This study sought to develop and validate a general nutrition knowledge questionnaire (GNKQ) for Ugandan adults. The initial draft consisted of 133 items on five constructs associated with nutrition knowledge; expert recommendations (16 items), food groups (70 items), selecting food (10 items), nutrition and disease relationship (23 items), and food fortification in Uganda (14 items). The questionnaire validity was evaluated in three studies. For the content validity (study 1), a panel of five content matter nutrition experts reviewed the GNKQ draft before and after face validity. For the face validity (study 2), head teachers and health workers (n = 27) completed the questionnaire before attending one of three focus groups to review the clarity of the items. For the construct and test-rest reliability (study 3), head teachers (n = 40) from private and public primary schools and nutrition (n = 52) and engineering (n = 49) students from Makerere University took the questionnaire twice (two weeks apart). Experts agreed (content validity index, CVI > 0.9; reliability, Gwet’s AC1 > 0.85) that all constructs were relevant to evaluate nutrition knowledge. After the focus groups, 29 items were identified as unclear, requiring major (n = 5) and minor (n = 24) reviews. The final questionnaire had acceptable internal consistency (Cronbach α > 0.95), test-retest reliability (r = 0.89), and differentiated (p < 0.001) nutrition knowledge scores between nutrition (67 ± 5) and engineering (39 ± 11) students. Only the construct on nutrition recommendations was unreliable (Cronbach α = 0.51, test-retest r = 0.55), which requires further optimization. The final questionnaire included topics on food groups (41 items), selecting food (2 items), nutrition and disease relationship (14 items), and food fortification in Uganda (22 items) and had good content, construct, and test-retest reliability to evaluate nutrition knowledge among Ugandan adults.

Over 60% of EFNEP staff perceived overall delivery is easier in urban environments. Over 50% assumed urban areas would involve less travel and have an outpour of participants, however, traveling (20+ miles) was not uncommon to meet with groups with less than 10 in both rural and urban classes. Additionally, it was found that classes with <5 participants were meaningful and acceptable in rural environments, yet in urban environments, classes were oftentimes rescheduled due to low-participation rates (<5/group). More than 70% stated difficulty in retaining 100% of class participants for the entire EFNEP lesson-series. Conclusions and Implications: Extension agents have the responsibility to train EFNEP staff to meet the unique needs of urban and rural clients. Results from this research provides information for agents to adjust program planning, delivery, and staff training to aid educators to become more united as they understand the diversity between urban and rural counties and share how successes in these counties can bolster the Arizona's overall success in EFNEP. Funding: Expanded Food and Nutrition Education Program.

BackgroundAccurate measurement of body composition in children and adolescents is important as the quantities of fat and fat-free mass have implications for health risk. The objectives of the present study were: to determine the reliability of Fourier Transform Infrared spectroscopy (FTIR) measurements and; compare the Fat Mass (FM), Fat Free Mass (FFM) and body fat percentage (%BF) values determined by bioelectrical impedance analysis (BIA) to those determined by deuterium dilution method (DDM) to identify correlations and agreement between the two methods.MethodsA cross-sectional study was conducted among 203 children and adolescents aged 8–19 years attending schools in Kampala city, Uganda. Pearson product-moment correlation at 5% significance level was considered for assessing correlations. Bland Altman analysis was used to examine the agreement between of FTIR measurements and between estimates by DDM and BIA.. Reliability of measurements was determined by Cronbach’s alpha.ResultsThere was good agreement between the in vivo D2O saliva enrichment measurements at 3 and 4 h among the studied age groups based on Bland-Altman plots. Cronbach’s alpha revealed that measurements of D2O saliva enrichment had very good reliability. For children and young adolescents, DDM and BIA gave similar estimates of FFM, FM, and %BF. Among older adolescents, BIA significantly over-estimated FFM and significantly under-estimated FM and %BF compared to estimates by DDM. The correlation between FFM, FM and %BF estimates by DDM and BIA was high and significant among young and older adolescents and for FFM among children.ConclusionsReliability of the FTIR spectroscopy measurements was very good among the studied population. BIA is suitable for assessing body composition among children (8–9 years) and young adolescents (10–14 years) but not among older adolescents (15–19 years) in Uganda. The body composition measurements of older adolescents determined by DDM can be predicted using those provided by BIA using population-specific regression equations.

Valid and reliable questionnaires are necessary to improve the existence and quality of nutrition information, which determines interventions in low-resource settings, especially among decision makers and change agents. The present study evaluated the internal consistency and test-retest reliability of the data collected among 255 head teachers from schools in Mukono and Wakiso districts in Uganda using a general nutrition knowledge questionnaire (GNKQ) earlier developed. Cronbach alpha (α) was used to determine internal consistency. Pearson's correlation coefficient (r) and intraclass correlation coefficient were used to measure test-retest dependability on scores (ICC2,1). Overall internal consistency on 94 items was α = 0.89 at time one and 0.92 at time two. All items yielded data with a satisfactory internal consistency (α > 0.7). Two domains, Expert advice (ICC = 0.64) and Selecting food (ICC = 0.41), were determined to have insufficient test-retest reliability (r < 0.7 and ICC = 0.7), and their items were removed from the next analyses. The remaining nutrition knowledge topics with adequate test-retest reliability were food groupings (ICC = 0.9), nutrition and sickness (ICC = 0.91), and food fortification (ICC = 0.95). According to the findings, the prototype nutrition knowledge questionnaire had acceptable internal consistency and test-retest reliability. These findings indicate that the previously established questionnaire can be used to assess general nutrition knowledge among head teachers. To boost generalizability, future studies could use the questionnaire on a different group of adults.

The feeding and caring practices of infants and young children are critical to children’s nutrition status and development milestones. Most nutrition studies have focused on unfavorable factors that contribute to malnutrition rather than favorable factors that promote good nutrition status among children. This study aimed at identifying predictors of normal nutrition status among children aged 6–24 months in Gulu District, Northern Uganda. A matched case-control study was conducted on a sample of 300 (i.e., 100 cases and 200 controls) purposively selected children during October–December 2021. Controls were children that had normal nutrition status, whereas cases with undernourished children had at least one type of undernutrition. Logistic regression was used to determine the predictors of good nutrition status using odds ratios (ORs). The mean age of the cases and controls was 15 months (SD ± 6) and 13 months (SD ± 5), respectively. At multivariable analysis, breastfeeding in the first hour of the child’s life (AOR = 3.31 95% CI. 1.52–7.23), use of family planning (AOR = 2.21 95% CI. 1.25–3.90), number of under-fives in the household (AOR = 0.31 95% CI. 0.13–0.73) and hand washing with soap (AOR = 3.63 95% CI. 1.76–7.49) were significantly independently associated with a child’s good nutrition status. Interventions that can improve children’s nutrition status include breastfeeding in the first hour of child’s life, use of family planning methods, child spacing and hand washing with soap.