Abstract
Aim
The objective of this study was to test whether the Family Nutrition and Physical Activity (FNPA) Screening Tool, which evaluates environmental risk factors affecting the occurrence of obesity in children, is valid and reliable in the Turkish population.
Subject and methods
We included 638 parents with children between the ages of 6 and 18 in 12 schools randomly determined in our city. A data form containing sociodemographic characteristics (14 questions) and the FNPA scale (20 questions) adapted to Turkish were applied to the parents. The validity of the scale was analyzed in terms of construct validity using exploratory and confirmatory factor analysis. Reliability analysis was carried out by calculations using the internal consistency coefficient, the intraclass correlation coefficient, and corrected item total correlations. The intraclass correlation coefficient determined test–retest reliability.
Results
The internal consistency (Cronbach’s alpha) coefficient of the scale was 0.76 and the test–retest reliability correlation coefficient was 0.92 (p < 0.001). The 20-item FNPA scale displayed a five-factor construct and the confirmatory factor analysis confirmed a five-factor construct. It was determined that all factors explained 51% of the total variance of the scale and factor loadings varied between 0.32 and 0.82.
Conclusion
Psychometric analysis results demonstrated that the Turkish version of the FNPA scale is a reliable and valid evaluation tool. The scale can be used for children aged between 6 and 18 years to evaluate family environments and combine information from various behaviors associated with childhood obesity.
Similar content being viewed by others
Code availability
Not applicable.
References
Agha M, Agha R (2017) The rising prevalence of obesity: part a: impact on public health. Int J Surg Oncol (N Y) 2(7):e17. https://doi.org/10.1097/IJ9.0000000000000017
Albright JJ, Park HM (2009) Confirmatory factor analysis Using Amos, LISREL, Mplus, and SAS/STAT CALIS. University Information Technology Services Center for Statistical and Mathematical Computing Indiana University Press, Bloomington, pp 9–13. http://www.indiana.edu/~statmath/stat/all/cfa/index.htm
Alpar R (2016) Uygulamalı İstatistik ve Geçerlik-Güvenirlik, 4rd edn. Detay yayıncılık, Ankara, pp 453–509
Asparouhov T, Muthén B (2009) Exploratory structural equation modeling. Struct Eq Model 16(3):397–438
Baydur H, Eser E (2006) Uygulama: Yaşam kalitesi ölçeklerinin psikometrik çözümlenmesi. Sağlıkta Birikim 1(2):99–123
Buyuktuncer Z, Akyol A, Ayaz A et al (2019) Turkish version of the Yale food addiction scale: preliminary results of factorial structure, reliability, and construct validity. J Health Popul Nutr 38:42. https://doi.org/10.1186/s41043-019-0202-4
Çapık C, Gözüm S, Aksayan S (2018) Kültürlerarası ölçek uyarlama aşamaları, dil ve kültür uyarlaması: Güncellenmiş rehber. FNJN 26(3):199–210. https://doi.org/10.26650/FNJN397481
Center for Disease Control (CDC) (2019) http://www.cdc.gov/growthcharts/. Accessed 24 July 2019
Christison AL, Daley BM, Asche CV et al (2014) Pairing motivational interviewing with a nutrition and physical activity assessment and counseling tool in pediatric clinical practice: a pilot study. Child Obes 10:432–441. https://doi.org/10.1089/chi.2014.0057
Coto J, Pulgaron ER, Graziano PA et al (2019) Parents as role models: associations between parent and young children’s weight, dietary intake, and physical activity in a minority sample. Mater Child Health J 23:943–950. https://doi.org/10.1007/s10995-018-02722-z
Crede M, Harms P (2019) Questionable research practices when using confirmatory factor analysis. J Manag Psychol 34(1):18–30. https://doi.org/10.1108/JMP-06-2018-0272
Erkorkmaz Ü, Etikan İ, Demir O et al (2013) Doğrulayıcı faktör analizi ve uyum indeksleri. J Med Sci 33(1):210–223. https://doi.org/10.5336/medsci.2011-26747
Family Nutrition Physical Activity (FNPA) (2014) http://www.myfnpa.org/resources.html. Accessed 27 February 2019
Gauthier KI, Krajicek MJ (2013) Obesogenic environment: a concept analysis and pediatric perspective. J Spec Pediatr Nurs 18:202–210. https://doi.org/10.1111/jspn.12027
Guðmundsd òttir HB, Ólason DÞ, Guðmundsdóttir DG, Sigurðsson JF (2014) A psychometric evaluation of the Icelandic version of the WHO-5. Scandinavian J Psychol 55:567–572. https://doi.org/10.1111/sjop.12156
Hand RK, Birnbaum AS, Carter BJ et al (2014) The RD parent empowerment program creates measurable change in the behaviors of low-income families and children: an intervention description and evaluation. J Acad Nutr Diet 114:1923–1931. https://doi.org/10.1016/j.jand.2014.08.014
Harper C, Snowden M (2017) Environment and society: human perspectives on environmental issues, 6th edn. Routledge, New York
Herbenick SK, James K, Milton J, Cannon D (2018) Effects of family nutrition and physical activity screening for obesity risk in school-age children. J Spec Pediatr Nurs 23(4):e12229. https://doi.org/10.1111/jspn.12229
Huang H, Radzi WM, Salarzadeh Jenatabadi H (2017) Family environment and childhood obesity: a new framework with structural equation modeling. Int J Environ Res Public Health 14:e181. https://doi.org/10.3390/ijerph14020181
Ihmels MA, Welk G, Eisenmann JC, Nusser SM (2009a) Development and preliminary validation of a family nutrition and physical activity (FNPA) screening tool. Int J Behav Nutr Phys Act 6:14. https://doi.org/10.1186/1479-5868-6-14
Ihmels MA, Welk GJ, Eisenmann JC et al (2009b) Prediction of BMI change in young children with the family nutrition and physical activity (FNPA) screening tool. Ann Behav Med 38:60–68. https://doi.org/10.1007/s12160-009-9126-3
James K, Matsangas P, Connelly C (2014) Maternal self-efficacy and family health routines. ICAN: Infant, Child Adolescent Nutrition 6(6):351–356
Johnson R, Welk G, Saint-Maurice PF, Ihmels M (2012) Parenting styles and home obesogenic environments. Int J Environ ResPublic Health 9(4):1411–1426. https://doi.org/10.3390/ijerph9041411
Klimesh KA (2015) Associations between the Family Nutrition and Physical Activity screening tool and the Youth Activity Profile. Dissertation, Iowa State University. https://doi.org/10.31274/etd-180810-3930
Li CH (2016) Confirmatory factor analysis with ordinal data: comparing robust maximum likelihood and diagonally weighted least squares. Behav Res Methods 48(3):936–949. https://doi.org/10.3758/s13428-015-0619-7
Mattoo K, Shubayr M, Moaleem MA, Halboup E (2020) Influence of parental physical activity and screen time on the BMI of adult offspring in a Saudi population. Healthcare 8(2):110. https://doi.org/10.3390/healthcare8020110
Niermann CYN, Gerards SMPL, Kremers SPJ (2018) Conceptualizing family influences on children’s energy balance-related behaviors: levels of interacting family environmental subsystems (the LIFES framework). Int J Environ Res Public Health 15(12):2714. https://doi.org/10.3390/ijerph15122714
Parisi SM, Bodnar LM, Dubowitz T (2018) Weight resilience and fruit and vegetable intake among African-American women in an obesogenic environment. Public Health Nutr 21(2):391–402. https://doi.org/10.1017/S1368980017002488
Park SH, Park CG, McCreary L, Norr KF (2017) Cognitive ınterviews for validating the family nutrition physical activity instrument for Korean-American families with young children. J Pediatr Nurs 36:1–6. https://doi.org/10.1016/j.pedn.2017.04.014
Peyer KL, Welk G (2017) Construct validity of an obesity risk screening tool in two age groups. Int J Environ Res Public Health 14(4):419. https://doi.org/10.3390/ijerph14040419
Robinson LN, Rollo ME, Watson J et al (2014) Relationships between dietary intakes of children and their parents: a cross-sectional, secondary analysis of families participating in the family diet quality study. J Hum Nutr Diet 28:443–451. https://doi.org/10.1111/jhn.12261
Tami SH, Reed DB, Trejos E et al (2015) Pilot study: survey tools for assessing parenting styles and family contributors to the development of obesity in Arab children ages 6 to 12 years. Ethn Dis 25(4):463–468. https://doi.org/10.18865/ed.25.4.463
Tucker JM, Howard K, Guseman EH, Yee KE, Saturley H, Eisenmann JC (2017) Association between the family nutrition and physical activity screening tool and obesity severity in youth referred to weight management. Obesity Res Clin Pract 11:268–275. https://doi.org/10.1016/j.orcp.2016.09.007
Vaughn AE, Dearth-Wesley T, Tabak RG et al (2017) Development of a comprehensive assessment of food parenting practices: the home self-administered tool for environmental assessment of activity and diet family food practices survey. J Acad Nutr Diet 117:214–227. https://doi.org/10.1016/j.jand.2016.07.021
WHO (2019a) http://www.who.int/nutrition/en. Accessed 24 July 2019
WHO (2019b) https://www.who.int/news-room/detail/11-10-2017-tenfold-increase-in-childhood-and-adolescent-obesity-in-four-decades-new-study-by-imperial-college-london-and-who. Accessed 27 July 2019
Yasir AM (2016) Cross cultural adaptation & psychometric validation of instruments: step-wise description. Int J Psychiat 1(1):1–4
Yee KE, Eisenmann JC, Carlson JJ, Pfeiffer KA (2011) Association between the family nutrition and physical activity screening tool and cardiovascular disease risk factors in 10-year old children. Int J Pediatr Obes 6(3–4):314–320. https://doi.org/10.3109/17477166.2011.590198
Yee KE, Pfeiffer KA, Turek K et al (2015) Association of the Family Nutrition and Physical Activity Screening Tool with weight status, percent body fat, and acanthosis Nigricans in children from a low socioeconomic, Urban Community. Ethn Dis 25:399. https://doi.org/10.18865/ed.25.4.399
Funding
No funding was received for conducting this study.
Author information
Authors and Affiliations
Contributions
All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Sule Ozdemir and Ozlem Terzi. The first draft of the manuscript was written by Sule Ozdemir, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.
Corresponding author
Ethics declarations
Ethics approval
The questionnaire and methodology for this study was approved by the Human Research Ethics committee of the University of Ondokuz Mayis, Samsun, Turkey (Ethics approval number: 2019/109, Ethics approval number date: 07.02.2019).
Consent to participate
Informed consent was obtained from all individual participants included in the study.
Conflicts of interest
The authors have no conflicts of interest to declare that are relevant to the content of this article.
Additional information
Publisher’s note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Ozdemir, S., Terzi, O. & Dundar, C. The family nutrition and physical activity (FNPA) screening tool: psychometric characteristics, reliability, and validity in the Turkish population. J Public Health (Berl.) 30, 2525–2531 (2022). https://doi.org/10.1007/s10389-021-01540-y
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10389-021-01540-y