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Reproducibility and Relative Validity of a Dietary Screener Adapted for Use among Pregnant Women in Dhulikhel, Nepal

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Abstract

Objectives

Here we examined the reproducibility and validity of a dietary screener which was translated and adapted to assess diet quality among pregnant Nepalese women.

Methods

A pilot cohort of singleton pregnant women (N = 101; age 25.9 ± 4.1 years) was recruited from a tertiary, periurban hospital in Nepal. An adapted Nepali version of the PrimeScreen questionnaire, a brief 21-item dietary screener that assesses weekly consumption of 12 healthy and 9 unhealthy food groups, was administered twice, and a month apart, in both the 2nd and 3rd trimesters. Up to four inconsecutive 24-h dietary recalls (24-HDRs) were completed each trimester and utilized as the reference method for validation. For each trimester, data from multiple 24-HDRs were averaged across days, and items were grouped to match the classification and three weekly consumption categories (0–1, 2–3, or 4 + servings/week) of the 21 food groups represented on the PrimeScreen.

Results

Gwet’s agreement coefficients (AC1) were used to evaluate the reproducibility and validity of the adapted PrimeScreen against the 24-HDRs in both the 2nd and 3rd trimester. AC1 indicated good to excellent (≥ 0.6) reproducibility for the majority (85%) of food groups across trimesters. There was moderate to excellent validity (AC1 ≥ 0.4) for all food groups except for fruits and vegetables in the 2nd trimester, and green leafy vegetables and eggs in both the 2nd and 3rd trimesters.

Conclusions

The modified PrimeScreen questionnaire appears to be a reasonably valid and reliable instrument for assessing the dietary intake of most food groups among pregnant women in Nepal.

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Funding

This work was funded by Rutgers Global Health Institute and the National Institutes of Health/FIC (1R21TW011377-01).

Author information

Authors and Affiliations

  1. Department of Clinical and Preventive Nutrition Sciences, School of Health Professions, Rutgers The State University of New Jersey, 65 Bergen Street. Room 157, Newark, NJ, 07107, USA

    Kelly Martin, Krupali Shah, Laura Byham-Gray & Shristi Rawal

  2. Department of Human Ecology, SUNY Oneonta, Oneonta, NY, USA

    Kelly Martin

  3. Department of Obstetrics and Gynecology, Dhulikhel Hospital, Dhulikhel, Nepal

    Abha Shrestha

  4. Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Environmental and Occupational Health Sciences Institute, Rutgers The State University of New Jersey, Piscataway, NJ, USA

    Emily Barrett

  5. Department of Public Health, Kathmandu University School of Medical Sciences, Dhulikhel, Nepal

    Kusum Shrestha & Archana Shrestha

  6. Eunice Kennedy Shriver National Institute of Child Health and Development, Bethesda, MD, USA

    Cuilin Zhang

  7. Department of Chronic Disease and Epidemiology, Center of Methods for Implementation and Prevention Science, Yale School of Public Health, New Haven, CT, USA

    Archana Shrestha

  8. Institute for Implementation Science and Health, Kathmandu, Nepal

    Archana Shrestha

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Contributions

KM and SR had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Study concept and design: SR and AS. Acquisition, analysis, or interpretation of the data: KM, KS, KS, and SR. Drafting of the manuscript: KM and SR. Critical revision of the manuscript for important intellectual content: All authors. Statistical analysis: KM, KS, and SR.

Corresponding author

Correspondence to Shristi Rawal.

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A trained research assistant obtained written informed consent from all participants included in this manuscript.

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The research was conducted in accord with prevailing ethical principles and was reviewed and approved by the Rutgers Newark Health Sciences Institutional Review Board (Pro2018001976) and the Ethical Review Board of the Kathmandu University School of Medical Sciences (102/18).

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Martin, K., Shah, K., Shrestha, A. et al. Reproducibility and Relative Validity of a Dietary Screener Adapted for Use among Pregnant Women in Dhulikhel, Nepal. Matern Child Health J 27, 49–58 (2023). https://doi.org/10.1007/s10995-022-03547-7

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