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      Validation of a Food Frequency Questionnaire for Hispanics

      research-article
      , PhD , , DrPH, RD, , PhD, MPH, , , PsyD, LPC
      Preventing Chronic Disease
      Centers for Disease Control and Prevention

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          Abstract

          Introduction

          The Hispanic population will grow to comprise one fourth of the U.S. population by 2050. Compared with non-Hispanic whites, Hispanics have disproportionately higher rates of obesity, diabetes, and other diet-related conditions. Valid methods for studying the dietary intake of this group are needed.

          Methods

          From June through September 2000, we conducted a study of low-income Hispanic men and women (n = 89) who were recruited for a validation study of the Spanish-language food frequency questionnaire used in the Study of Women's Health Across the Nation. The mean age of the participants was 36.8 years, 42% were male, and 92% had been born in Mexico. Three 24-hour dietary recalls provided the reference data. The food frequency questionnaire was administered by interview, with a portion-size graphic to aid in quantitation. The questionnaire asked about diet in the previous 12 months. Mean nutrient values, correlation coefficients, and the sensitivity and specificity for identifying people with intakes of less than the recommended levels were calculated.

          Results

          Mean energy and macronutrient intake estimates were significantly higher by the food frequency questionnaire than by the 24-hour dietary recalls. Cholesterol, saturated fat, dietary fiber, iron, vitamin A, and percentage of energy from fat were not significantly different by the two methods. The median of unadjusted correlations was 0.52 and of deattenuated correlations was 0.61. The median sensitivity was 0.62, and the median specificity was 0.76.

          Conclusion

          The Study of Women's Health Across the Nation Spanish food frequency questionnaire appears to be reasonably valid in assessing the dietary intakes of Hispanics. Correlations tended to be higher than those found in other validation studies in Hispanic populations. Interviewer administration of questionnaires may be necessary in this population.

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          Most cited references28

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          Calibration of the dietary questionnaire for a multiethnic cohort in Hawaii and Los Angeles.

          The performance of the dietary questionnaire used in a multiethnic cohort study in Hawaii and Los Angeles was assessed in a calibration substudy that compared diet reported from the questionnaire with three 24-hour dietary recalls. For the calibration substudy, subjects from each of eight subgroups defined by sex and ethnic group (African-American, Japanese-American, Latino, and White) were chosen randomly from among the cohort members, and each participant's previous day's diet was assessed by telephone recall on three occasions over approximately 2 months. After completing the three 24-hour recalls, each calibration subject was sent a second questionnaire; 1,606 persons completed three recalls and a second questionnaire (127 to 267 per ethnic-sex group). This report describes correlation coefficients and calibration slopes for the relation between the 24-hour recalls and second questionnaire values for a selected set of macro- and micronutrients, as absolute intakes, nutrient densities, and calorie-adjusted nutrients. In all subgroups, estimates of the correlation between the questionnaire and 24-hour recalls were greater after energy adjustment (average correlations ranged from 0.57-0.74 for nutrient densities and from 0.55-0.74 for calorie-adjusted nutrients) than when absolute nutrient values were used (average range 0.26-0.57). For absolute nutrient intakes, the correlations were greatest for Whites, somewhat lower for Japanese-Americans and Latinos, and lowest for African-Americans. After energy adjustment, the difference between subgroups were diminished, and the correlations were generally highly satisfactory.
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            Validity and reproducibility of a food frequency interview in a Multi-Cultural Epidemiology Study.

            There is limited support for the validity and reproducibility of dietary assessment in culturally diverse populations. The goal of this study was to evaluate the comparative validity and reproducibility of a Food Frequency Questionnaire (FFQ) used in the observational, multi-cultural Insulin Resistance Atherosclerosis Study (IRAS). Women (n = 186) were approximately equally distributed by ethnicity from one urban center (African Americans and non-Hispanic whites) and one rural center (Hispanics and non-Hispanic whites). The IRAS FFQ was modified from the National Cancer Institute Health Habits and History Questionnaire to include ethnic and regional foods. Validity was assessed by comparing dietary values, including supplements, obtained from the FFQ to the average intake estimated from a series of 8 24-hour dietary recalls collected by telephone over the same 1-year period. Reproducibility was assessed among women who reported no change in their usual diet (n = 133) by comparing data from the original IRAS FFQ (in-person) with the FFQ administered for the validity study (two to four years later, by telephone). Correlation coefficients for validity were statistically significant for most nutrients (mean r = 0.62 urban non-Hispanic white, 0.61 rural non-Hispanic whites, 0.50 African American, 0.41 Hispanic) and did not differ among subgroups of obesity or diabetes status. The median correlation coefficient for the total sample was 0.49. Correlations were lower for women with less than 12 years of education (mean r = 0.30; median r = 0.25). The lower correlations among Hispanics was largely explained by the lower educational attainment in that sample. For reproducibility, the mean correlation for nutrients evaluated was r = 0.62 (median r = 0.63) and did not differ for subgroups. Although educational attainment must be considered, the IRAS FFQ appears to be reasonably valid and reliable in a diverse cohort.
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              Associations of race/ethnicity, education, and dietary intervention with the validity and reliability of a food frequency questionnaire: the Women's Health Trial Feasibility Study in Minority Populations.

              This report describes the associations of race/ethnicity and years of education with the validity, reliability, and bias of a self-administered food frequency questionnaire (FFQ) designed to be sensitive to low-fat, regional, and ethnic dietary patterns. Data were from the Women's Health Trial Feasibility Study in Minority Populations, a randomized clinical trial conducted between 1992 and 1994 to test the feasibility of a low-fat dietary intervention that targeted low-income, black, and Hispanic women. Of 1,015 participants eligible for these analyses, 28.1% were black, 16.2% were Hispanic, and 12.3% had not completed high school. The analyses focused on percentage of energy obtained from fat, and used 4-day food records as the criterion instrument. Validity at baseline, defined as the correlation between FFQs and food records, was lower among blacks than among whites (0.26 vs. 0.49; p or =16 years of education, respectively; for trend, p < 0.05). Six months after randomization, validity increased in most race/ethnicity and education subgroups, and differences across groups became small and statistically nonsignificant. Validity increased significantly among participants receiving the dietary intervention, while increases among control women were somewhat smaller. Reliability, defined as the correlation between baseline and 6-month measures among controls, was similar across racial/ethnic and educational groups. Bias at baseline, defined as the mean value from the FFQ minus the mean from the food record, was 4.6 percentage points of energy from fat; it was lowest among blacks (p < 0.01) and did not differ by years of education. These results suggest that special protocols which address participant training may be necessary when using self-administered FFQs in minority or poorly educated populations.
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                Author and article information

                Contributors
                University of California, Berkeley, School of Public Health, Division of Community Health and Human Development
                ,
                University of California, Berkeley, School of Public Health, Division of Community Health and Human Development, Berkeley, Calif
                University of California, Berkeley, School of Public Health, Division of Community Health and Human Development, Berkeley, Calif
                University of California, Berkeley, School of Public Health, Division of Community Health and Human Development, Berkeley, Calif
                The David & Alice Jurist Institute for Research, Hackensack University Medical Center, Hackensack, NJ
                Journal
                Prev Chronic Dis
                Preventing Chronic Disease
                Centers for Disease Control and Prevention
                1545-1151
                July 2006
                15 June 2006
                : 3
                : 3
                : A77
                Affiliations
                University of California, Berkeley, School of Public Health, Division of Community Health and Human Development
                University of California, Berkeley, School of Public Health, Division of Community Health and Human Development, Berkeley, Calif
                University of California, Berkeley, School of Public Health, Division of Community Health and Human Development, Berkeley, Calif
                University of California, Berkeley, School of Public Health, Division of Community Health and Human Development, Berkeley, Calif
                The David & Alice Jurist Institute for Research, Hackensack University Medical Center, Hackensack, NJ
                Article
                PCDv33_05_0219
                1636705
                16776878
                8272d7e6-1aad-4a4c-9d0d-3eb384a29de2
                Copyright @ 2006
                History
                Categories
                Original Research
                Peer Reviewed

                Health & Social care
                Health & Social care

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