Development, Reliability and Validity Testing of Toddler NutriSTEP®: A Nutrition Risk Screening Questionnaire for Children 18-35 Months of Age

Background /Objectives Nutrition is vital for optimal growth and development of young children. Nutrition risk screening can facilitate early intervention when followed by nutritional assessment and treatment. NutriSTEP® is a valid and reliable nutrition risk screening questionnaire for preschoolers (3-5 years). A need was identified for a similar questionnaire for toddlers (18-35 months). The purpose was to develop a reliable and valid Toddler NutriSTEP®. Subjects/Methods Toddler NutriSTEP® was developed in four phases. Content and face validity were determined with a literature review, parent focus groups (n=6, 48 participants) and experts (n=13) (Phase A). A draft questionnaire was refined with key intercept interviews of 107 parents/caregivers (Phase B). Test-retest reliability (Phase C), based on intra-class correlations (ICC), Kappa (ĸ) statistics, and Wilcoxon tests was assessed with 133 parents/caregivers. Criterion validity (Phase D) was assessed using Receiver Operating Characteristic (ROC) curves by comparing scores on the Toddler NutriSTEP® to a comprehensive nutritional assessment of 200 toddlers with a registered dietitian (RD). Results The Toddler NutriSTEP® was reliable between two administrations (ICC=0.951, F=20.53, pThe accepted manuscript in pdf format is listed with the files at the bottom of this page. The presentation of the authors' names and (or) special characters in the title of the manuscript may differ slightly between what is listed on this page and what is listed in the pdf file of the accepted manuscript; that in the pdf file of the accepted manuscript is what was submitted by the author