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http://dx.doi.org/10.4162/nrp.2022.16.2.272

Higher food literacy scores are associated with healthier diet quality in children and adolescents: the development and validation of a two-dimensional food literacy measurement tool for children and adolescents  

Park, Dahyun (Interdisciplinary Program in Precision Public Health, Graduate School, Korea University)
Choi, Mi-Kyung (Faculty of Food and Health Sciences, College of Natural Sciences, Keimyung University)
Park, Yoo Kyoung (Department of Medical Nutrition, Graduate School of East-West Medical Science, Kyung Hee University)
Park, Clara Yongjoo (Department of Food and Nutrition, Chonnam National University)
Shin, Min-Jeong (Interdisciplinary Program in Precision Public Health, Graduate School, Korea University)
Publication Information
Nutrition Research and Practice / v.16, no.2, 2022 , pp. 272-283 More about this Journal
Abstract
BACKGROUND/OBJECTIVES: Most child and adolescent food literacy measurement tools focus on nutrition and food safety. However, the importance of aspects related to the food system such as food distribution and food waste and their effects on environmental sustainability is growing. We therefore developed and validated a two-dimensional tool for children (8-12 years old) and adolescents (13-18 years old) that can comprehensively measure food literacy. The association of food literacy with diet quality and self-reported health was assessed. SUBJECTS/METHODS: First, we developed a food literacy conceptual framework that contains food system and literacy dimensions through a literature review, focus group interviews, and expert review. After a face validity study, we conducted the main survey (n = 200) to validate the questionnaire. Construct validity and reliability were assessed using exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and Cronbach's alpha. RESULTS: As a result of the Delphi study, content validity was confirmed for the remaining 30 items after two items were excluded (content validity ratio = 0.86). Eleven items were excluded from the EFA results, while the CFA results indicated appropriate fit indices for the proposed model (comparative fit index = 0.904, root mean square error of approximation = 0.068). The final food literacy questionnaire consisted of 19 questions and comprised 5 factors: production, distribution, selection, preparation and cooking, and intake. Food literacy was positively associated with diet quality, as assessed by the Nutrition Quotient score, in both children and adolescents and with self-reported health in adolescents.
Keywords
Literacy; health literacy; questionnaire; eating behavior; sustainable development; diet, food, and nutrition;
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1 Vingilis ER, Wade TJ, Seeley JS. Predictors of adolescent self-rated health. Analysis of the National Population Health Survey. Can J Public Health 2002;93:193-7.   DOI
2 Ewert A, Place G, Sibthorp J. Early-life outdoor experiences and an individual's environmental attitudes. Leis Sci 2005;27:225-39.   DOI
3 Otto S, Evans GW, Moon MJ, Kaiser FG. The development of children's environmental attitude and behavior. Glob Environ Change 2019;58:101947.   DOI
4 Fosse NE, Haas SA. Validity and stability of self-reported health among adolescents in a longitudinal, nationally representative survey. Pediatrics 2009;123:e496-501.   DOI
5 Das JK, Salam RA, Thornburg KL, Prentice AM, Campisi S, Lassi ZS, Koletzko B, Bhutta ZA. Nutrition in adolescents: physiology, metabolism, and nutritional needs. Ann N Y Acad Sci 2017;1393:21-33.   DOI
6 Story M. Nutritional requirements during adolescence. In: McAnarney ER, Kreipe RE, Orr DE, Comerci GD, editors. Textbook of Adolescent Medicine. Philadelphia (PA): W.B. Saunders; 1992. p.75-84.
7 Ng M, Fleming T, Robinson M, Thomson B, Graetz N, Margono C, Mullany EC, Biryukov S, Abbafati C, Abera SF, et al. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 2014;384:766-81.   DOI
8 Vidgen HA, Gallegos D. Defining food literacy and its components. Appetite 2014;76:50-9.   DOI
9 Widener P, Karides M. Food system literacy: empowering citizens and consumers beyond farm-to-fork pathways. Food Cult Soc 2014;17:665-87.   DOI
10 Kyriazos TA. Applied psychometrics: sample size and sample power considerations in factor analysis (EFA, CFA) and SEM in general. Psychology (Irvine) 2018;9:2207-30.   DOI
11 Thomas H, Azevedo Perry E, Slack J, Samra HR, Manowiec E, Petermann L, Manafo E, Kirkpatrick SI. Complexities in Conceptualizing and measuring food literacy. J Acad Nutr Diet 2019;119:563-73.   DOI
12 Stjernqvist NW, Elsborg P, Ljungmann CK, Benn J, Bonde AH. Development and validation of a food literacy instrument for school children in a Danish context. Appetite 2021;156:104848.   DOI
13 Bailey CJ, Drummond MJ, Ward PR. Food literacy programmes in secondary schools: a systematic literature review and narrative synthesis of quantitative and qualitative evidence. Public Health Nutr 2019;22:2891-913.   DOI
14 Ronto R, Ball L, Pendergast D, Harris ND. Food literacy at secondary schools in Australia. J Sch Health 2016;86:823-31.   DOI
15 Jung E. Korea Health Statistics 2019: Korea National Health and Nutrition Examination Survey (KNHANES VIII-1). Cheongju: Korea Disease Control and Prevention Agency; 2020.
16 Kim HY, Kwon S, Lee JS, Choi YS, Chung HR, Kwak TK, Park J, Kang MH. Development of a Nutrition Quotient (NQ) equation modeling for children and the evaluation of its construct validity. Korean J Nutr 2012;45:390.   DOI
17 Park D, Park YK, Park CY, Choi MK, Shin MJ. Development of a comprehensive food literacy measurement tool integrating the food system and sustainability. Nutrients 2020;12:1-13.   DOI
18 Azevedo Perry E, Thomas H, Samra HR, Edmonstone S, Davidson L, Faulkner A, Petermann L, Manafo E, Kirkpatrick SI. Identifying attributes of food literacy: a scoping review. Public Health Nutr 2017;20:2406-15.   DOI
19 Cunningham SJ. Predicting obesity in young adulthood from childhood and parental obesity. Emerg Off Pediatr 1997;10:204.
20 Slater J, Falkenberg T, Rutherford J, Colatruglio S. Food literacy competencies: a conceptual framework for youth transitioning to adulthood. Int J Consum Stud 2018;42:547-56.   DOI
21 Lynn MR. Determination and quantification of content validity. Nurs Res 1986;35:382-5.
22 Hu LT, Bentler PM. Cutoff criteria for fit indexes in covariance structure analysis: conventional criteria versus new alternatives. Struct Equ Modeling 1999;6:1-55.   DOI
23 United Nations. THE 17 GOALS | Sustainable Development [Internet]. New York (NY): United Nations; 2021 [cited 2021 March 16]. Available from: https://sdgs.un.org/goals.
24 Hanh N. Sustainable food systems concept and framework. Rome: Food and Agriculture Organization of the United Nations; 2018.
25 Kremers SP, de Bruijn GJ, Visscher TL, van Mechelen W, de Vries NK, Brug J. Environmental influences on energy balance-related behaviors: a dual-process view. Int J Behav Nutr Phys Act 2006;3:9.   DOI
26 Begley A, Paynter E, Butcher LM, Dhaliwal SS. Effectiveness of an adult food literacy program. Nutrients 2019;11:1-15.   DOI
27 Evans GW, Otto S, Kaiser FG. Childhood origins of young adult environmental behavior. Psychol Sci 2018;29:679-87.   DOI
28 Kline RB. Principles and Practice of Structural Equation Modeling. New York (NY): The Guilford Press; 2011.
29 Marsh HW, Hau KT, Wen Z. In search of golden rules: Comment on hypothesis-testing approaches to setting cutoff values for fit indexes and dangers in overgeneralizing Hu and Bentler's (1999) findings. Struct Equ Modeling 2004;11:320-41.   DOI
30 Kim HY, Lee JS, Hwang JY, Kwon S, Chung HR, Kwak TK, Kang MH, Choi YS. Development of NQ-A, nutrition quotient for Korean adolescents, to assess dietary quality and food behavior. J Nutr Health 2017;50:142-57.   DOI
31 Amin SA, Lehnerd M, Cash SB, Economos CD, Sacheck JM. Development of a tool for food literacy assessment in children (TFLAC). J Nutr Educ Behav 2019;51:364-9.   DOI
32 Tabacchi G, Battaglia G, Messina G, Paoli A, Palma A, Bellafiore M. Validity and internal consistency of the preschool-flat, a new tool for the assessment of food literacy in young children from the training-tohealth project. Int J Environ Res Public Health 2020;17:1-15.
33 Doustmohammadian A, Omidvar N, Keshavarz-Mohammadi N, Abdollahi M, Amini M, Eini-Zinab H. Developing and validating a scale to measure Food and Nutrition Literacy (FNLIT) in elementary school children in Iran. PLoS One 2017;12:e0179196.   DOI
34 Krause C, Sommerhalder K, Beer-Borst S, Abel T. Just a subtle difference? Findings from a systematic review on definitions of nutrition literacy and food literacy. Health Promot Int 2018;33:378-89.   DOI
35 Yuen EY, Thomson M, Gardiner H. Measuring nutrition and food literacy in adults: a systematic review and appraisal of existing measurement tools. Health Lit Res Pract 2018;2:e134-60.
36 Cullen T, Hatch J, Martin W, Higgins JW, Sheppard R. Food literacy: definition and framework for action. Can J Diet Pract Res 2015;76:140-5.   DOI
37 Story M, Stang J. Understanding adolescent eating behaviors. In: Story M, Stang J, editors. Guidelines for Adolescent Nutrition Services. Minneapolis (MN): Center for Leadership, Education and Training in Maternal and Child Nutrition; 2005. p. 9-19.
38 Lawshe CH. A quantitative approach to content validity. Person Psychol 1975;28:563-75.   DOI
39 Guadagnoli E, Velicer WF. Relation of sample size to the stability of component patterns. Psychol Bull 1988;103:265-75.   DOI
40 Vaitkeviciute R, Ball LE, Harris N. The relationship between food literacy and dietary intake in adolescents: a systematic review. Public Health Nutr 2015;18:649-58.   DOI
41 Bentler PM, Bonett DG. Significance tests and goodness of fit in the analysis of covariance structures. Psychol Bull 1980;88:588-606.   DOI
42 Farmland Information Center. A primer on community food systems: linking food, nutrition and agriculture - FIC. Northampton (MA): Farmland Information Center; 2019 [cited 2021 July 27]. Available from: https://farmlandinfo.org/publications/a-primer-on-community-food-systems-linking-food-nutrition-and-agriculture/.
43 Brooks N, Begley A. Adolescent food literacy programmes: a review of the literature. Nutr Diet 2014;71:158-71.   DOI
44 Tabachnick BG, Fidell LS. Using Multivariate Statistics Title: Using Multivariate Statistics. London: Pearson; 2019.
45 Food and Agriculture Organization of the United Nations. Sustainable Food Systems. Concept and Framework. Rome: Food and Agriculture Organization of the United Nations; 2018. p.1-8.
46 Corraliza JA, Collado S. Ecological awareness and children's environmental experience. Pap Psicol 2019;40:190-6.
47 Jorgensen KA. Bringing the jellyfish home: environmental consciousness and 'sense of wonder' in young children's encounters with natural landscapes and places. Environ Educ Res 2016;22:1139-57.   DOI
48 Ronto R, Ball L, Pendergast D, Harris N. Adolescents' perspectives on food literacy and its impact on their dietary behaviours. Appetite 2016;107:549-57.   DOI
49 Nunally JC, Bernstein IH. Psychometric Theory. New York (NY): McGraw-Hill; 1978.