Nutrition Screening Tool for Every Preschooler (NutriSTEP™): validation and test-retest reliability of a parent-administered questionnaire assessing nutrition risk of preschoolers

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Abstract

Objectives

Study 1: To establish the validity of scores on Nutrition Screening Tool for Every Preschooler (NutriSTEP), a community-based parent-administered screening tool for assessing nutrition risk, by comparing scores to an expert rating. Study 2: To demonstrate test-retest reliability of NutriSTEP.

Subjects/Methods

Study 1: Parents of 269 preschoolers (of 294 parents recruited from the community), completed the NutriSTEP questionnaire; a registered dietitian (RD) assessed the nutritional status (based on medical and nutritional history, 3 days of dietary recall and anthropometric measurements) of these preschoolers and rated their nutritional risk (1 (low) to 10 (high risk)). Receiver operating characteristic (ROC) curves were used to establish validity and determine appropriate cut points based on sensitivity and specificity. Study 2: Parents of 140 preschoolers (of 161 recruited) completed NutriSTEP on two occasions. Intraclass correlation (ICC) and k were used to assess reliability.

Results

Study 1: Scores on NutriSTEP and the RD rating were correlated (r=0.48, P=0.01). Area under the ROC curve for the high risk RD rating (score 8 + ) and the moderate risk rating (score 5 + ) were 81.5 and 73.8%, respectively. A moderate risk cut point of 420 and high risk cut point of 425 were identified for the NutriSTEP scores. Study 2: The NutriSTEP score was reliable between administrations (ICC = 0.89, F = 16.7, P<0.001). Most items on the questionnaire had adequate (κ>0.5) or excellent (κ>0.75) agreement.

Conclusions

The NutriSTEP questionnaire is both valid and reliable for determining nutritional risk in preschoolers.

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