Reliability and Validity of a Nutrition and Physical Activity Environmental Self-Assessment for Child Care

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  • Benjamin, Sara E
    • Other Affiliation: Department of Ambulatory Care and Prevention, Harvard Medical School and Harvard Pilgrim Health Care, Boston, MA USA
  • Neelon, Brian
    • Affiliation: Gillings School of Global Public Health, Department of Biostatistics
  • Ball, Sarah C
    • Affiliation: UNC Center for Health Promotion and Disease Prevention
  • Bangdiwala, Shrikant
    • Affiliation: Gillings School of Global Public Health, Department of Biostatistics
  • Ammerman, Alice
    • Affiliation: Gillings School of Global Public Health, Department of Nutrition
  • Ward, Dianne
    • Affiliation: Gillings School of Global Public Health, Department of Nutrition
Abstract
  • Abstract Background Few assessment instruments have examined the nutrition and physical activity environments in child care, and none are self-administered. Given the emerging focus on child care settings as a target for intervention, a valid and reliable measure of the nutrition and physical activity environment is needed. Methods To measure inter-rater reliability, 59 child care center directors and 109 staff completed the self-assessment concurrently, but independently. Three weeks later, a repeat self-assessment was completed by a sub-sample of 38 directors to assess test-retest reliability. To assess criterion validity, a researcher-administered environmental assessment was conducted at 69 centers and was compared to a self-assessment completed by the director. A weighted kappa test statistic and percent agreement were calculated to assess agreement for each question on the self-assessment. Results For inter-rater reliability, kappa statistics ranged from 0.20 to 1.00 across all questions. Test-retest reliability of the self-assessment yielded kappa statistics that ranged from 0.07 to 1.00. The inter-quartile kappa statistic ranges for inter-rater and test-retest reliability were 0.45 to 0.63 and 0.27 to 0.45, respectively. When percent agreement was calculated, questions ranged from 52.6% to 100% for inter-rater reliability and 34.3% to 100% for test-retest reliability. Kappa statistics for validity ranged from -0.01 to 0.79, with an inter-quartile range of 0.08 to 0.34. Percent agreement for validity ranged from 12.9% to 93.7%. Conclusion This study provides estimates of criterion validity, inter-rater reliability and test-retest reliability for an environmental nutrition and physical activity self-assessment instrument for child care. Results indicate that the self-assessment is a stable and reasonably accurate instrument for use with child care interventions. We therefore recommend the Nutrition and Physical Activity Self-Assessment for Child Care (NAP SACC) instrument to researchers and practitioners interested in conducting healthy weight intervention in child care. However, a more robust, less subjective measure would be more appropriate for researchers seeking an outcome measure to assess intervention impact.
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  • Article
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  • In Copyright
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  • Sara E Benjamin et al.; licensee BioMed Central Ltd.
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Journal title
  • International Journal of Behavioral Nutrition and Physical Activity
Journal volume
  • 4
Journal issue
  • 1
Page start
  • 29
Language
  • English
Is the article or chapter peer-reviewed?
  • Yes
ISSN
  • 1479-5868
Bibliographic citation
  • International Journal of Behavioral Nutrition and Physical Activity. 2007 Jul 05;4(1):29
Publisher
  • BioMed Central Ltd
Access right
  • Open Access
Date uploaded
  • August 24, 2012

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file details 1479-5868-4-29.pdf 2019-05-06 Public Download
file details Nutrition and Physical Activity Self-Assessment for Child Care. This self-assessment instrument is used by child care facilities to assess their nutrition and physical activity environments. 2019-05-06 Public Download
file details 1479-5868-4-29.xml 2019-05-06 Public Download