Original Communication
European Journal of Clinical Nutrition (2005) 59, 1149–1157. doi:10.1038/sj.ejcn.1602225; published online 13 July 2005
Validity and reliability of SCREEN II (Seniors in the Community: Risk evaluation for eating and nutrition, Version II)
Guarantor: H Keller.
Contributors: RG completed the analyses, SLK provided input to study procedures/questionnaires. HK wrote the manuscript with input from RG and SLK.
H H Keller1, R Goy2 and S-L Kane3
- 1Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, Ontario, Canada
- 2College of Social and Applied Human Studies, University of Guelph, Guelph, Ontario, Canada
- 3Department of Medicine, Division of Geriatric Medicine, McMaster University, Hamilton, Ontario, Canada
Correspondence: HH Keller, Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, Ontario, Canada N1G 2W1. E-mail: hkeller@uoguelph.ca
Received 1 December 2004; Revised 16 May 2005; Accepted 26 May 2005; Published online 13 July 2005.
Abstract
Background:
Nutrition risk screening for community-living seniors is of great interest in the health arena. However, to be useful, nutrition risk indices need to be valid and reliable. The following three studies describe construct validation, test–retest and inter-rater reliability of SCREEN II.
Methods:
Study (1) seniors were recruited from the general community and from a geriatrician's clinic to complete a nutritional assessment and SCREEN II. 193 older adults provided medical and nutritional history, 3 days of dietary recall and anthropometric measurements. A dietitian reviewed all information collected and ranked seniors on risk: 1 (low) to 10 (high risk). Receiver operating characteristic curves were completed. An abbreviated SCREEN II was developed through statistical analysis and expert ranking of the 17 items. Studies (2) and (3) seniors were recruited from the community to self-administer (n=149) or be interviewed (n=97) using SCREEN II twice within 2 weeks. For self-administration one index was completed via mail. Interviewer administration was completed via telephone with two interviewers. Intra-class correlations were calculated.
Results:
(1) Total and abbreviated SCREEN II have increased sensitivity and specificity as compared to SCREEN I in identifying seniors at nutritional risk. (2) Test–retest reliability was adequate (intra-class correlation (ICC)=0.83). (3) Inter-rater reliability was adequate (ICC=0.83).
Conclusions:
SCREEN II appears to be a valid and reliable tool for the identification of risk for impaired nutritional states in community-living older adults, and is an improvement over SCREEN I.
Keywords:
nutrition, screening, older adults
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