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Title: Qualitative analysis of cognitive interviews with school children: A web-based food intake questionnaire

Author
item FERNANDES-DAVIES, VANESSA - Universidade Federal De Santa Catarina (UFSC)
item KUPEK, EMIL - Universidade Federal De Santa Catarina (UFSC)
item DI PIETRO, PATRICIA - Universidade Federal De Santa Catarina (UFSC)
item DE ASSIS, MARIA - Universidade Federal De Santa Catarina (UFSC)
item VIEIRA, FRANCILENE - Universidade Federal De Santa Catarina (UFSC)
item PERUCCHI, CLARICE - Universidade Federal De Santa Catarina (UFSC)
item MAFRA, RAFAELLA - Universidade Federal De Santa Catarina (UFSC)
item Thompson, Deborah - Debbe
item BARANOWSKI, TOM - Children'S Nutrition Research Center (CNRC)

Submitted to: JMIR Public Health and Surveillance
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 9/3/2016
Publication Date: 11/17/2016
Publication URL: http://handle.nal.usda.gov/10113/63325
Citation: Fernandes-Davies, V., Kupek, E., Di Pietro, P.F., De Assis, M.A., Vieira, F.G., Perucchi, C., Mafra, R., Thompson, D.J., Baranowski, T. 2016. Qualitative analysis of cognitive interviews with school children: A web-based food intake questionnaire. JMIR Public Health and Surveillance. 2(2):e167.

Interpretive Summary: WebCAAFE is a new computerized dietary assessment tool for 7-11 year old children in Brazil. Cognitive interviews were conducted with 40 Brazilian 7-11 year old children to identify whether children easily understood the instructions, knew how to make it work, and solicited suggestions on how to improve it. Results indicated that children did not know the meaning of the word "meal," and generally understood the instructions. Younger children apparently responded randomly when they didn't remember what they had eaten while older children who could not remember reported eating nothing. To improve WebCAAFE they suggested that the name of the food automatically appear below an image of the food during portion size assessment. A substantial number of changes will be made in the next version of WebCAAFE.

Technical Abstract: The use of computers to administer dietary assessment questionnaires has shown potential, particularly due to the variety of interactive features that can attract and sustain children's attention. Cognitive interviews can help researchers to gain insights into how children understand and elaborate their response processes in this type of questionnaire. Cognitive interview results of children who answered the WebCAAFE, a Web-based questionnaire, were used to obtain an in-depth understanding of children's response processes. Cognitive interviews were conducted with children (using a pretested interview script). Analyses were carried out using thematic analysis within a grounded theory framework of inductive coding. A total of 40 children participated in the study, and 4 themes were identified: (1) the meaning of words, (2) understanding instructions, (3) ways to resolve possible problems, and (4) suggestions for improving the questionnaire. Most children understood questions that assessed nutritional intake over the past 24 hours, although the structure of the questionnaire designed to facilitate recall of dietary intake was not always fully understood. Younger children (7 and 8 years old) had more difficulty relating the food images to mixed dishes and foods eaten with bread (e.g., jam, cheese). Children were able to provide suggestions for improving future versions of the questionnaire. More attention should be paid to children aged 8 years or below, as they had the greatest difficulty completing the WebCAAFE.