Development and preliminary validation of a Family Nutrition and Physical Activity (FNPA) screening tool

Ihmels, Welk, Eisenmann, Nusser

Description

Parents directly influence children's physical activity and nutrition behaviors and also dictate the physical and social environments that are available to their children. This paper summarizes the development of an easy to use screening tool (The Family Nutrition and Physical Activity (FNPA) Screening Tool) designed to assess family environmental and behavioral factors that may predispose a child to becoming overweight. Methods The FNPA instrument was developed using constructs identified in a comprehensive evidence analysis conducted in collaboration with the American Dietetics Association. Two or three items were created for each of the ten constructs with evidence grades of II or higher. Parents of first grade students from a large urban school district (39 schools) were recruited to complete the FNPA screening tool and provide permission to link results to BMI data obtained from trained nurses in each school. A total of 1085 surveys were completed out of the available sample of 2189 children in the district. Factor analysis was conducted to examine the factor structure of the scale. Mixed model analyses were conducted on the composite FNPA score to determine if patterns in home environments and behaviors matched some of the expected socio-economic (SES) and ethnic patterns in BMI. Correlations among FNPA constructs and other main variables were computed to examine possible associations among the various factors. Finally, logistic regression was used to evaluate the construct validity of the FNPA scale. Results Factor analyses revealed the presence of a single factor and this unidimensional structure was supported by the correlation analyses. The correlations among constructs were consistently positive but the total score had higher correlations with child BMI than the other individual constructs. The FNPA scores followed expected demographic patterns with low income families reporting lower (less favorable) scores than moderate or high income families. Children with a total score in the lowest tertile (high risk family environment and behaviors) had an odds ratio (OR) of 1.7 (95% CI = 1.07 – 2.80) compared to children with a total score in the highest tertile (more favorable family environment and behaviors) but this effect was reduced when parent BMI was included as a covariate. Conclusion The results support the contention that the FNPA tool captures important elements of the family environment and behaviors that relate to risk for child overweight.

Informations

• Publié par: biomed
• Publié le: 01 janvier 2009
• Nombre de lectures: 35
• Langue: English

Extrait

International Journal of Behavioral Nutrition and Physical Activity

BioMedCentral

Open Access Research Development and preliminary validation of a Family Nutrition and Physical Activity (FNPA) screening tool 1 1 2 3 Michelle A Ihmels* , Greg J Welk , Joey C Eisenmann and Sarah M Nusser

1 2 Address: Department of Kinesiology, Iowa State University, Ames, Iowa, USA, Department of Kinesiology, Michigan State University, East 3 Lansing, Michigan, USA and Department of Statistics, Iowa State University, Ames, Iowa, USA Email: Michelle A Ihmels*  [e-mail]; Greg J Welk  [e-mail]; Joey C Eisenmann  [e-mail]; Sarah M Nusser  [e-mail] * Corresponding author

Published: 12 March 2009 Received: 3 March 2008 Accepted: 12 March 2009 International Journal of Behavioral Nutrition and Physical Activity2009,6:14 doi:10.1186/14795868614 This article is available from: http://www.ijbnpa.org/content/6/1/14 © 2009 Ihmels et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract Background:Parents directly influence children's physical activity and nutrition behaviors and also dictate the physical and social environments that are available to their children. This paper summarizes the development of an easy to use screening tool (The Family Nutrition and Physical Activity (FNPA) Screening Tool) designed to assess family environmental and behavioral factors that may predispose a child to becoming overweight. Methods:The FNPA instrument was developed using constructs identified in a comprehensive evidence analysis conducted in collaboration with the American Dietetics Association. Two or three items were created for each of the ten constructs with evidence grades of II or higher. Parents of first grade students from a large urban school district (39 schools) were recruited to complete the FNPA screening tool and provide permission to link results to BMI data obtained from trained nurses in each school. A total of 1085 surveys were completed out of the available sample of 2189 children in the district. Factor analysis was conducted to examine the factor structure of the scale. Mixed model analyses were conducted on the composite FNPA score to determine if patterns in home environments and behaviors matched some of the expected socioeconomic (SES) and ethnic patterns in BMI. Correlations among FNPA constructs and other main variables were computed to examine possible associations among the various factors. Finally, logistic regression was used to evaluate the construct validity of the FNPA scale. Results:Factor analyses revealed the presence of a single factor and this unidimensional structure was supported by the correlation analyses. The correlations among constructs were consistently positive but the total score had higher correlations with child BMI than the other individual constructs. The FNPA scores followed expected demographic patterns with low income families reporting lower (less favorable) scores than moderate or high income families. Children with a total score in the lowest tertile (high risk family environment and behaviors) had an odds ratio (OR) of 1.7 (95% CI = 1.07 – 2.80) compared to children with a total score in the highest tertile (more favorable family environment and behaviors) but this effect was reduced when parent BMI was included as a covariate. Conclusion:The results support the contention that the FNPA tool captures important elements of the family environment and behaviors that relate to risk for child overweight.

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