Qualitative Analysis of Cognitive Interviews With School Children: A Web-Based Food Intake Questionnaire

BACKGROUND: The use of computers to administer dietary assessment questionnaires has shown potential, particularly due to the variety of interactive features that can attract and sustain children’s attention. Cognitive interviews can help researchers to gain insights into how children understand and elaborate their response processes in this type of questionnaire. OBJECTIVE: To present the cognitive interview results of children who answered the WebCAAFE, a Web-based questionnaire, to obtain an in-depth understanding of children’s response processes. METHODS: Cognitive interviews were conducted with children (using a pretested interview script). Analyses were carried out using thematic analysis within a grounded theory framework of inductive coding. RESULTS: A total of 40 children participated in the study, and 4 themes were identified: (1) the meaning of words, (2) understanding instructions, (3) ways to resolve possible problems, and (4) suggestions for improving the questionnaire. Most children understood questions that assessed nutritional intake over the past 24 hours, although the structure of the questionnaire designed to facilitate recall of dietary intake was not always fully understood. Younger children (7 and 8 years old) had more difficulty relating the food images to mixed dishes and foods eaten with bread (eg, jam, cheese). Children were able to provide suggestions for improving future versions of the questionnaire. CONCLUSIONS: More attention should be paid to children aged 8 years or below, as they had the greatest difficulty completing the WebCAAFE.