Abstract
Mixed methods OBJECTIVES: Individuals with spinal cord injuries and disorders (SCI/D) experience several chronic and SCI-specific secondary health complications that are influenced by nutrition, which is a modifiable risk factor. Improving nutritional knowledge is essential to support healthy dietary behaviors, yet no validated tool exists in this population. This study describes the development and content validation of a nutrition knowledge questionnaire for individuals with SCI/D.
Veterans Health Administration and a research rehabilitation hospital in Chicago, USA.
A 106-item questionnaire was developed based on two literature reviews and a nutrition advisory member focus group. Content validity was evaluated by subject matter experts who rated the relevance of each item. Experts rated the clarity of each item and provided open-ended feedback. With clarity scores and open-ended feedback, the item-level Content Validity Index (I-CVI) and the scale-level Content Validity Index (S-CVI/Ave) were calculated to select items for pilot testing. An I-CVI of 0.78 and a S-CVI/Ave of 0.90 were considered the thresholds for excellent content validity.
Content validity was evaluated by 14 subject matter experts. The I-CVI for 23 items fell below the threshold and the S-CVI/Ave was 0.83, falling short of the threshold. In response to these evaluations, of 106 initial items, 13 were removed, and 5 were modified.
Scoring and open-ended feedback from experts allowed the questionnaire to be refined before psychometric testing. This measure represents the first of its kind to be developed and validated to assess the nutrition knowledge of people with SCI/D.