Development And Evaluation Of Nutrition Literacy Measurement Scale For Chinese Adults

Objective:To develop a nutrition literacy measurement tool with multiple features for adults,and evaluating the reliability and validity of the scale to provide an effective tool for the nutrition promotion health actions.Method:A ONE-TWO-THREE-SIX conceptual framework and 50 potential items were developed by literature on nutrition literacy which collected through literature review.Expert interviews were conducted to determine the connotation of the scope of the Nutrition Literacy Assessment Scale.A two-round Delphi Consultation was used to screen the items.Combined with selection methods to screen the items: critical ration method,correction item-total correlation coefficient method and factor analysis method.Using Cronbach alpha coefficient and Guttman Split half coefficient to test the reliability of the scale.The validity of the scale is tested in terms of content validity and structure validity.Result:1.Fourteen representative measurement tools were integrated through literature review.Combined with THE DIETARY GUIDELINES FOR CHINESE and residents’ eating habits,this study developed a ONE-TWO-THREE-SIX conceptual framework:1 refers to nutrition literacy;2 refers to the cognition and skills about nutrition;3 refers three levels of nutrition literacy including the functional literacy,interactive literacy and critical literacy.6 refers to six dimensions included knowledge,understanding,obtaining,applying,interactive,and critical.On the basis of this conceptual framework,50 items were compiled as the initial item pool.2.Through two rounds of Delphi expert consultation,the research team retained the "1236" nutrition literacy theoretical framework.The positive coefficients of the two rounds of expert consultation were 100%,the authority coefficients were 0.86 and 0.90, and the Kendall’s coefficients were 0.421 and 0.562(P<0.05).By deleting 10 items,adding 3 items,and modifying 15 items,43 items were finally retained in the initial nutrition literacy measurement scale.3.Item screening results showed that the differences between the high and low groups of all items were statistically significant(P<0.01);the correlation coefficients of each item and the total score of the scale were all greater than 0.4;the EFA of 43 items shows that the KMO is 0.973,and the result of Bartlett’s sphere test shows that the data is suitable for factor analysis(P<0.01);the result of principal component analysis shows that 43 items’ λ are more than 0.4 on 6 factors.43 items were finally retained.4.The reliability and validity test results of the scale show that the Cronbach’s αcoefficient of the total scale is 0.971,and the half-reliability coefficient is 0.855;the content validity S-CVI index of the scale is 0.982,and the content validity of the item level The index I-CVI range from 0.846 to 1.000;the confirmatory factor analysis results show that the standardized factor loads of the six dimensions are between 0.463 to 0.938,the AVE value is between 0.552 to 0.807,and the CR value is between 0.860 to 0.961.Conclusion:1.The framework of nutrition literacy framework proposed in this study has a complete system,covering two dimensions and three levels of functional interactive and critical nutrition literacy,which is embodied in six fields of knowledge,understanding,obtaining,applying,interactive,and critical.2 The validity and reliability of the nutrition literacy scale developed in this study are scientific and reliable.The study conducive to the formulation of relevant intervention strategies to improve the level of adult nutrition literacy,so as to play a positive role in the nutrition and health education of Chinese residents.