Original Article
European Journal of Clinical Nutrition (2008) 62, 770–780; doi:10.1038/sj.ejcn.1602780; published online 6 June 2007
Nutrition Screening Tool for Every Preschooler (NutriSTEP™): validation and test–retest reliability of a parent-administered questionnaire assessing nutrition risk of preschoolers
Guarantor: JA Randall Simpson.
Contributors: JARS, HHK, LAR and JEB planned and designed the study and obtained funding. LAR managed and coordinated the project. JARS coordinated data collection for some of the test–retest reliability. HHK was responsible for data analysis. All authors contributed to the writing and revision of the paper.
J A Randall Simpson1, H H Keller1, L A Rysdale2 and J E Beyers2
- 1Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, ON, Canada
- 2Sudbury & District Health Unit, Sudbury, ON, Canada
Correspondence: Professor JA Randall Simpson, Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, ON N1G 2W1, Canada. E-mail: rjanis@uoguelph.ca
Received 14 August 2006; Revised 20 March 2007; Accepted 12 April 2007; Published online 6 June 2007.
Abstract
Objectives:
Study 1: To establish the validity of scores on Nutrition Screening Tool for Every Preschooler (NutriSTEP), a community-based parent-administered screening tool for assessing nutrition risk, by comparing scores to an expert rating. Study 2: To demonstrate test–retest reliability of NutriSTEP.
Subjects/Methods:
Study 1: Parents of 269 preschoolers (of 294 parents recruited from the community), completed the NutriSTEP questionnaire; a registered dietitian (RD) assessed the nutritional status (based on medical and nutritional history, 3 days of dietary recall and anthropometric measurements) of these preschoolers and rated their nutritional risk (1 (low) to 10 (high risk)). Receiver operating characteristic (ROC) curves were used to establish validity and determine appropriate cut points based on sensitivity and specificity. Study 2: Parents of 140 preschoolers (of 161 recruited) completed NutriSTEP on two occasions. Intraclass correlation (ICC) and 
were used to assess reliability.
Results:
Study 1: Scores on NutriSTEP and the RD rating were correlated (r=0.48, P=0.01). Area under the ROC curve for the high risk RD rating (score 8+) and the moderate risk rating (score 5+) were 81.5 and 73.8%
, respectively. A moderate risk cut point of >20 and high risk cut point of >25 were identified for the NutriSTEP scores. Study 2: The NutriSTEP score was reliable between administrations (ICC=0.89, F=16.7, P<0.001). Most items on the questionnaire had adequate (>0.5) or excellent (>0.75) agreement.
Conclusions:
The NutriSTEP questionnaire is both valid and reliable for determining nutritional risk in preschoolers.
Keywords:
screening, preschoolers, nutrition risk, validity, reliability
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