Evaluating the accuracy of a geographic closed-ended approach to ethnicity measurement, a practical alternative

Purpose: Measuring ethnicity accurately is important for identifying ethnicity variations in disease risk. We evaluated the degree of agreement and accuracy of maternal ethnicity measured using the new standardized closed-ended geographically based ethnicity question and geographic reclassification of open-ended ethnicity questions from the Canadian census. Methods: A prospectively designed study of respondent agreement of mothers of healthy children age 1-5 years recruited through the TARGet Kids! practice based research network. For the primary analysis, the degree of agreement between geographic reclassification of the Canadian census maternal ethnicity variables and the new geographically based closed-ended maternal ethnicity variable completed by the same respondent was evaluated using a kappa analysis. Results: 862 mothers who completed both measures of ethnicity were included in the analysis. The kappa agreement statistic for the two definitions of maternal ethnicity was 0.87 (95% CI: 0.84-0.90) indicating good agreement. Overall accuracy of the measurement was 93%. Sensitivity and specificity ranged from 83-100% and 96-100% respectively. Conclusion: The new standardized closed-ended geographically based ethnicity question represents a practical alternative to widely used open-ended ethnicity questions. It may reduce risk of misinterpretation of ethnicity by respondents, simplify analysis and improve the accuracy of ethnicity measurement.This work was supported by the Canadian Institutes of Health Research [grant numbers 248319, 221549]

Descriptive characteristics of study sample of N = 109 children participating in the validation of a parent proxy-reported short beverage screener against a 24-hour recall.

Descriptive characteristics of study sample of N = 109 children participating in the validation of a parent proxy-reported short beverage screener against a 24-hour recall.</p

Kappa coefficient, sensitivity, and specificity for any daily SCB intake (>0 cups/day) compared to none (0 cups/day) for the N = 109 children participating in the validation of a parent proxy-reported short beverage screener (Nutrition and Health Questionnaire; NHQ) against a 24-hour recall (Automated Self-Administered 24-h Dietary Assessment Tool-Canada; ASA24).

Kappa coefficient, sensitivity, and specificity for any daily SCB intake (>0 cups/day) compared to none (0 cups/day) for the N = 109 children participating in the validation of a parent proxy-reported short beverage screener (Nutrition and Health Questionnaire; NHQ) against a 24-hour recall (Automated Self-Administered 24-h Dietary Assessment Tool-Canada; ASA24).</p

Bland-Altman plot.

Describes the agreement between a parent proxy-reported short beverage screener (Nutrition and Health Questionnaire; NHQ) and a 24-hour recall (Automated Self-Administered 24-h Dietary Assessment Tool-Canada; ASA24) for total sugar-containing beverages (SCBs) among N = 109 children. The solid red line represents the mean of the difference between the two measures (-0.14 cups/day). The dashed red lines represent +/- 2 standard deviations of this difference (1.43 cups/day, -1.72 cups/day).</p

Question number 28 on the <i>TARGet Kids</i>! Nutrition and Health Questionnaire (NHQ).

This was the short beverage screener used in this study for comparison with the 24-hour dietary recall. (TIF)</p

Descriptive characteristics of a sub-sample of N = 101 children participating in the validation of a parent proxy-reported short beverage screener against a 24-hour recall.

Sub-sample contained those children whose parents indicated that their 24-hour recall represented typical intake. Values are reported as Mean (SD) or n (%) where appropriate. (DOCX)</p

Mean difference and correlation between beverage volumes for a sub-sample of N = 101 children participating in the validation of a parent proxy-reported short beverage screener (Nutrition and Health Questionnaire; NHQ) against a 24-hour recall (Automated Self-Administered 24-h Dietary Assessment Tool-Canada; ASA24).

Sub-sample contained those children whose parents indicated that their 24-hour recall represented typical intake. Beverage volumes are reported as mean (SD). Mean difference and Spearman correlation are reported with the 95% confidence interval (CI). (DOCX)</p

Mean difference and correlation between beverage volumes for the N = 109 children participating in the validation of a parent proxy-reported short beverage screener (Nutrition and Health Questionnaire; NHQ) against a 24-hour recall (Automated Self-Administered 24-h Dietary Assessment Tool-Canada; ASA24).

Mean difference and correlation between beverage volumes for the N = 109 children participating in the validation of a parent proxy-reported short beverage screener (Nutrition and Health Questionnaire; NHQ) against a 24-hour recall (Automated Self-Administered 24-h Dietary Assessment Tool-Canada; ASA24).</p