Development, Reliability and Validity Testing of Toddler NutriSTEP®: A Nutrition Risk Screening Questionnaire for Children 18-35 Months of Age

Abstract

Background /Objectives Nutrition is vital for optimal growth and development of young children. Nutrition risk screening can facilitate early intervention when followed by nutritional assessment and treatment. NutriSTEP® is a valid and reliable nutrition risk screening questionnaire for preschoolers (3-5 years). A need was identified for a similar questionnaire for toddlers (18-35 months). The purpose was to develop a reliable and valid Toddler NutriSTEP®. Subjects/Methods Toddler NutriSTEP® was developed in four phases. Content and face validity were determined with a literature review, parent focus groups (n=6, 48 participants) and experts (n=13) (Phase A). A draft questionnaire was refined with key intercept interviews of 107 parents/caregivers (Phase B). Test-retest reliability (Phase C), based on intra-class correlations (ICC), Kappa (ĸ) statistics, and Wilcoxon tests was assessed with 133 parents/caregivers. Criterion validity (Phase D) was assessed using Receiver Operating Characteristic (ROC) curves by comparing scores on the Toddler NutriSTEP® to a comprehensive nutritional assessment of 200 toddlers with a registered dietitian (RD). Results The Toddler NutriSTEP® was reliable between two administrations (ICC=0.951, F=20.53, p