Evaluation of paper-based and web-based food frequency questionnaires for 7-year-old children in Singapore

Abstract Advances in technology enabled the development of a web-based, pictorial food frequency questionnaire (FFQ) to collect parent-report dietary intakes of 7-year-old children in the GUSTO study. This study aimed to compare intakes estimated from a paper-FFQ and a web-FFQ, and examine the relative validity of both FFQs against 3-day diet records (3DDR). Ninety-two mothers reported food intakes of their 7-year-old child on a paper-FFQ, a web-FFQ and a 3DDR. A usability questionnaire collected participants’ feedback on the web-FFQ. Correlations and agreement in energy, nutrients and food groups intakes between the dietary assessments were evaluated using Pearson’s correlation, Lin’s concordance, Bland-Altman plots, Cohen’s kappa and tertile classification. The paper- and web-FFQ had good correlations (≥0.50) and acceptable-good agreement (Lin’s concordance ≥0.30; Cohen’s kappa ≥0.41; ≥50% correct and ≤10% mis-classification into same or extreme tertiles). Compared to 3DDR, both FFQs showed poor agreement (<0.30) in assessing absolute intakes except micronutrients (web-FFQ had acceptable-good agreement); but showed acceptable-good ability to classify children into tertiles (κ≥0.21; ≥40% and ≤15% correct or misclassification). Bland-Altman plots suggest good agreement between web-FFQ and 3DDR in assessing micronutrients and several food groups. The web-FFQ was well-received (e.g. >89% found it user-friendly), and majority (81%) preferred the web-FFQ over the paper-FFQ. The newly developed web-FFQ produced intake estimates comparable to the paper-FFQ, has acceptable-good agreement with 3DDR in assessing absolute micronutrients intakes, and acceptable-good ability to classify children according to categories of intakes. The positive acceptance of the web-FFQ makes it a feasible tool for future dietary data collection.

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Development, Relative Validity and Reproducibility of the Aus-SDS (Australian Short Dietary Screener) in Adults Aged 70 Years and above

Nutrients ◽

10.3390/nu12051436 ◽

2020 ◽

Vol 12 (5) ◽

pp. 1436 ◽

Cited By ~ 1

Author(s):

Adelle M. Gadowski ◽

Tracy A. McCaffrey ◽

Stephane Heritier ◽

Andrea J. Curtis ◽

Natalie Nanayakkara ◽

...

Keyword(s):

Daily Intake ◽

Kappa Statistic ◽

Food Groups ◽

Cohen’S Kappa ◽

Relative Validity ◽

Cohen's Kappa ◽

Spearman’S Correlation ◽

Acceptable Agreement ◽

Dietary Screener ◽

Good Agreement

The aim of this study was to assess the relative validity and reproducibility of a six-item Australian Short Dietary Screener (Aus-SDS). The Aus-SDS assessed the daily intake of core food groups (vegetables, fruits, legumes and beans, cereals, protein sources and dairy sources) in 100 Australians (52 males and 48 females) aged ≥70 years. Relative validity was assessed by comparing intakes from the Aus-SDS1 with an average of three 24-h recalls (24-HRs), and reproducibility using two administrations of the Aus-SDS (Aus-SDS1 and Aus-SDS2). Cohen’s kappa statistic between the Aus-SDS1 and 24-HRs showed moderate to good agreement, ranging from 0.44 for fruits and dairy to 0.64 for protein. There was poor agreement for legume intake (0.12). Bland–Altman plots demonstrated acceptable limits of agreement between the Aus-SDS1 and 24-HRs for all food groups. Median intakes obtained from Aus-SDS1 and Aus-SDS2 did not differ. For all food groups, Cohen’s kappa statistic ranged from 0.68 to 0.89, indicating acceptable agreement between the Aus-SDS1 and Aus-SDS2. Spearman’s correlation coefficient between Aus-SDS1 and 24-HRs across all food groups ranged from 0.64 for fruit to 0.83 for protein. We found the Aus-SDS to be a useful tool in assessing daily intake of core food groups in this population.

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Comparing Interviewer-Administered and Web-Based Food Frequency Questionnaires to Predict Energy Requirements in Adults

Nutrients ◽

10.3390/nu10091292 ◽

2018 ◽

Vol 10 (9) ◽

pp. 1292 ◽

Cited By ~ 1

Author(s):

Didier Brassard ◽

Simone Lemieux ◽

Amélie Charest ◽

Annie Lapointe ◽

Patrick Couture ◽

...

Keyword(s):

Energy Intake ◽

Control Method ◽

Test Method ◽

Energy Requirements ◽

Dietary Intakes ◽

Registered Dietitian ◽

Web Based ◽

Food Frequency ◽

Feeding Trials ◽

The Web

Traditional food frequency questionnaires (FFQs) are influenced by systematic error, but web-based FFQ (WEB-FFQs) may mitigate this source of error. The objective of this study was to compare the accuracy of interview-based and web-based FFQs to assess energy requirements (mERs). The mER was measured in a series of controlled feeding trials in which participants daily received all foods and caloric drinks to maintain stable body weight over 4 to 6 weeks. FFQs assessing dietary intakes and hence mean energy intake were either interviewer-administered by a registered dietitian (IA-FFQ, n = 127; control method) or self-administered using a web-based platform (WEB-FFQ, n = 200; test method), on a single occasion. Comparison between self-reported energy intake and mER revealed significant under-reporting with the IA-FFQ (−9.5%; 95% CI, −12.7 to −6.1) and with the WEB-FFQ (−11.0%; 95% CI, −15.4 to −6.4), but to a similar extent between FFQs (p = 0.62). However, a greater proportion of individuals were considered as accurate reporters of energy intake using the IA-FFQ compared with the WEB-FFQ (67.7% vs. 48.0%, respectively), while the prevalence of over-reporting was lower with the IA-FFQ than with the WEB-FFQ (6.3% vs. 17.5%, respectively). These results suggest less accurate prediction of true energy intake by a self-administered WEB-FFQ than with an IA-FFQ.

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Reproducibility and relative validity of a newly developed web-based food-frequency questionnaire for assessment of preconception diet

BMC Nutrition ◽

10.1186/s40795-019-0310-y ◽

2019 ◽

Vol 5 (1) ◽

Cited By ~ 2

Author(s):

L. Salvesen ◽

E. R. Hillesund ◽

F. N. Vik ◽

A. L. Brantsæter ◽

N. C. Øverby

Keyword(s):

Correlation Coefficient ◽

Rank Correlation ◽

Food Groups ◽

Cohen’S Kappa ◽

Food Frequency ◽

Relative Validity ◽

Spearman’S Rank Correlation ◽

Cohen's Kappa ◽

Spearman’S Rank Correlation Coefficient ◽

Median Correlation

Abstract Background The importance of diet and nutrition during preconception age is a window of opportunity to promote future parental and transgenerational health. As a sub-study to a large Norwegian study, ‘Diet today – health of tomorrow’, a food-frequency questionnaire (FFQ) was developed to assess diet during the preconception phase in young adults aged 20 – 30 years and in this paper we report the reproducibility and relative validity of this questionnaire. Methods The FFQ was developed from an existing FFQ validated in adolescents. Participants were recruited on social media and at a university. Reproducibility was assessed by comparing the test and retest of the FFQ. Relative validity was assessed by comparing intake measured by the FFQ with a 7-day weighed food record. Energy, nutrients and food intake were used to assess the reproducibility and relative validity of the FFQ. The study applied the Spearman’s rank correlation coefficient, percentage of agreement and Cohen’s Kappa to assess reproducibility and validity. Results There were 32 participants recruited to the study, of which 21 participants completed both the test-retest reproducibility and the relative validation. The test-retest reproducibility had a median correlation coefficient of 0.85 for energy and nutrients, a median Spearman’s rank correlation coefficient of 0.75 and a median Cohen’s Kappa of 0.51 for food groups. The relative validity of the FFQ had a median correlation coefficient of 0.59 for energy and nutrients, a median Spearman’s rank correlation coefficient of 0.54 and a median Cohen’s Kappa of 0.28 for food groups. Conclusion This newly developed FFQ for preconception diet in young adults had a satisfactory test-retest reproducibility and fair relative validity.

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Evaluation of dietary intake assessed by the Dutch self-administered web-based dietary 24-h recall tool (Compl-eat™) against interviewer-administered telephone-based 24-h recalls

Journal of Nutritional Science ◽

10.1017/jns.2017.45 ◽

2017 ◽

Vol 6 ◽

Cited By ~ 13

Author(s):

Saskia Meijboom ◽

Martinette T. van Houts-Streppel ◽

Corine Perenboom ◽

Els Siebelink ◽

Anne M. van de Wiel ◽

...

Keyword(s):

Dietary Intake ◽

Large Scale ◽

Alcohol Intake ◽

Lower Number ◽

Vitamin B ◽

Food Groups ◽

Web Based ◽

The Web

AbstractSelf-administered web-based 24-h dietary recalls (24 hR) may save a lot of time and money as compared with interviewer-administered telephone-based 24 hR interviews and may therefore be useful in large-scale studies. Within the Nutrition Questionnaires plus (NQplus) study, the web-based 24 hR tool Compl-eat™ was developed to assess Dutch participants’ dietary intake. The aim of the present study was to evaluate the performance of this tool against the interviewer-administered telephone-based 24 hR method. A subgroup of participants of the NQplus study (20–70 years, n 514) completed three self-administered web-based 24 hR and three telephone 24 hR interviews administered by a dietitian over a 1-year period. Compl-eat™ as well as the dietitians guided the participants to report all foods consumed the previous day. Compl-eat™ on average underestimated the intake of energy by 8 %, of macronutrients by 10 % and of micronutrients by 13 % as compared with telephone recalls. The agreement between both methods, estimated using Lin's concordance coefficients (LCC), ranged from 0·15 for vitamin B1 to 0·70 for alcohol intake (mean LCC 0·38). The lower estimations by Compl-eat™ can be explained by a lower number of total reported foods and lower estimated intakes of the food groups, fats, oils and savoury sauces, sugar and confectionery, dairy and cheese. The performance of the tool may be improved by, for example, adding an option to automatically select frequently used foods and including more recall cues. We conclude that Compl-eat™ may be a useful tool in large-scale Dutch studies after suggested improvements have been implemented and evaluated.

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Paper-Based Versus Web-Based Versions of Self-Administered Questionnaires, Including Food-Frequency Questionnaires: Prospective Cohort Study

JMIR Public Health and Surveillance ◽

10.2196/11997 ◽

2019 ◽

Vol 5 (4) ◽

pp. e11997 ◽

Cited By ~ 2

Author(s):

Itziar Zazpe ◽

Susana Santiago ◽

Carmen De la Fuente-Arrillaga ◽

Jorge M Nuñez-Córdoba ◽

Maira Bes-Rastrollo ◽

...

Keyword(s):

Physical Activity ◽

Cohort Study ◽

Alcohol Consumption ◽

Healthy Eating ◽

Prospective Cohort ◽

Leisure Time ◽

Eating Attitudes ◽

Web Based ◽

Food Frequency ◽

The Web

Background Web-based questionnaires allow collecting data quickly, with minimal costs from large sample groups and through Web-based self-administered forms. Until recently, there has been a lack of evidence from large-scale epidemiological studies and nutrition surveys that have evaluated the comparison between traditional and new technologies to measure dietary intake. Objective This study aimed to compare results from the general baseline questionnaire (Q_0) and the 10-year follow-up questionnaire (Q_10) in the Seguimiento Universidad de Navarra (SUN) prospective cohort, obtained from different subjects, some of whom used a paper-based version, and others used a Web-based version. Both baseline and 10-year assessments included a validated 136-item semiquantitative food-frequency questionnaire (FFQ), used to collect dietary intake. Methods The SUN project is a prospective cohort study (with continuous open recruitment and many participants who were recently recruited). All participants were university graduates. Participants who completed the validated FFQ at baseline (FFQ_0, n=22,564) were selected. The variables analyzed were classified into 6 groups of questions: (1) FFQ (136 items), (2) healthy eating attitudes (10 items), (3) alcohol consumption (3 items), (4) physical activity during leisure time (17 items), (5) other activities (24 items), and (6) personality traits (3 items). Multiple linear and logistic regression models were used to assess the adjusted differences between the mean number of missing values and the risk of having apparently incorrect values for FFQ items or mismatches and inconsistencies in dietary variables. Results Only 1.5% (339/22564) and 60.71% (6765/11144) participants reported their information using the Web-based version for Q_0 and Q_10, respectively, and 51.40 % (11598/22564) and 100.00% (11144/11144) of participants who completed the Q_0 and Q_10, respectively, had the option of choosing the Web-based version. Sociodemographic, lifestyle, health characteristics, food consumption, and energy and nutrient intakes were similar among participants, according to the type of questionnaire used in Q_10. Less than 0.5% of values were missing for items related to healthy eating attitudes, alcohol consumption, and personality traits in the Web-based questionnaires. The proportion of missing data in FFQ, leisure time physical activity, and other activities was higher in paper-based questionnaires than Web-based questionnaires. In Web-based questionnaires, a high degree of internal consistency was found when comparing answers that should not be contradictory, such as the frequency of fruit as dessert versus total fruit consumption and the frequency of fried food consumptions versus oil consumption. Conclusions Incorporating a Web-based version for a baseline and 10-year questionnaire has not implicated a loss of data quality in this cohort of highly educated adults. Younger participants showed greater preference for Web-based questionnaires. Web-based questionnaires were filled out to a greater extent and with less missing items than paper-based questionnaires. Further research is needed to optimize data collection and response rate in Web-based questionnaires.

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The web-based ASSO-food frequency questionnaire for adolescents: relative and absolute reproducibility assessment

Nutrition Journal ◽

10.1186/1475-2891-13-119 ◽

2014 ◽

Vol 13 (1) ◽

Cited By ~ 15

Author(s):

Anna Rita Filippi ◽

Emanuele Amodio ◽

Giuseppe Napoli ◽

João Breda ◽

Antonino Bianco ◽

...

Keyword(s):

Food Frequency Questionnaire ◽

Web Based ◽

Food Frequency ◽

The Web

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Relative validity of a food-frequency questionnaire developed to assess food intake of schoolchildren living in the Brazilian Western Amazon

Cadernos de Saúde Pública ◽

10.1590/s0102-311x2011001100013 ◽

2011 ◽

Vol 27 (11) ◽

pp. 2197-2206 ◽

Cited By ~ 13

Author(s):

Fernanda Baeza Scagliusi ◽

Mariana Tarricone Garcia ◽

Ana Luiza Coutinho Indiani ◽

Marly Augusto Cardoso

Keyword(s):

Food Intake ◽

Food Frequency Questionnaire ◽

Correlation Coefficients ◽

Dietary Intakes ◽

Food Frequency ◽

Relative Validity ◽

Vitamins A And C ◽

The Mean ◽

Almost All ◽

Good Agreement

This study aimed to assess the relative validity of a food frequency questionnaire (FFQ) developed to assess food intake of schoolchildren from the Brazilian Western Amazon. The dietary intakes of 61 schoolchildren, aged between six and nine 9 years, were measured using two 24-hour dietary recalls and one FFQ, conducted with the children's, mother or guardians. Validity of the FFQ compared to the mean of the two dietary recalls was assessed using Pearson's correlation coefficient adjusted for attenuation and energy intake, Bland & Altman plots and evaluation of agreement levels between the two assessment methods. Energy-adjusted and deattenuated correlation coefficients ranged from -0.03 for vitamin C, to 0.93 for calcium. The mean coefficient was 0.46. The mean proportion of subjects classified within one quintile by the two methods was 66%. The Bland & Altman plots indicated good agreement for almost all nutrients, with a mean limit of agreement of 108%. These results indicate that, although there was a lack of accuracy for certain nutrients, such as vitamins A and C, the FFQ ensures reliable estimates of intake of most nutrients.

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Comparison of Self-Administered Web-Based and Interviewer Printed Food Frequency Questionnaires for Dietary Assessment in Italian Adolescents

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16111949 ◽

2019 ◽

Vol 16 (11) ◽

pp. 1949 ◽

Cited By ~ 4

Author(s):

Martina Barchitta ◽

Andrea Maugeri ◽

Ottavia Agrifoglio ◽

Giuliana Favara ◽

Claudia La Mastra ◽

...

Keyword(s):

Fatty Acids ◽

Correlation Coefficients ◽

Weighted Kappa ◽

Rank Test ◽

Nutrient Intakes ◽

Web Based ◽

Food Frequency ◽

Wilcoxon Rank Test ◽

Italian Adolescents ◽

The Web

Innovative tools for assessing food and nutrient intakes in adolescence are essential to uncover the long-term effects of diet on chronic diseases. Here, we developed and compared a web-based self-administered food frequency questionnaire (web-FFQ) with a traditional interviewer printed FFQ (print-FFQ) among 174 Italian adolescents (aged 15–18 years). To assess the reliability of the web-FFQ compared with the print-FFQ, we used Spearman’s rank correlation coefficients, Wilcoxon rank test, quartile misclassification analysis, Cohen’s weighted kappa and the Bland–Altman method. Correlation coefficients ranged from 0.14 (i.e., pizza) to 0.67 (i.e., raw vegetables) for foods, and from 0.45 (i.e., monounsaturated fatty acids, MUFA) to 0.62 (i.e., zinc) for nutrients. Results from the Wilcoxon rank test showed that food and nutrient intakes were comparable between two FFQs, except for nuts, shellfish, fruit juices and MUFA. Adolescents classified into the same or adjacent quartiles ranged from 68.2% (i.e., tea) to 89.1% (i.e., raw vegetables and dipping sauces) for foods, and from 77.2% (i.e., vitamin C) to 87.2% (i.e., folate and calcium) for nutrients. Except for pizza, the weighted kappa indicated moderate to substantial agreement for other foods and nutrients. Finally, we demonstrated that the web-FFQ significantly overestimated shellfish and fruit juice intakes, while it underestimated nuts, canned fish, olive oil, total energy intake, fatty acids and calcium. The limits of agreement analysis indicated moderate to wide individual differences for all groups. In conclusion, our self-administered web-FFQ represents an easy, suitable and cost-effective tool for assessing food and nutrient intakes in adolescents. However, the wide individual differences in level of agreement suggest that additional refinements and calibrations are necessary to investigate the effects of absolute nutrient intakes at the individual level.

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Seroprevalence of SARS-CoV-2 Assessed by Four Chemiluminescence Immunoassays and One Immunocromatography Test for SARS-Cov-2

Frontiers in Public Health ◽

10.3389/fpubh.2021.649781 ◽

2021 ◽

Vol 9 ◽

Author(s):

Pellegrino Cerino ◽

Alfonso Gallo ◽

Biancamaria Pierri ◽

Carlo Buonerba ◽

Denise Di Concilio ◽

...

Keyword(s):

Screening Program ◽

Kappa Coefficient ◽

Cohen’S Kappa ◽

Campania Region ◽

Entire Cohort ◽

Cohen's Kappa ◽

Rapid Tests ◽

Second Wave ◽

Cohen’S Kappa Coefficient ◽

Good Agreement

The onset of the new SARS-CoV-2 coronavirus encouraged the development of new serologic tests that could be additional and complementary to real-time RT-PCR-based assays. In such a context, the study of performances of available tests is urgently needed, as their use has just been initiated for seroprevalence assessment. The aim of this study was to compare four chemiluminescence immunoassays and one immunochromatography test for SARS-Cov-2 antibodies for the evaluation of the degree of diffusion of SARS-CoV-2 infection in Salerno Province (Campania Region, Italy). A total of 3,185 specimens from citizens were tested for anti-SARS-CoV-2 antibodies as part of a screening program. Four automated immunoassays (Abbott and Liaison SARS-CoV-2 CLIA IgG and Roche and Siemens SARS-CoV-2 CLIA IgM/IgG/IgA assays) and one lateral flow immunoassay (LFIA Technogenetics IgG–IgM COVID-19) were used. Seroprevalence in the entire cohort was 2.41, 2.10, 1.82, and 1.85% according to the Liaison IgG, Abbott IgG, Siemens, and Roche total Ig tests, respectively. When we explored the agreement among the rapid tests and the serologic assays, we reported good agreement for Abbott, Siemens, and Roche (Cohen's Kappa coefficient 0.69, 0.67, and 0.67, respectively), whereas we found moderate agreement for Liaison (Cohen's kappa coefficient 0.58). Our study showed that Abbott and Liaison SARS-CoV-2 CLIA IgG, Roche and Siemens SARS-CoV-2 CLIA IgM/IgG/IgA assays, and LFIA Technogenetics IgG-IgM COVID-19 have good agreement in seroprevalence assessment. In addition, our findings indicate that the prevalence of IgG and total Ig antibodies against SARS-CoV-2 at the time of the study was as low as around 3%, likely explaining the amplitude of the current second wave.

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Reproducibility and validity of the EatWellQ8 web-based food frequency questionnaire against a paper-based food frequency questionnaire and a 4-day weighed food record (Preprint)

10.2196/preprints.13591 ◽

2019 ◽

Author(s):

Balqees Alawadhi ◽

Rosalind Fallaize ◽

Rodrigo Franco ◽

Faustina Hwang ◽

Julie Lovegrove

Keyword(s):

Food Frequency Questionnaire ◽

Nutrient Intake ◽

Food Groups ◽

Food Record ◽

Nutrient Intakes ◽

Web Based ◽

Food Frequency ◽

Moderate Agreement ◽

Exact Agreement ◽

Cross Classification

BACKGROUND The web-based EatWellQ8 food frequency questionnaire (FFQ) was developed as a dietary assessment tool for healthy adults in Kuwait. Validation against reliable instruments and an assessment of its reproducibility are required to ensure its accuracy in computing nutrient intake OBJECTIVE To assess the reproducibility and validity of the EatWellQ8 FFQ against a paper based (PFFQ) and a 4-day weighed food record (WFR). METHODS Reproducibility of the EatWellQ8 FFQ was assessed using test-retest methodology. Participants were required to complete the FFQ at two time points, 4 weeks apart. To assess validity of the EatWellQ8 FFQ, a subset of the participants were asked to complete a PFFQ or a 4-day WFR 1 week after administration of the EatWellQ8 FFQ. The level of agreement between nutrient and food group intakes estimated by repeated EatWellQ8 FFQ and the EatWellQ8 FFQ and the PFFQ and the 4-day WFR were evaluated using Bland-Altman methodology and classification into quartiles of daily intake. Crude unadjusted correlation coefficients were also calculated. RESULTS A total of 99 participants (65% female: 35% male) completed the study, 53 participated in the reproducibility study and the 4-day WFR validity study (mean age 37 years) and a further 46 participated in the PFFQ validity study (mean age 36 years). Crude unadjusted correlations for repeated EatWellQ8 FFQ ranged from (0.37-0.82) (P<0.01). Mean cross-classification into “exact agreement plus adjacent” was 88% for nutrient intakes, 86% for food groups, and Bland-Altman plots showed good agreement for energy-adjusted macronutrient intakes. Agreement between the EatWellQ8 FFQ and PFFQ varied, with crude unadjusted correlations ranging from (0.42-0.73) (P<0.05). Mean cross-classification into “exact agreement plus adjacent” was 84% for nutrient intake and 74% for food groups. Bland-Altman plots showed moderate agreement for both energy and energy-controlled nutrient intakes. Crude unadjusted correlations for the EatWellQ8 FFQ and the 4-day WFR ranged from (0.40-0.88) (P<0.01). Mean cross-classification into “exact agreement plus adjacent” was 85% for nutrient intake and 83% for food groups. Bland-Altman plots showed moderate agreement for energy-adjusted macronutrient intakes. CONCLUSIONS Results indicate that the web-based EatWellQ8 FFQ is reproducible for assessing nutrient and food group intake and has moderate agreement compared to a PFFQ and a 4-day WFR for measuring energy and nutrient intakes.

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