Reliability and validity of the Family Eating and Activity Habits Questionnaire

Abstract

Objective: The purpose of this work was to develop and test an instrument that will identify the factors that facilitate childhood obesity and monitor the environmental changes and family behavior modi®cations associated with weight loss. Design and methods:The relevant factors that affect obesity and weight loss in children were divided into four scales: activity level, stimulus exposure, eating related to hunger, and eating style. We designed a questionnaire to be completed by the parents of the obese child aged 6 ± 11 years. Scores accumulated were calculated separately for each member of the family. Higher numerical scores re¯ected less appropriate eating patterns. The questionnaire reliability (test ± retest), internal consistency and ability to discriminate obese vs normal-weight children's behaviors was tested using a pilot population of 40 mothers not enrolled in a formal weight loss program. The questionnaire reliability (parents' report and spouse report) and predictive validity was tested using a selective population: 60 parents of obese children enrolled in a clinical intervention intended to treat childhood obesity with an environmental approach vs a dietary approach. Results: The content validity of the questionnaire was evaluated by a team of ten experts. Cronbach's a was calculated to test internal consistency. Mean r was 0.83. Pearson's correlation coef®cients were computed between test and retest scores for individual items and for the total score, and ranged from 0.78 to 0.90 (median 0.84) (P`0.01 for all). Total score test ± retest r was 0.85 (P`0.01). The total family score was also higher in the families with an obese child compared to families with a normal-weight child, P`0.01. No signi®cant differences were noted between parent report and spouse report scores. The construct validity of the questionnaire was also supported by its high sensitivity to weight loss treatment. Weight loss in the child correlated highly with improvement in questionnaire score. Conclusions: The Family Activity and Eating Habits Questionnaire is reliable and internally consistent, and it is useful as an optional tool for planning an intervention program for childhood obesity. Descriptors: Family Activity and Eating Habits Questionnaire; childhood obesity IntroductionChildhood obesity has signi®cant immediate and long-term implications (Must et al, 1992; Pi Sunyer, 1993;Mossberg, 1989). The medical literature is replete with studies of obesity-enhancing behaviors in children. These include eating in response to stimuli other than hunger; leisure time spent in sedentary manner; excess availability to unsuitable foods and environmental modeling of poor eating behavior (Wadden, 1992;Epstein, 1996;Wardle, 1996). The majority of authors agree that obesity would be limited if children were to eat only when hungry (Wadden, 1992;Epstein, 1996). Most nonproductive food intake occurs for reasons other than hunger: boredom, stress, social pressure, etc. To limit these opportunities, it was suggested that eating should take p...

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