Accuracy and Precision of Two Short Screeners to Assess Change in Fruit and Vegetable Consumption among Diverse Populations Participating in Health Promotion Intervention Trials

Abstract

Two short frequency questionnaires, the NCI 19-item Fruit and Vegetable Screener (FVS) and a single question on overall fruit and vegetable consumption (1-item), were evaluated for their ability to assess change in fruit and vegetable (FV) consumption over time and in response to intervention among participants in 5 health promotion trials in the Behavior Change Consortium. Cross-sectional differences and correlations of FV estimates at baseline and at follow-up were compared for the FVS (n = 315) and the 1-item (n = 227), relative to multiple 24-h recall interviews (24HR). The FVS significantly overestimated daily intake by 1.27 servings at baseline among men and by 1.42 and 1.59 servings at baseline and follow-up, respectively, in women, whereas the 1-item measure significantly underestimated intake at both time points in men (0.98 serving at baseline, 0.75 serving at follow-up) and women (0.61 and 0.41 serving). Cross-sectional deattenuated correlations with 24HR at follow-up were 0.48 (FVS) and 0.50 (1-item). To evaluate the capacity of the 2 screeners to assess FV change, we compared mean posttest effects with 24HR by treatment group overall and by gender. Treatment group differences were not significant for either 24HR or 1-item. Among 315 subjects, the FVS treatment group differences were significant both overall and within gender but not when repeated in the sample of 227. Findings suggest multiple 24HR at multiple time points in adequate sample sizes remain the gold standard for FV reports. Biases in FVS estimates may reflect participants' lifestyles and sociodemographic characteristics and require further examination in longitudinal samples representative of diverse populations.

Association between the frequency of fruit and vegetable consumption and cardiovascular disease in male smokers and non-smokers

“…In this respect, Thompson et al (2002) showed that questionnaires with a restricted number of items and lacking a quantitative assessment of portion size do not very much affect the ability to rank subjects according to F&V intake. Furthermore, it was recently reported that a 19-item F&V screener and a single question on overall F&V had similar correlations with multiple 24-h dietary recall interviews (Peterson et al, 2008). Moreover, the correlation analysis between frequency of F&V intake and plasma vitamin concentrations observed in the present study suggests that our assessment of the frequency of F&V intake was reasonably accurate (Dauchet et al, 2004).…”

Adaptive e-learning to improve dietary behaviour: a systematic review and cost-effectiveness analysis.

“…an overestimation of the extent of dietary change). 87,88 Diet records can also lead to a simplification of dietary practices, because of the high respondent burden involved in recording food intakes. 86 The multiple-day 24-hour recall also has advantages over other dietary assessment methods: it is likely to be more responsive to dietary change than either the FFQ or food habit/food pattern questionnaires; and is likely to be more accurate than shopping receipts, because they do not account for household food distribution, food wastage or food gifts/purchases without receipts, which may differ pre and post intervention.…”

“…43 62,65 A screening FFQ will probably underestimate dietary change, especially if key food sources of target nutrients cannot be reported. 89 However, a social desirability bias may also occur with a screening FFQ, 87 so the direction of bias is unpredictable.…”

“…fruit and vegetables) within a more extensive questionnaire either alone (n = 5) 42,52,56,71,75 or in combination with another dietary assessment technique (n = 6). 48,49,51,58,59,62 A recent validation study showed that, unlike a screening FFQ, a one-item question did not overestimate an intervention effect, 87 presumably because less emphasis was placed on the desired dietary change in the questionnaire. The extent to which these results can be generalised to other studies is not known.…”

Adapting and RE-AIMing a heart disease prevention program for older women with diabetes

“…Behavioral measures were as follows: (a) daily fruit and vegetable intake (NCI fruit and vegetable scan [20] and Food Frequency Questionnaire [FFQ;21] in the MLP, and FFQ ¡Viva Bien! ), with the criterion set at greater than or equal to five servings a day; (b) percent of calories from saturated fat (FFQ in both studies), with the criterion set at less than 10%; (c) physical activity (frequency/week of moderate physical activity measured by the CHAMPS Activities Questionnaire for Older Adults [22] in the MLP and days/week of physical activity measured by the International Physical Activity Questionnaire [23] in ¡Viva Bien!…”