| Part 1:Development and Evaluation of the School-age Children’s Dietary Providers’ Dietary Literacy QuestionnaireObjectiveTo develop the questionnaire of dietary literacy of daily diet providers for school-age and to evaluate the reliability and validity of the questionnaire.MethodsTaking the definition of dietary literacy as the main theoretical basis,an expert group discussion was conducted by Delphi method to develop a dietary literacy questionnaire for daily diet providers of school-age children.Using the method of stratified cluster sampling,a survey was conducted on the daily diet providers of 1 137 urban and rural children in Hefei in November 2018.Pearson correlation coefficient,t test and other methods were used to analyze the decision value,correlation and internal consistency of the questionnaire.AMOS 23.0 software was used to build a structural equation model to evaluate the structural validity of the questionnaire.After an interval of one week,90 dietary providers of school-age children were retested by random sampling to analyze the test-retest reliability of the questionnaire,and the reliability and validity of the questionnaire were evaluated by Cronbach’s α,Guttman coefficient and construct validity.Further analyze the educational level of children’s daily diet providers and the differences in the scores of "dietary literacy questionnaire for school-age children’s dietary providers" in urban and rural areas,as well as the differences in dietary literacy scores of dietary providers with different children’s dietary behavior.to evaluate the discriminant validity of the questionnaire.Results1,043 valid questionnaires were collected.894(85.7%)are children’s parents and 128(12.3%)are children’s grandparents.After the expert group discussion,the questionnaire preliminarily identified four first-level indicators for the attitude,action,skills and environment of daily diet providers towards children’s diet.The average authority coefficient of experts is 0.87.The questionnaire finally retained 30 items,including four dimensions of attitude,action,skills and environment of school-age children’s daily diet providers to children’s meals,with a cumulative variance contribution rate of 52.470%.The Cronbach’s α coefficient,split-half reliability and test-retest reliability of the questionnaire were 0.874,0.813 and 0.878 respectively.The fitting indexes of structural equation model: 2/df=2.28,RMSEA=0.042,NFI=0.841,GFI=0.927,AGFI=0.912,RFI=0.821,IFI=0.904,TLI=0.891 and CFI=0.903,are all in the acceptable range.There were significant differences in the scores of the daily dietary provider questionnaire among education level,region,and children’s dietary behaviors(P < 0.05).The questionnaire had good discriminative validity.ConclusionThe questionnaire on dietary literacy of daily diet providers for school-age children has good reliability and validity,and can provide an important reference for evaluating the dietary literacy of daily diet providers of school-age children.Part 2:A Study on the Relationship between Dietary Literacy of Daily Dietary Providers and Child Health and Eating Behavior in School-aged ChildrenObjectiveTo explore the effects of dietary literacy of children’s daily dietary providers on children’s health and eating behaviors,so as to provide scientific basis for strengthening dietary literacy of major providers of daily diet for school-age children.MethodsA stratified cluster sampling method was used to investigate 1137 primary school children grade 3-6 in urban and rural areas.In November 2018,height,weight,skin-fold thickness were measured,BMI and percentage of body fat were calculated.The contents of hemoglobin,Ca,Fe,Zn and other trace elements in peripheral blood were measured.The children’s eating behavior questionnaire(CEBQ)was completed by the guardian of the child who provided meals for children.Multiple linear regression models were used to analyze the association between children’s dietary behavior and nutritional status indicators.ResultsThere was a statistically significant difference in the distribution of BMI among children in school-age children’s daily dietary providers(P < 0.05).Multiple linear regression analysis showed that the dietary literacy dimensions and total scores of the main dietary providers of school-age children were negatively correlated with children’s diet picky,food response and craving behavior,while eating with children food preferences were positively correlated(P < 0.05).In addition to the behavioral dimension,the dietary literacy dimensions and total scores of the primary dietary providers of school-age children were negatively correlated with the children’s diet picky behavior;except for the environmental dimension,the dietary literacy dimensions and total scores of the daily primary dietary providers of school-age children was negatively correlated with grouping and children’s diet cravings(P<0.05).ConclusionThe dietary literacy of the dietary providers of school-age children has a great impact on children’s health and eating behaviors.Intervention measures should be developed to improve the dietary literacy of children’s daily major dietary providers,so as to promote healthy eating behavior among school-age children. |
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