Questionnaire to Evaluate Infant Feeding Behaviors
Research Brief
Development and Evaluation of the Infant Feeding Education Questionnaire for the Expanded Food and Nutrition Education ProgramABSTRACT
Objective
Develop and evaluate the Infant Feeding Education Questionnaire (IFEQ) to measure the impact of the Expanded Food and Nutrition Education Program (EFNEP) infant-feeding education on knowledge, attitudes, and behavioral intent.
Methods
Evaluation included content validity testing through expert reviews and cognitive interviews with low-income mothers (n = 37); construct validity using the known-groups technique (n = 679); convergent validity testing using the Infant Feeding Practices Study II questionnaire (n = 66); and test-retest reliability (n = 66).
Results
The IFEQ had strong construct validity for knowledge and attitudes; IFEQ scores were significantly higher for the high-knowledge/attitude group (29.6 ± 3.08) than the low-knowledge/attitude group (14.5 ± 5.81; P < .001). The IFEQ failed to show convergent validity. The percent agreement between baseline and retest questions was moderate to high, indicating reliability over time.
Conclusions and Implications
This study represents the first steps in the development of the IFEQ. There's a need to perform further testing to establish convergent validity and pilot-test the questions following EFNEP infant-feeding education.
Section snippets
INTRODUCTION
Infancy presents a critical time for establishing dietary patterns and food-related practices that persist through the life span.1 Rapid weight gain and excess weight during infancy can lead to an increased risk of overweight or obesity during childhood and subsequent life stages.2 , 3 Infants from low-income families are especially vulnerable to subsequent obesity, possibly owing to a higher prevalence of undesirable feeding practices.2 , 4 Overweight during infancy is associated with respiratory
METHODS
Following psychometric analysis guidelines,16 the IFEQ was developed using content validity and cognitive interviews and evaluated using construct and convergent validity and test-retest reliability. Mothers were targeted for this tool because women make up most of EFNEP participants and typically serve as primary caregivers during infancy.17
The University of Wisconsin-Madison Institutional Review Board approved this study.
Instrument Development
Demographic characteristics for participants from all tests are presented in Table 2. Expert review of topics resulted in modification to 2 topics and 4 subtopics, the addition of 3 subtopics, and added detail to 10 subtopics. Some suggestions to add new subtopics or add detail to existing subtopics were not adopted because they did not reflect the infant-feeding curricula reviewed previously. As previously stated, expert review of IFEQ questions only resulted in minor changes to the wording.
Of
DISCUSSION
This study describes the development and evaluation of the IFEQ to measure the postintervention impact of EFNEP infant-feeding education for use among low-income mothers with infants across the US. To the authors' knowledge, IFEQ is the first questionnaire to evaluate EFNEP infant-feeding education that has been tested for validity and reliability.
Using the known-groups technique, it can be reasoned that the high-knowledge group is more informed and has stronger attitudes toward desirable
IMPLICATIONS FOR RESEARCH AND PRACTICE
Researchers and EFNEP nutrition educators can use the IFEQ to evaluate infant-feeding education and improve or sustain effective programming targeting low-income mothers with infants. Using infant-feeding curricula delivered by EFNEP and similar programs allowed for the identification of topics and development of questions that closely match current education. Because the Supplemental Nutrition Assistance Program–Education curricula and the WIC Works Resource System also were used, the IFEQ
ACKNOWLEDGMENTS
This research was funded by the Wisconsin Alumni Research Foundation and the National Institute of Food and Agriculture US Department of Agriculture Hatch Grant Project 1012544. The authors thank Susan Baker, Kathryn McGirr, Karen Frank, Cheng Li, Debra Palmer-Keenan, Michael Puglisi, Pam Halbach, Jill Hicks, Lisa Messer, Amanda Moore, Meredith Quenzer, Teresa Ward, Laura Yergler, Jen Birstler, Samuel Engle, and Elizabeth Chitwood for their assistance. They also express gratitude to the WIC
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© 2019 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.
Source: https://www.sciencedirect.com/science/article/abs/pii/S1499404619310139
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