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Liu KSN, Chen JY, Sun KS, Tsang JPY, Ip P, Wong CKH, Lam CLK. The Knowledge, Attitudes, and Practices of Healthy Eating Questionnaire: a pilot validation study in Chinese families. Front Public Health 2024; 12:1355638. [PMID: 39086814 PMCID: PMC11288980 DOI: 10.3389/fpubh.2024.1355638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 07/03/2024] [Indexed: 08/02/2024] Open
Abstract
Introduction Identifying the knowledge, attitudes, and practices (KAP) gaps of healthy eating can inform the design of effective interventions. This study aimed to test the validity and psychometric properties of a KAP of Healthy Eating Questionnaire (KAP-HEQ) tailored to the Chinese culture. Methods The dimensions and potential items of each KAP scale were identified from published KAP and health literacy questionnaires, which were supplemented by the findings of a previous qualitative healthy eating study. Content validity of the KAP-HEQ was evaluated by eight experts and eight Chinese parent-adolescent dyads in Hong Kong through content validity ratio (CVR), content validity index (CVI), and qualitative feedback. The feasibility, construct validity, reliability, and sensitivity of the KAP-HEQ were evaluated in this pilot study among 60 adolescent-parent dyads (120 persons) through an online survey. The first 30 dyads who completed the KAP-HEQ were invited to repeat the KAP-HEQ 2 weeks later to assess the test-retest reliability. Results The final 44-item KAP-HEQ was completed in 10-15 min by both adolescents and their adult parents. The CVR ranged from -0.38 to 1, and the CVI ranged from 0.56 to 1. Over 80% of the items achieved convergent validity (a significantly positive correlation with its hypothesized scale) and discriminant validity (a higher correlation with its hypothesized scale than with the other two scales). Cronbach's alpha for the internal consistency of the Overall, Attitude, and Practice scales was >0.7, while that of the Knowledge scale was 0.54. The intraclass correlation coefficient (ICC) on test-retest reliability of the Overall and individual scales were all >0.75 except that of the Knowledge scale (ICC = 0.58). The significant differences in KAP scale scores with small to large effect sizes were found between known groups as hypothesized, except the Attitude score between groups by household income, which supported the sensitivity of the KAP-HEQ. Conclusion The KAP-HEQ has shown good validity, reliability, and sensitivity among Chinese adolescents and adults, which can be applied to evaluate KAP status and gaps to inform the design and assess the effectiveness of healthy eating interventions.
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Affiliation(s)
- Kiki S. N. Liu
- Department of Family Medicine and Primary Care, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Julie Y. Chen
- Department of Family Medicine and Primary Care, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
- Department of Family Medicine, The University of Hong Kong Shenzhen Hospital, Shenzhen, China
| | - Kai-Sing Sun
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Joyce P. Y. Tsang
- Department of Family Medicine and Primary Care, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
- School of Health Sciences, Saint Francis University, Hong Kong, Hong Kong SAR, China
| | - Patrick Ip
- Department of Paediatrics and Adolescent Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Carlos K. H. Wong
- Department of Family Medicine and Primary Care, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
- Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
- Laboratory of Data Discovery for Health Limited (D24H), Hong Kong, Hong Kong SAR, China
- Department of Infectious Disease Epidemiology and Dynamics, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Cindy L. K. Lam
- Department of Family Medicine and Primary Care, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
- Department of Family Medicine, The University of Hong Kong Shenzhen Hospital, Shenzhen, China
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Mokari-Yamchi A, Faghfouri AH, Gholami S, Nattagh-Eshtivani E, Gheibi S. Association of household food insecurity with sociodemographic factors and obesity in US youth: findings from the National Health and Nutrition Examination Survey 2017-2018. Front Public Health 2024; 12:1387638. [PMID: 39086807 PMCID: PMC11288867 DOI: 10.3389/fpubh.2024.1387638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Accepted: 07/01/2024] [Indexed: 08/02/2024] Open
Abstract
Background The objective is to determine the prevalence of household food insecurity (HFI) based on sociodemographic factors and their relationship to obesity in youth. Methods The study included a sample of 1,962 youth (aged 6-18) from the National Health and Nutrition Examination Survey (NHANES). The US Household Food Security Survey Module is used to measure food security over the past 12 months. Logistic regression models were used to estimate adjusted odds ratios (ORs) while controlling for covariates. Results In total, 27.4% of the individuals surveyed experienced HFI. Youth from food insecure households were more likely to be obese (adjusted odds ratio [aOR]: 1.59 [95% confidence interval: 1.19-2.13]) and also having abdominal obesity (aOR: 1.56 [95% CI: 1.19-2.03]). however, factors such as non-Hispanic ethnicity, having a Head of household with a college degree, and households with an income exceeding 350% of the poverty line were associated with a reduced risk of facing HFI. Conclusion Hispanic individuals, households with lower parental education levels, and lower family incomes, are disproportionately affected by food insecurity. Furthermore, HFI has been associated with an increased risk of overweight and abdominal obesity among youth. Addressing FI requires targeted policies and interventions that prioritize vulnerable groups.
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Affiliation(s)
- Amin Mokari-Yamchi
- Maternal and Childhood Obesity Research Center, Urmia University of Medical Sciences, Urmia, Iran
| | - Amir Hossein Faghfouri
- Maternal and Childhood Obesity Research Center, Urmia University of Medical Sciences, Urmia, Iran
| | - Samira Gholami
- Maternal and Childhood Obesity Research Center, Urmia University of Medical Sciences, Urmia, Iran
| | - Elyas Nattagh-Eshtivani
- Department of Nutrition, Food Sciences and Clinical Biochemistry, School of Medicine, Social Determinants of Health Research Center, Gonabad University of Medical Science, Gonabad, Iran
| | - Shahsanam Gheibi
- Maternal and Childhood Obesity Research Center, Urmia University of Medical Sciences, Urmia, Iran
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Colillas-Malet E, Bosque-Prous M, Esquius L, González-Casals H, Lafon-Guasch A, Fortes-Muñoz P, Espelt A, Aguilar-Martínez A. Relationship between Diet Quality and Socioeconomic and Health-Related Factors in Adolescents by Gender. Nutrients 2023; 16:139. [PMID: 38201968 PMCID: PMC10780370 DOI: 10.3390/nu16010139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 12/15/2023] [Accepted: 12/20/2023] [Indexed: 01/12/2024] Open
Abstract
Adolescence is a key period for consolidating heathy lifestyles and proper eating habits that can last into adulthood. To analyze the diet quality of Spanish adolescents and its association with socioeconomic factors and health behaviors by gender, a cross-sectional study was conducted using data from the DESKcohort project, consisting of a biannual panel survey on health, health behaviors, and associated determinants, collected in secondary education centers. The study population consisted of 7319 students aged 12 to 18 years. Data were collected from October 2019 to March 2020. The dependent variable was diet quality score according to the Spanish adaptation of the Healthy Eating Index (S-HEI). The independent variables included were socioeconomic factors and health behaviors. We conducted linear regression separately by gender. Diet quality score was significantly higher for girls than for boys (68 and 65, respectively, p < 0.001). For both genders, poorer diet quality was associated with a low level of physical activity [-0.9 (95% CI = -1.6:-0.2) in boys, -1.2 (95% CI = -1.9:-0.4) in girls], alcohol use [-2.5 (95% CI = -3.7:-1.3) in boys, -1.0 (95% CI = -1.9:0.0) in girls], poor self-perceived health [-1.1 (95% CI = -2.4:0.2) in boys, -3.5 (95% CI = -4.6:-2.4) in girls], and having attended Intermediate Level Training Cycles [-2.9 (95% CI = -4.3:-1.5) in boys, -1.9 (95% CI = -3.5:-0.3) in girls]. In girls, poorer diet quality also was associated with low mood [-1.1 (95% CI = -1.9:-0.3)]. The variance was 9% in boys and 12% in girls. Our results highlight the need to consider socioeconomic and health-related factors, as well as gender, when conducting interventions to promote healthy eating among adolescents.
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Affiliation(s)
- Ester Colillas-Malet
- Epi4health Research Group, Faculty of Health Sciences of Manresa, Universitat de Vic—Universitat Central de Catalunya (UVic-UCC), Av. Universitària 4-6, 08242 Manresa, Spain; (E.C.-M.); (H.G.-C.); (A.L.-G.); (A.E.)
| | - Marina Bosque-Prous
- Epi4health Research Group, Faculty of Health Sciences, Universitat Oberta de Catalunya, Rambla del Poblenou, 156, 08018 Barcelona, Spain; (M.B.-P.); (P.F.-M.)
- Departament de Psicobiologia i Metodologia en Ciències de la Salut, Universitat Autònoma de Barcelona (UAB), C/de Ca n’Altayó s/n, 08193 Bellaterra, Spain
| | - Laura Esquius
- Epi4health Research Group, Faculty of Health Sciences, Universitat Oberta de Catalunya, Rambla del Poblenou, 156, 08018 Barcelona, Spain; (M.B.-P.); (P.F.-M.)
| | - Helena González-Casals
- Epi4health Research Group, Faculty of Health Sciences of Manresa, Universitat de Vic—Universitat Central de Catalunya (UVic-UCC), Av. Universitària 4-6, 08242 Manresa, Spain; (E.C.-M.); (H.G.-C.); (A.L.-G.); (A.E.)
- Centre d’Estudis Epidemiològics sobre les ITS i Sida de Catalunya (CEEISCAT), 08916 Badalona, Spain
- Fundació Institut d’Investigació en Ciències de la Salut Germans Trias i Pujol (IGTP), 08916 Badalona, Spain
| | - Aina Lafon-Guasch
- Epi4health Research Group, Faculty of Health Sciences of Manresa, Universitat de Vic—Universitat Central de Catalunya (UVic-UCC), Av. Universitària 4-6, 08242 Manresa, Spain; (E.C.-M.); (H.G.-C.); (A.L.-G.); (A.E.)
- Epi4health Research Group, Faculty of Health Sciences, Universitat Oberta de Catalunya, Rambla del Poblenou, 156, 08018 Barcelona, Spain; (M.B.-P.); (P.F.-M.)
| | - Paula Fortes-Muñoz
- Epi4health Research Group, Faculty of Health Sciences, Universitat Oberta de Catalunya, Rambla del Poblenou, 156, 08018 Barcelona, Spain; (M.B.-P.); (P.F.-M.)
| | - Albert Espelt
- Epi4health Research Group, Faculty of Health Sciences of Manresa, Universitat de Vic—Universitat Central de Catalunya (UVic-UCC), Av. Universitària 4-6, 08242 Manresa, Spain; (E.C.-M.); (H.G.-C.); (A.L.-G.); (A.E.)
- Departament de Psicobiologia i Metodologia en Ciències de la Salut, Universitat Autònoma de Barcelona (UAB), C/de Ca n’Altayó s/n, 08193 Bellaterra, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), C/Monforte de Lemos 3 Pabellón 11, 28029 Madrid, Spain
| | - Alicia Aguilar-Martínez
- Foodlab Research Group, Faculty of Health Sciences, Universitat Oberta de Catalunya, Rambla del Poblenou, 156, 08018 Barcelona, Spain;
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