Validating the food behavior questions from the School Physical Activity and Nutrition questionnaire

The purpose of the study was to evaluate the validity of food consumption items from the School Physical Activity and Nutrition (SPAN) questionnaire for 4th graders.; Validity was assessed by comparing foods selected on the questionnaire with foods reported from a single 24-hour recall covering the same reference period (yesterday). The data were collected from 121 fourth grade students at five Indiana elementary schools during Tuesdays through Fridays. Trained investigators collected recall data using Nutrition Data System for Research (NDS-R), developed at University of Minnesota, leaving at least 2 hours between recall and SPAN administrations. Recall data were reclassified to match the questionnaire's 20 food items. The Statistical Package for the Social Sciences (SPSS) and Statistical Analysis System (SAS) were used to analyze the data. Validity of each food question was tested using percentage agreement, kappa agreement (inter-instrument agreement corrected for chance) and Spearman correlations. Prevalence, sensitivity, specificity, positive and negative predictive values also were used to explore the ability of SPAN to assess children's compliance with current dietary guidelines, matching USDA food groupings from aggregated recall data and appropriate questionnaire items.; Correlation between SPAN item responses and recall data ranged from .25 for breads to .67 for gravy. The percentage agreement ranged from 26% for breads to 90% for gravy. The kappa statistic varied from .06 for candy to .60 for beans. Most questions showed fair (Q8, 10, 11, 12, 20, 21, 22 & 24) to good (Q9, 14, 16, 17, 19, & 23) validity. Questions with low validity include, 15 (breads), 18 (vegetables), 26 (chocolate candy), and 29 (snack frequency). Validity markers for most of the food-related questions were similar between boys and girls. Food behavior questions that were clearly defined had better validity, while the questions containing multiple foods or mixed-food dishes showed low validity.; SPAN questionnaire can be administered in the classroom quickly and easily in 4th graders to measure most previous day dietary behaviors. Some questions showed poor validity needing modification and further investigation. Exploratory analyses of grouping foods to determine compliance with Dietary Guidelines were inconclusive.