Development and validation of a food and nutrition literacy questionnaire for Chinese school-age children

BACKGROUND: This study aimed to develop and validate the Food and Nutrition Literacy Questionnaire for Chinese School-age Children (FNLQ-SC). METHODS: A comprehensive literature review and qualitative study were initially performed to identify the dimensions and core components of food and nutrition literacy. A cross-sectional survey of 4359 school-age children was conducted, and junior middle school students were used to analyze the reliability and validity of the questionnaire (n = 2452). The reliability of the questionnaire was determined by internal consistency, the construct validity was assessed by exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), and the content validity was assessed by the Pearson correlation coefficient. RESULTS: From the literature review and qualitative methods, 19 core components of the FNLQ-SC were developed, including one dimension of food and nutrition knowledge and understanding, and four skill dimensions (ability of access, selection, preparing food and healthy eating). The overall FNLQ-SC questionnaire had acceptable internal consistency (Cronbach’s α = 0.698). The EFA of skill components extracted 5 factors that were included in the conceptual framework in a slightly different model, and the cumulative contribution of variance accounted for 50.60% of the overall variance. The CFA of skill components showed an acceptable fit in general and the root mean square error of approximation (RMSEA) was 0.070 (between 0.50 to 0.80). The communality was greater than 0.20 for all components. The Pearson correlation coefficients between each dimension and the overall questionnaire ranged from 0.370 to 0.877. The average FNLQ-SC score of all 4395 participants was 61.91 ± 9.22, and the score for the knowledge and understanding dimension was higher than that for the skill dimensions. Multiple linear regression analysis indicated that not only social demographic characteristics (being a girl, being an only child, living someplace other than at school, having an urban registered permanent residence status, being from an affluent family, and being cared for by parents/grandparents with a higher education level) but also the home food environment were predictors of food and nutrition literacy in school-age children (R(2) = 0.226, F = 81.401, P<0.05). CONCLUSION: The Food and Nutrition Literacy Questionnaire (FNLQ-SC) developed here had good reliability, and it can potentially be a useful instrument for assessing food and nutrition literacy among Chinese school-age children.