Reliability and relative validity of a child nutrition questionnaire to simultaneously assess dietary patterns associated with positive energy balance and food behaviours, attitudes, knowledge and environments associated with healthy eating

Food behaviours, attitudes, environments and knowledge are relevant to professionals in childhood obesity prevention, as are dietary patterns which promote positive energy balance. There is a lack of valid and reliable tools to measure these parameters. The aim of this study was to determine the reliability and relative validity of a child nutrition questionnaire assessing all of these parameters, used in the evaluation of a community-based childhood obesity prevention project

The challenges of quantitative evaluation of a multi-setting, multi-strategy community-based childhood obesity prevention programme: lessons learnt from the eat well be active Community Programs in South Australia

Objective To describe the rationale, development and implementation of the quantitative component of evaluation of a multi-setting, multi-strategy, community-based childhood obesity prevention project (the eat well be active (ewba) Community Programs) and the challenges associated with this process and some potential solutions. Design ewba has a quasi-experimental design with intervention and comparison communities. Baseline data were collected in 2006 and post-intervention measures will be taken from a non-matched cohort in 2009. Schoolchildren aged 10–12 years were chosen as one litmus group for evaluation purposes. Setting Thirty-nine primary schools in two metropolitan and two rural communities in South Australia. Subjects A total of 1732 10–12-year-old school students completed a nutrition and/or a physical activity questionnaire and 1637 had anthropometric measures taken; 983 parents, 286 teachers, thirty-six principals, twenty-six canteen and thirteen out-of-school-hours care (OSHC) workers completed Program-specific questionnaires developed for each of these target groups. Results The overall child response rate for the study was 49 %. Sixty-five per cent, 43 %, 90 %, 90 % and 68 % of parent, teachers, principals, canteen and OSHC workers respectively, completed and returned questionnaires. A number of practical, logistical and methodological challenges were experienced when undertaking this data collection. Conclusions Learnings from the process of quantitative baseline data collection for the ewba Community Programs can provide insights for other researchers planning similar studies with similar methods, particularly those evaluating multi-strategy programmes across multiple settings

Reliability of Questionnaires to Assess the Healthy Eating and Activity Environment of a Child's Home and School

Copyright © 2013 Annabelle Wilson et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.Childhood overweight and obesity are a growing concern globally, and environments, including the home and school, can contribute to this epidemic. This paper assesses the reliability of two questionnaires (parent and teacher) used in the evaluation of a community-based childhood obesity prevention intervention, the eat well be active (ewba) Community Programs. Parents and teachers were recruited from two primary schools and they completed the same questionnaire twice in 2008 and 2009. Data from both questionnaires were classified into outcomes relevant to healthy eating and activity, and target outcomes, based on the goals of the ewba Community Programs, were identified. Fourteen and 12 outcomes were developed from the parent and teacher questionnaires, respectively. Sixty parents and 28 teachers participated in the reliability study. Intraclass correlation coefficients for outcomes ranged from 0.37 to 0.92 (parent) () and from 0.42 to 0.86 (teacher) (). Internal consistency, measured by Cronbach’s alpha, of teacher scores ranged from 0.11 to 0.91 and 0.13 to 0.78 for scores from the parent questionnaire. The parent and teacher questionnaires are moderately reliable tools for simultaneously assessing child intakes, environments, attitudes, and knowledge associated with healthy eating and physical activity in the home and school and may be useful for evaluation of similar programs

Improving weight status in childhood: results from the 'eat well be active' community programs

There is a clear need for effective prevention and treatment interventions to manage the high prevalence of childhood overweight globally. It is well recognised that changes in the social and economic environment in the last three decades have been a major contributor to altered eating and activity patterns resulting in positive energy balance. The most recent update to the Cochrane review of interventions for preventing obesity in children identified that the majority of childhood obesity prevention intervention evaluations were short-term (12 months or less) and largely focussed on individual behaviour change. Also from this review there is now some early evidence that settings-based obesity prevention interventions are effective at reducing body mass index in the short term. However, given the short-term nature of these interventions, sustainability of this change is unclear, and stronger evidence from larger-scale evaluations is needed about what intervention components are feasible to be embedded into children’s settings and systems (e.g. the school environment) to be able to translate and scale up research findings into effective public health approaches. Until recently, effective obesity prevention interventions have largely drawn upon behaviour change theories, which appear to be unlikely to produce sustainable change in outcomes if they do not consider the broader social and environmental context. Models based on ecological theory show the complex interaction between individuals’ behaviour and their broader environments, that influence eating and activity. A community-based, capacity-building approach aims to promote sustainable skill development and increase the ability of individuals to improve environments that promote health outcomes.This presents a promising approach to obesity prevention, and evidence is needed on processes and outcomes of interventions guided by such theories

Reliability of Questionnaires to Assess the Healthy Eating and Activity Environment of a Child's Home and School

Childhood overweight and obesity are a growing concern globally, and environments, including the home and school, can contribute to this epidemic. This paper assesses the reliability of two questionnaires (parent and teacher) used in the evaluation of a community-based childhood obesity prevention intervention, the eat well be active (ewba) Community Programs. Parents and teachers were recruited from two primary schools and they completed the same questionnaire twice in 2008 and 2009. Data from both questionnaires were classified into outcomes relevant to healthy eating and activity, and target outcomes, based on the goals of the ewba Community Programs, were identified. Fourteen and 12 outcomes were developed from the parent and teacher questionnaires, respectively. Sixty parents and 28 teachers participated in the reliability study. Intraclass correlation coefficients for outcomes ranged from 0.37 to 0.92 (parent) (P<0.05) and from 0.42 to 0.86 (teacher) (P<0.05). Internal consistency, measured by Cronbach’s alpha, of teacher scores ranged from 0.11 to 0.91 and 0.13 to 0.78 for scores from the parent questionnaire. The parent and teacher questionnaires are moderately reliable tools for simultaneously assessing child intakes, environments, attitudes, and knowledge associated with healthy eating and physical activity in the home and school and may be useful for evaluation of similar programs

Changes in Primary School Children's Behaviour, Knowledge, Attitudes, and Environments Related to Nutrition and Physical Activity

Rigorous evaluation of large-scale community-based obesity interventions can provide important guidance to policy and decision makers. The eat well be active (ewba) Community Programs, a five-year multilevel, multistrategy community-based obesity intervention targeting children in a range of settings, was delivered in two communities. A comprehensive mixed-methods evaluation using a quasiexperimental design with nonmatched comparison communities was undertaken. This paper describes the changes in primary school children's attitudes, behaviours, knowledge, and environments associated with healthy eating and physical activity, based on data from six questionnaires completed pre- and postintervention by students, parents, and school representatives. As self-reported by students in years from five to seven there were few significant improvements over time in healthy eating and physical activity behaviours, attitudes, knowledge, and perceived environments, and there were few changes in the home environment (parent report). Overall there were considerably more improvements in intervention compared with comparison schools affecting all environmental areas, namely, policy, physical, financial, and sociocultural, in addition to improvements in teacher skill and knowledge. These improvements in children's learning environments are important and likely to be sustainable as they reflect a change of school culture. More sensitive evaluation tools may detect behaviour changes