contribution rate of 74.54%. The correlation between PedsQL™ 4.0 and Transplant Module was 0.748 for children self-report and 0.808 for parent proxy-report.

CONCLUSIONS

This study provides evidence that the Chinese mandarin version of the PedsQL™ Stem Cell Transplant is feasible, reliable and valid in evaluating the QoL of Chinese children after HSCT.

Development and Validity of a General Nutrition Knowledge Questionnaire (GNKQ) for Chinese Adults

Nutrition knowledge refers to understanding concepts and processes related to nutrition and health, proven to be an essential determinant of healthy eating. However, partially due to the lack of nutrition knowledge and unhealthy eating patterns, more and more Chinese people face overweight, obesity, and a high risk of suffering from various chronic diseases. This study aimed to develop a general nutritional knowledge questionnaire (GNKQ) in a Chinese context to diagnose and improve nutrition knowledge education for Chinese people. The newly adapted questionnaire was based on the Turkey version of GNKQ, and absorbed dietary recommendations in a Chinese context. It was first validated by four nutrition experts, then tested by eleven volunteers (one public nutritionist, one preventive medicine graduate student, and nine psychology graduate students). Finally, the questionnaire was tested by 278 participants, including 175 adults, to determine internal consistency, content validity, and convergent validity. Moreover, the construct validity was evaluated by comparing the differences between 50 students in nutrition-related majors and 53 students in nutrition-unrelated majors. The final Chinese version of GNKQ kept 32 questions with 68 items after deleting some questions based on item difficulty and discrimination. The data showed that the overall internal consistency coefficient was 0.885, and the test-retest reliability was 0.769, p < 0.001. Students majoring in nutrition had larger scores than in nutrition-unrelated majors. The convergent validity for each demographic variable was consistent with previous studies, such as larger nutrition knowledge scores for females and those with a higher education. Therefore, the revised Chinese version of GNKQ showed good reliability and validity, indicating that it could be an effective tool to assess the nutrition knowledge of Chinese adults.

Feasibility Study of a Newly Developed Technology-Mediated Lifestyle Intervention for Overweight and Obese Young Adults

Background: Poor eating habits and sedentary lifestyle are common among young adults and increase the risk for chronic diseases later in life. Due to the widespread use of information technology among young adults, the Rashakaty (Fitness for Me) study aimed to develop and test the feasibility of a technology-based nutrition education intervention. This would support overweight and obese university students to achieve weight loss, enhance nutrition knowledge, and increase physical activity levels. Methods: We enrolled 246 participants in a 16-week non-randomized feasibility study with two arms: Rashakaty-Basic and Rashakaty-Enhanced. The intervention was guided by social cognitive theory and was delivered via a website and mobile apps. Results: Among the 161 participants who completed the endline assessments, there was no significant difference in weight loss between the two arms. However, waist circumference decreased more (p = 0.003) in the Rashakaty -Enhanced group. Additionally, changes in knowledge related to sources of nutrients (p < 0.001) and diet–disease relationships (p = 0.006) were significantly higher among the Rashakaty-Enhanced group. Rashakaty-Enhanced participants reported increased number of days spent on moderate physical activity (p = 0.013) and minutes walked (p < 0.001). Moreover, they also reported higher scores in social support from friends to reduce fat intake (p = 0.006) and from family and friends to increase physical activity (p = 0.001). Conclusions: The results of this feasibility study can assist in the development and implementation of future technology–mediated health promotion programs in the UAE, especially for young adults.