Validity and reliability of a simple low cost measure to quantify children’s dietary intake in afterschool settings

摘要

Interest in evaluating and improving children’s diets in afterschool settings has grown, necessitating the development of feasible yet valid measures for capturing children’s intake in such settings. This study’s purpose was to test the criterion validity and cost of three unobtrusive visual estimation methods compared to a plate-weighing method: direct on-site observation using a 4-category rating scale and off-site rating of digital photographs taken on-site using 4- and 10-category scales. Participants were 111 children in grades 1–6 attending four afterschool programs in Boston, MA in December 2011. Researchers observed and photographed 174 total snack meals consumed across two days at each program. Visual estimates of consumption were compared to weighed estimates (the criterion measure) using intra-class correlations. All three methods were highly correlated with the criterion measure, ranging from 0.92–0.94 for total calories consumed, 0.86–0.94 for consumption of pre-packaged beverages, 0.90–0.93 for consumption of fruits/vegetables, and 0.92–0.96 for consumption of grains. For water, which was not pre-portioned, coefficients ranged from 0.47–0.52. The photographic methods also demonstrated excellent inter-rater reliability: 0.84–0.92 for the 4-point and 0.92–0.95 for the 10-point scale. The costs of the methods for estimating intake ranged from $0.62 per observation for the on-site direct visual method to $0.95 per observation for the criterion measure. This study demonstrates that feasible, inexpensive methods can validly and reliably measure children’s dietary intake in afterschool settings. Improving precision in measures of children’s dietary intake can reduce the likelihood of spurious or null findings in future studies.