Assessing the validity and reliability of a questionnaire on dietary fibre-related knowledge in a Turkish student population

Characterizing landscape fragmentation of Koitobos river sub-basin, Trans-Nzoia, Kenya

The changes in landscape structure and functioning due to unprecedented human interference are hastening across the globe and it is thus a compelling necessity to preserve and restore our ecosystems. This study aimed to characterize levels of landscape fragmentation, habitat structure, driving forces, and perceptions of the residents on the most preferred reconfiguration approaches. The land use/land cover [LULC] change was first determined by interpreting the 1973, 1986, 1995, 2002, 2014, and 2022 Landsat images using the QGIS 3.26 while the selected landscape fragmentation metrics were analyzed using FRAGSTATS 4.2. Forests, shrubs, and grasslands showed a declining trend, except for agriculture, water, and built-up areas, which depicted high increases for the study periods [1973 to 2022]. The landscape of the study area is characterized as progressively fragmenting as signified by high escalated values of patch number [374 %], edge density [7828 %] between 1986 and 2002, contagion [10.3%], and a declined value of Shannon Diversity Index [SHDI] [-17.42%], Shannon evenness index [SHEI] [-25.8 %] and connectedness [-43.3%]. Considering these results, high losses of forests and grasslands coupled with expansive farmlands and built-up areas have led to unprecedented landscape fragmentation From field surveys and oral interviews, this has not only left streams vulnerable to massive sediment loads but has also triggered annual floods which occur during wet months even though change in onset of rainfall seasons was also reported. The findings call for restoration and integrated and sustainable restoration efforts, especially for the forests, grasslands, and riparian corridors along with sustainable urban planning and community-based sensitization on watershed management.

Food Habits and Lifestyle of Romanians in the Context of the COVID-19 Pandemic

The pandemic caused by the SARS-CoV-2 virus has produced significant changes in socio-cultural life, diet, and interpersonal relationships across the world’s population. The present study aims to identify changes in lifestyle and diet among the Romanian population one year after the onset of the COVID-19 pandemic. An online questionnaire with 58 items (addressing the following aspects: socio-demographic and anthropometric data, current eating habits, and lifestyle changes) was distributed using institutional mailing lists and social media. A total number of 2040 respondents participated in the study, of whom 1464 were women, and 576 men. Among the respondents, 1598 came from urban areas and 442 from rural areas. The processing of the collected data showed significant changes in the behavior of the respondents caused by the pandemic situation with psycho-affective changes in some cases. The number of people who had anxiety, depression and nervousness increased by up to 20%. The majority of respondents (over 57%) were up to 30 years old, either students (43.50%) or employees going to workplaces (33.20%). Analyzing eating habits, we found that diet modification was needed to increase the daily consumption of fruits, vegetables, fish, and seafood. Regarding weight status during the pandemic, we noticed that 34.7% of normal-weight respondents said that they gained weight while 49.7% of overweight people and 52.5% of obese people said that they gained weight (p < 0.0001). Regarding psycho-emotional behavior, 11.81% of the surveyed women stated that they frequently had depressive states during the pandemic period and 11.63% of the men stated that they frequently presented depressive states during the pandemic (p = 0.005).

Implementing and Monitoring Circular Business Models: An Analysis of Italian SMEs

The transition from a linear to a circular economy (CE) is at the center of the debate among institutions, enterprises, practitioners, and scholars. Small- and medium-sized enterprises (SMEs), with their high presence in the business environment, play a pivotal role in the successful implementation of CE principles. Therefore, this paper aims to understand the state of the CE among Italian SMEs, considering both their different sizes and sectors. This study investigates CE knowledge and application, strategic relevance, benefits from and barriers to the transition towards circular business models, and the use of CE-related performance indicators in management control and external reporting. Through an online survey carried out in cooperation with the Italian Confederation of Craft Trades and Small- and Medium-Sized Enterprises (CNA), we collected primary data from 623 respondents. Findings revealed the existence of cultural, technological, market and financial barriers, which have hampered the adoption of circular practices among Italian SMEs. Poor understanding of CE potential, combined with difficulty in raising public and private funds to finance the transition from linear to circular, are the greatest problems. To overcome such issues, we recommend serious intervention by public institutions, trade and consumer associations, and the higher education system to develop a climate more favorable to the CE.

The Translation and Psychometric Evaluation of the Persian Version of Brief Multidimensional Life Satisfaction Scale for Iranian Patients with Cancer

Background: Due to the growing prevalence of cancer globally, the disease is considered one of the most important sources of stress, disability, and reduced life satisfaction. Although life satisfaction is supposed to be a relatively stable psychological construct, it may change in response to life events. Life-satisfaction is the assessment of the quality of life according to one’s chosen criteria. Objectives: The purpose of this research is the psychometric evaluation of the Persian version of “Brief Multidimensional Life Satisfaction Scale” (BMLSS) in Iranian patients with cancer. Methods: The present study was a methodological research, during which the BMLSS was translated and the Farsi version was validated for patients with cancer. Results: The fit indices of confirmatory factor analysis confirmed the dual dimension of the BMLSS. Regarding the convergent validity of the BMLSS, the total score of the instrument had a positive and significant relationship with age and the sense of religiosity. Cronbach's alpha and Intraclass Correlation were calculated. Conclusions: The findings indicated that this Persian version has good validity and reliability and can be used as a comprehensive instrument in Iran.

Development and validation of a questionnaire to evaluate the impact of COVID-19 on lifestyle-related behaviours: eating habits, activity and sleep behaviour

OBJECTIVE

This study was conducted to develop and validate a questionnaire to assess the impact of COVID-19 pandemic on lifestyle-related behaviour related to eating, activity and sleep pattern.

DESIGN

Indexed study used a mixed method design. Phase I employed qualitative methods for development of questionnaire including literature review, focus group discussion, expert evaluation and pre-testing. Phase II used quantitative methods for establishing construct validity of the questionnaire via parallel factor analysis.

PARTICIPANTS

Phase 1 involved participation of experts from different fields (Departments of Medicine, Nutrition and Clinical Psychology) and general adult population. For phase II, data were collected from 124 adult respondents (female = 57·26 %); mean age (36 ± 14·8 years) residing in an urban setting.

RESULTS

The questionnaire consisted of three sections: (A) socio-demographic and anthropometric parameters, (B) twenty-four items each for investigating the changes in eating, activity and sleep behaviour before v. during COVID-19, (C) six items assessing COVID-19 specific reasons for lifestyle change. The Cronbach's α value of the questionnaire is 0·83 suggesting its good internal consistency.

CONCLUSIONS

This appears to be a valid tool to assess the impact of COVID-19 on lifestyle-related behaviours with potential utility for public health researchers to identify these changes at community level and develop strategies to reinforce corrective behaviours.

A short questionnaire to assess changes in lifestyle-related behaviour during COVID 19 pandemic

BACKGROUND AND AIMS

The lasting impact of COVID 19 pandemic and associated restrictions are bound to be significant on lifestyle-related behaviour including diet, physical activity and sleep which is one of the important components in the management of diabetes mellitus and metabolic syndrome. This study was conducted to develop and validate a questionnaire to assess changes in individual's lifestyle-related behaviour during COVID 19 pandemic.

MATERIALS AND METHODS

The questionnaire was developed through a standardised methodology including literature review, focus group discussion, expert evaluation, pre-testing and validation. The face validity and content validity of the questionnaire were analysed. A cross-sectional survey was carried out on 103 participants to validate the questionnaire that used a 5-point Likert scale for the response option. Exploratory factor analysis was performed to establish construct validity. Cronbach's alpha was calculated to test the internal consistency of the whole questionnaire.

RESULTS

A questionnaire with 20 items to assess the lifestyle-related behaviour of people was developed. The questionnaire shows a satisfactory validity and a good internal consistency with the Cronbach's alpha value of 0.72.

CONCLUSION

The developed tool is valid and reliable to assess the changes in lifestyle-related behaviour of individuals during COVID 19 pandemic.

Validation of a General and Sports Nutrition Knowledge Questionnaire in Italian Early Adolescents

To the best of our knowledge, no specific questionnaires on sports nutrition knowledge (NK) have been validated so far in Italian early adolescents. The aim of the present study was to validate a short (26-item) general and sports NK questionnaire in a group of Italian early adolescents. To this aim, the questionnaire was administered to 264 subjects for analysis of internal consistency, and in a subgroup (n = 39) for evaluating the reliability over time. The questionnaire revealed good overall internal consistency and reliability (Cronbach’s α = 0.684) and a highly significant correlation over time (r = 0.977, p < 0.001). Comparison with other validated questionnaires is tricky, because the previous questionnaires were validated in different populations, such as middle or late adolescents or adults, with a higher number of items compared to our questionnaire. Furthermore, data on adolescent NK in Italy are very limited. This study provides a brief, feasible, and validated questionnaire that can be used for investigating sports NK in young subjects. It could be used for evaluating the efficacy of education on general and sports nutrition in both the general population and athletes, and for investigating the relationship between NK and different sports in early adolescence.

Providing Sustainable Knowledge for the Young Graduates of Economic and Social Sciences. Case Study: Comparative Analysis of Required Global Competences in Two Romanian Universities

One of the most important challenges for our society is to keep a properly balanced insight of the relevant triangle of: Quality, functionality, and productivity. Regarding this, the most important challenge for universities now is to understand which are the main global competencies needed in the market, and to put them into practice in the educational process. Our main purpose in this paper is to identify the perception of students of the international competences, the personal competences, theoretical competences, practical competences, and others necessary competences needed for the national and international labor markets. For this purpose, a quantitative study was conducted, based on a survey addressed to 310 bachelor students, coming from two Romanian universities specialized in two domains: In social and in economic fields. The results present common and different views of the two groups of students, regarding specific competencies developed during studies and perceived to be needed on the labor market.

Food and Nutrition-Related Knowledge, Attitudes, and Practices among Reproductive-Age Women in Marginalized Areas in Sri Lanka

Nutrient deficiencies are a public health problem in Sri Lanka. Achieving food security is a major challenge due to unhealthy eating patterns. The nutritional status of a woman and her knowledge is a powerful indicator of the nutritional security of her children and household food security. Nutrition-related knowledge and attitude are necessary for dietary changes towards a healthier dietary pattern. For that reason, food and nutrition-related Knowledge, Attitude and Practice (KAP) is one of the key factors to achieving household food and nutritional security. The main objective of this study is to assess the food and nutrition-related KAP among reproductive-age women and understanding of household food and nutritional security in Sri Lanka as an example for marginalized societies. Thus, a cross-sectional survey was conducted using the KAP model questionnaire administered on 400 reproductive age women (18-49 Years) in marginalized areas in Sri Lanka. Data were collected using a random sampling method. The research results clearly showed that the reproductive age women have a low level of nutritional knowledge in the areas being investigated. Most women have a positive attitude towards receiving nutritional knowledge but have low-level practice about a healthy diet. Furthermore, knowledge, practices, and attitudes of women largely affect their BMI status, as well as household food security. Multiple linear regression analysis was used to analyze the influential factors. There was a highly significant positive correlation between nutritional knowledge, attitude score, and BMI level and a significant difference was found in the area, age, family size, monthly income, educational level, attitudes towards nutrition, food and nutrition practices across the reproductive women (R2:467, p < 0.01). The research results showed that KAP largely determines women's nutrition and household food security. Based on the results of this research, there is a need to enhance nutritional education in reproductive-age women in marginalized areas in Sri Lanka.

Development and Validation of a Questionnaire Assessing Knowledge, Attitude, and Practices about Obesity among Obese Individuals

AIM

The objective of this study was to develop and validate a knowledge, attitude, and practice (KAP) questionnaire about obesity among obese individuals.

MATERIALS AND METHODS

The questionnaire was developed following a standardized protocol that consisted of literature review, focused group discussions, and expert opinion. A cross-sectional survey on 100 obese individuals was carried out to validate the tool. Exploratory factor analysis was performed, using principal component with varimax rotation, to establish the construct validity of the questionnaire. Internal consistency of the questionnaire was tested using Cronbach's α coefficient.

RESULTS

KAP questionnaire with 42 items categorized under three domains knowledge, attitude, and practices was developed. The KAP sections have 14, 15, and 13 items, respectively. Independent Cronbach's α for KAP domains were 0.75, 0.75, and 0.63, respectively, indicating good internal consistency.

CONCLUSION

The developed questionnaire will be helpful in achieving better understanding of the patients' KAP about obesity. It has satisfactory validity and good internal consistency.

Questionnaire development and validation for designing a health telemonitoring system for frail elderly people

BACKGROUND

Advancements in information technology have been instrumental in successful recent developments in telemonitoring systems. In this regard, there is a lack of development of valid and reliable tools to determine the requirements and applications of telemonitoring systems used to provide health care for frail elderly people living at home, specifically in a national setting.

METHOD

A cross-sectional study was carried out in 2018. The statistical population was 15 geriatric and gerontology professionals and 15 health information management experts. Then, content validity ratio (CVR), Cronbach's alpha, and correlation coefficient were calculated for measuring content validity, internal consistency and external reliability (through the test-retest method) respectively. SPSS software was used to analyze the collected data.

RESULTS

Based on the identified items, a draft questionnaire was developed. Using the validity analysis in two stages, 37 items were removed, and 60 items were approved as the essential system requirements. The final questionnaire was organized into five sections with content validity index 99% and internal reliability (Cronbach's alpha coefficient 0.9). Furthermore, the external reliability results of the questionnaire showed that this instrument has a desirable correlation coefficient (r = 0.85, p-value<0.05).

CONCLUSION

Considering the desirable validity and reliability of the questionnaire developed, it is recommended to telemonitoring system designers to determine the usages and requirements of health monitoring systems for frail elderly people living at home. The verified instrument is suitable for use in countries with the same living conditions and level of development as Iran.

Development and validation of a questionnaire to self-assess patient knowledge of direct oral anticoagulants (KODOA-test)

Objective

Few studies have examined associations between patient knowledge of direct oral anticoagulants (DOAC) and clinical outcomes, mostly because of the lack of validated questionnaires for assessing knowledge. The aim of this study was to develop and validate a questionnaire to self-assess knowledge of DOAC.

Methods

Twelve anticoagulation experts participated in the questionnaire development process to ensure content validity. The Knowledge Of Direct Oral Anticoagulants (KODOA)-test was submitted to patients on DOAC and to pharmacists to assess construct validity. Responsiveness was evaluated after educational counseling. Test-retest reliability was assessed to ensure stability over time, and Cronbach's α was calculated for internal reliability. Index of difficulty and item discrimination (D-value) were calculated to assess the performance of single items.

Results

The KODOA-test contains 15 items with multiple-choice answers. Each correct answer scores 1 point (max. score of 15). The KODOA-test was administered to 32 patients on DOAC and 28 pharmacists. Pharmacists scored significantly higher than patients at baseline (median score 13.3 vs 10.0; p<0.001), supporting construct validity. Patient scores increased significantly after educational counseling (median score 11 [interquartile range 2] vs 14 [interquartile range 3]; p<0.001). Test-retest and Cronbach's α were acceptable with a Pearson's correlation of 0.8 and an α of 0.67. The index of difficulty for most items was satisfactory (0.38-0.72) and the mean D-value was 42.5%.

Conclusion

The KODOA-test is a brief, valid, and reliable knowledge self-assessment questionnaire that may be used in clinical trials to investigate associations between knowledge increase and patient-related outcomes.

The effect of oligofructose-enriched inulin supplementation on gut microbiota, nutritional status and gastrointestinal symptoms in paediatric coeliac disease patients on a gluten-free diet: study protocol for a pilot randomized controlled trial

Background

A lifelong gluten-free diet (GFD) is regarded as the only proven and accepted therapy for coeliac disease (CD). However, even patients who strictly follow a GFD often suffer from intestinal symptoms and malabsorption. Selective modulation of intestinal microbiota with prebiotics could remedy various symptoms associated with CD. The use of prebiotics in the treatment of intestinal diseases remains insufficiently investigated. To our knowledge, this study makes the first attempt to evaluate the effect of prebiotic supplementation on gastrointestinal symptoms and nutritional status of children with CD. We hypothesized that adherence to a GFD supplemented with oligofructose-enriched inulin (Synergy 1) would deliver health benefits to children suffering from CD without any side effects, and that it would alleviate intestinal inflammation, restore and stabilize gut microbial balance and reverse nutritional deficiencies through enhanced absorption of vitamins and minerals.

Methods

A randomized, placebo-controlled clinical trial was designed to assess the impact of the Synergy 1 on paediatric CD patients following a GFD. We randomized 34 children diagnosed with CD into an intervention group receiving 10 g of the Synergy 1 supplement daily and a placebo group (receiving maltodextrin) during a 12-week nutritional intervention. Selected biochemical parameters, nutritional status and the characteristics of faecal bacteria will be determined in samples collected before and after the intervention. Analysis of vitamins and amino acids concentration in biological fluids will allow to assess the dietary intake of crucial nutrients. The compliance to a GFD will be confirmed by a Food Frequency Questionnaire (FFQ-6) and the analysis of serum anti-tissue transglutaminase and faecal gluten immunogenic peptides (GIP).

Conclusion

The identification of the beneficial effects of the Synergy 1 supplement on children with CD could have important implications for nutritional recommendations for CD patients and for alleviating the harmful effects of the disease.

Trial registration

ClinicalTrials.gov Registration Number: NCT03064997.

Electronic supplementary material

The online version of this article (doi:10.1186/s12937-017-0268-z) contains supplementary material, which is available to authorized users.

Exercise and eating habits among urban adolescents: a cross-sectional study in Kolkata, India

BACKGROUND

Unhealthy eating and lack of exercise during adolescence culminated into earlier onset and increasing burden of atherosclerotic cardiovascular diseases (CVDs) worldwide. Among urban Indian adolescents, prevalence of these risk factors of CVD seemed to be high, but data regarding their pattern and predictors was limited. To address this dearth of information, a survey was conducted among urban adolescent school-students in Kolkata, a highly populated metro city in eastern India.

METHODS

During January-June, 2014, 1755 students of 9th-grade were recruited through cluster (schools) random sampling. Informed consents from parents and assents from adolescents were collected. Information on socio-demographics, CVD-related knowledge and perception along with eating and exercise patterns were collected with an internally validated structured questionnaire. Descriptive and regression analyses were performed in SAS-9.3.2.

RESULTS

Among 1652 participants (response rate = 94.1%), about 44% had poor overall knowledge about CVD, 24% perceived themselves as overweight and 60% considered their general health as good. Only 18% perceived their future CVD-risk and 29% were engaged in regular moderate-to-vigorous exercise. While 55% skipped meals regularly, 90% frequently consumed street-foods and 54% demonstrated overall poor eating habits. Males were more likely to engage in moderate-to-vigorous exercise [adjusted odds ratio (AOR) = 3.40(95% confidence interval = 2.55-4.54)] while students of higher SES were less likely [AOR = 0.59(0.37-0.94)]. Males and those having good CVD-related knowledge were more likely to exercise at least 1 h/day [AOR = 7.77(4.61-13.07) and 2.90(1.46-5.78) respectively]. Those who perceived their future CVD-risk, skipped meals more [2.04(1.28-3.25)] while Males skipped them less [AOR = 0.62(0.42-0.93)]. Subjects from middle class ate street-foods less frequently [AOR = 0.45(0.24-0.85)]. Relatively older students and those belonging to higher SES were less likely to demonstrate good eating habits [AOR = 0.70(0.56-0.89) and 0.23(0.11-0.47) respectively]. A large knowledge-practice gap was evident as students with good CVD-related knowledge were less likely to have good eating habits [AOR = 0.55(0.32-0.94)].

CONCLUSIONS

CVD-related knowledge as well as eating and exercise habits were quite poor among adolescent school-students of Kolkata. Additionally, there was a large knowledge-practice gap. Multi-component educational interventions targeting behavioral betterment seemed necessary for these adolescents to improve their CVD-related knowledge, along with appropriate translation of knowledge into exercise and eating practices to minimize future risk of CVDs.

Development and validation of an Arabic questionnaire to assess psychosocial determinants of eating behavior among adolescents: a cross-sectional study

BACKGROUND

There is a scarcity of studies that evaluate the psychosocial determinants of eating behavior among adolescents in the Eastern Mediterranean region. The availability of such data is limited by the lack of valid culturally appropriate tools. The current study aims to develop and validate an Arabic questionnaire that measures psychosocial determinants of eating behavior among adolescents.

METHODS

A cross-sectional study was carried out to validate a five-scale questionnaire developed to measure nutrition-related knowledge, attitude, practices, and self-efficacy and social norms. Content validity was assessed by Lawshe's method, factor analysis was used to assess construct validity, and Cronbach's α was used to test internal consistency. Temporal stability was assessed by test-retest reliability. A random sample of public and private school students participated in the validation study.

RESULTS

All the five scales demonstrated excellent content validity (content validity ratio, CVR ≥0.778). Factor analysis revealed several dimensions for each scale. Cronbach's α for the identified dimensions or subscales ranged between 0.495 and 0.809 indicating acceptable internal consistency. Cronbach's α for the total scales ranged between 0.759 and 0.836. Test-retest analysis revealed good temporal stability (intraclass correlation, ICC >0.7).

CONCLUSIONS

A psychometrically valid tool to measure psychosocial determinants of eating behavior was developed. This tool can serve as a potential instrument for pretest and impact evaluation of ongoing nutrition education interventions and curricula. Based on results obtained from this tool, efficacious modifications can be instilled for nutrition policies and interventions.

Validity and Reliability of General Nutrition Knowledge Questionnaire for Adults in Uganda

This study sought to develop and validate a general nutrition knowledge questionnaire (GNKQ) for Ugandan adults. The initial draft consisted of 133 items on five constructs associated with nutrition knowledge; expert recommendations (16 items), food groups (70 items), selecting food (10 items), nutrition and disease relationship (23 items), and food fortification in Uganda (14 items). The questionnaire validity was evaluated in three studies. For the content validity (study 1), a panel of five content matter nutrition experts reviewed the GNKQ draft before and after face validity. For the face validity (study 2), head teachers and health workers (n = 27) completed the questionnaire before attending one of three focus groups to review the clarity of the items. For the construct and test-rest reliability (study 3), head teachers (n = 40) from private and public primary schools and nutrition (n = 52) and engineering (n = 49) students from Makerere University took the questionnaire twice (two weeks apart). Experts agreed (content validity index, CVI > 0.9; reliability, Gwet’s AC1 > 0.85) that all constructs were relevant to evaluate nutrition knowledge. After the focus groups, 29 items were identified as unclear, requiring major (n = 5) and minor (n = 24) reviews. The final questionnaire had acceptable internal consistency (Cronbach α > 0.95), test-retest reliability (r = 0.89), and differentiated (p < 0.001) nutrition knowledge scores between nutrition (67 ± 5) and engineering (39 ± 11) students. Only the construct on nutrition recommendations was unreliable (Cronbach α = 0.51, test-retest r = 0.55), which requires further optimization. The final questionnaire included topics on food groups (41 items), selecting food (2 items), nutrition and disease relationship (14 items), and food fortification in Uganda (22 items) and had good content, construct, and test-retest reliability to evaluate nutrition knowledge among Ugandan adults.

Psychometric Properties of the Persian Version of Self-Transcendence Scale: Adolescent Version

BACKGROUND

Given the greater tendency during adolescence toward risk-taking, identifying and measuring the factors affecting the adolescents' health is highly important to ensure the efficacy of health promoting interventions. One of these factors is self-transcendence. The aim of this study was to assess the psychometric features of the Self-Transcendence Scale (adolescents' version) in students in Tehran, the capital city of Iran.

METHODS

This research was conducted in 2015. For this purpose, 1210 high school students were selected through the multistage cluster sampling method. After the backward-forward translation, the psychometric properties of the scale were examined through the assessment of the (face and construct) validity and reliability (internal consistency and stability) of the scale. The construct validity was assessed using two methods, factor analysis, and convergence of the scale with the Hopefulness Scale for Adolescents.

RESULTS

The result of face validity was minor modifications in some words. The exploratory factor analysis resulted in the extraction of two dimensions, with explaining 52.79% of the variance collectively. In determining the convergent validity, the correlation between hopefulness score and self-transcendence score was r=0.47 (P<0.001). The internal consistency of the scale was determined using Cronbach's alpha of 0.82 for the whole scale and 0.75 and 0.70 for each of the sub-scales. The stability reliability was found to have an ICC of 0.86 and a confidence interval of 95%.

CONCLUSION

The Persian version of the Adolescents' Self-Transcendence Scale showed an acceptable validity and reliability and can be used in the assessment of self-transcendence in Iranian adolescents.