Validating the Food Behavior Questions from the Elementary School SPAN Questionnaire

Background: The School Physical Activity and Nutrition (SPAN) questionnaire was developed as a surveillance instrument to measure physical activity, nutrition attitudes, and dietary and physical activity behaviors in children and adolescents. The SPAN questionnaire has 2 versions. Objective: This study was conducted to evaluate the validity of food consumption items from the elementary school version of the SPAN questionnaire. Design: Validity was assessed by comparing food items selected on the questionnaire with food items reported from a single 24-hour recall covering the same reference period. Setting: 5 elementary schools in Indiana. Participants: Fourth-grade student volunteers (N = 121) from 5 elementary schools. Main Outcome Measure: Agreement between responses to SPAN questionnaire items and reference values obtained through 24-hour dietary recall. Analysis: The agreement between the questionnaire and the 24-hour recall was measured using Spearman correlation, percentage agreement, and kappa statistic. Results: Correlation between SPAN item responses and recall data ranged from .25 (bread and related products) to .67 (gravy). The percentage agreement ranged from 26% (bread and related products) to 90% (gravy). The kappa statistic varied from .06 (chocolate candy) to .60 (beans). Conclusions and implications: Results from this study indicate that the SPAN questionnaire can be administered in the classroom quickly and easily to measure many previous day dietary behaviors of fourth graders. However, questions addressing consumption of "vegetables," "candy," and "snacks" need further investigation.