Jessica L. Thomson

Background: Online surveys offer rapid, cost-effective, and convenient tools for data collection. However, online survey research carries risk, particularly for fraudulent behavior. The objective of this study was to describe lessons learned from implementing an online survey designed to test and validate a comprehensive tool for measuring perceived diet quality. Methods: Participants were recruited via flyers posted at various community organizations. Recruitment flyers contained a QR code to access the recruitment survey. The study consisted of two surveys, the Perceived Diet Quality Questionnaire (PDQ-Q) and Diet ID ^TM , a dietary assessment, tool. Email reminders were sent to participants who had not completed the surveys within specified time frames. Chi square tests were used to determine whether participant characteristics differed by reminder status (no reminder vs. ≥1 reminder). Results: Of the 1,337 recruitment surveys submitted, 962 individuals were enrolled in the study, with 605 (63%) and 591 (61%) valid and complete PDQ-Q and Diet ID ^TM surveys submitted. Majority reasons for not enrolling 375 individuals in the study included duplicate name, email address or telephone number (73%) and suspicious or invalid contact information (15%). The mean number of reminders sent to participants who completed the PDQ-Q and the Diet ID ^TM was 1.8 (SD = 0.9) and 1.7 (SD = 1.4). For both surveys, the percentage of participants who needed ≥1 reminder increased as age increased (PDQ-Q: 21% for 18–29 years vs. 35% for ≥60 years; Diet ID ^TM : 10% for 18–29 years vs. 22% for ≥60 years). Conclusions: While QR codes and mobile-first surveys increase accessibility and reduce participant burden, they also introduce risks to data integrity resulting in the need for verification checks. Incorporating verification procedures may reduce redundant submissions and improve efficiency. The observed pattern of diminishing returns after two completion reminders indicates that reminder schedules can be optimized to balance participant engagement. Participant characteristics associated with the need for reminders suggest that fully digital protocols may disadvantage some groups. Future research may involve testing recruitment and retention strategies, evaluating cost-effectiveness of number of email reminders vs. completion percentage, and examining how tailored engagement influences participation among underrepresented populations.

Background/Objectives: Perceived diet quality (PDQ), measured with a single question, has been linked to better cardiometabolic health indicators. However, no published comprehensive tool to measure PDQ exists. Therefore, the objective of this study was to describe the development and initial psychometric evaluation of a novel tool to measure perceived diet quality (PDQ). Methods: Development included focus groups (n = 27) and thematic analysis. Psychometric evaluation included expert reviews (n = 3), cognitive interviews (n = 13), and online cross-sectional nonexperimental survey (n = 605). Eleven items—with 3 addressing perceived diet quality based on qualitative, graded, and numeric ratings, and satisfaction with diet healthfulness, balanced meals, meal planning/preparation, nutrition knowledge, home cooking vs. eating out/takeout, food label use, difficulty eating healthy, and guilt/regret about food choices comprising the other items. Analysis included exploratory factor analysis, concurrent and convergent validity, and construct reliability. Results: Seven of the 11 variables were retained for final factor solution. Mean (SD) of PDQ Scale, possible score range 6.5–35 points, was 22.6 (5.4). Construct reliability was demonstrated by McDonald’s omega of 0.91. Concurrent validity was demonstrated by correlation of 0.74 between single qualitative PDQ item (current assessment method) and PDQ Scale. Weak to moderate convergent validity was demonstrated by correlations of 0.31 and 0.51 between the PDQ Scale and diet quality scores measured using the Healthy Eating Index and Global Dietary Recommendations, respectively. Correlations were generally significantly higher than correlations with single qualitative PDQ item. Conclusions: The PDQ Scale may be better measure of self-assessed diet quality than the current single qualitative item.

American adults struggle with accurately assessing the quality of their diet, with the majority overrating their diet quality. Thus, the objective of the study was to explore what individuals think about when asked to rate their diet quality. Virtual focus groups were conducted from October 2023 to April 2024, using a semi-structured interview with open-ended questions. Convenience samples of small-scale farmers, school food service directors, health clinic patients, and university students and staff in Mississippi and Arkansas participated (N = 27). Themes and subthemes from NVivo-transcribed discussions were identified and coded inductively. Four subthemes emerged for description of diet: balance, consideration for others, convenience, and location. Four subthemes emerged for quality of diet: availability/access, culture/tradition, health considerations, and making better choices. Three subthemes emerged for healthy food: composition/preparation, nourishing benefits, and taste/flavor. Three subthemes emerged for unhealthy food: addicting/overconsumption, composition/preparation, and undesirable effects. Three subthemes emerged for nutrition knowledge: audience specific, general knowledge, and ambivalence. Three subthemes emerged for food shopping: food types, family influence/preference, and planning. Factors shaping how individuals perceive their diet quality are complex with intertwining components. Understanding the complexity involved in self-perceptions of diet quality will help us better quantify perceptions and link them to measurable outcomes.

Background/Objectives: An adapted version of an online pictorial food frequency questionnaire (FFQ), VioScreen-Allergy, assesses total dietary intake and intake of allergens and foods in the maternal diet index (MDI), linked to offspring allergy. This study assessed intermethod reliability, test–retest reliability, and external validity of the VioScreen-Allergy. Methods: Females of childbearing age were recruited at Denver Health and Children’s Hospital, Colorado, USA, and were asked to complete four 24 h recalls and two VioScreen-Allergy FFQs over the course of a month. All those with at least two 24 h dietary recalls and both VioScreen-Allergy assessments were analyzed. Energy-adjusted and non-adjusted linear mixed models (1) compared MDI scores and intake of nutrients and allergens as measures of intermethod reliability; (2) evaluated VioScreen-Allergy test–retest reliability as differences between repeated measurements; and (3) assessed external validity by modeling associations between VioScreen-Allergy-derived intake of beta-carotene and orange vegetables and Veggie Meter^®-assessed skin carotenoids. Bonferroni corrections controlled multiple comparisons within the assessment. Results: Of 53 participants enrolled, 25 demographically dissimilar participants were included in the analysis. There were no significant differences between 24 h recall and VioScreen-Allergy mean intakes of macronutrients, micronutrients, allergens, or MDI, except for Vitamin C, niacin, and cashew allergen protein. There were no significant differences between repeated measurements of VioScreen-Allergy, either energy-adjusted or unadjusted. Both beta-carotene and orange vegetable servings were significantly associated with Veggie Meter^®. Conclusions: Although non-significance could have been due to low power, clinical as well as statistical assessments of intermethod reliability, test–retest reliability, and external validity suggest that VioScreen-Allergy has reasonable utility for trials assessing food allergens and MDI in the context of overall intake. The VioScreen questionnaire can also be used in future studies to assess macro- and micronutrient intake. Additional validation studies assessing different portion sizes and foods eaten by infants and young children are currently undergoing.

Self-rated health (SRH), an indicator of overall health status, has been associated with morbidity and mortality. Yet links between SRH and nutrition are lacking, especially in conjunction with other characteristics affecting SRH. Therefore, the study objective was to identify significant sociodemographic/socioeconomic, chronic disease, dietary habits, and food environment explanatory variables for perceptions of self-rated health (SRH). Data were collected in 2021 and consisted of households at risk of or experiencing food insecurity. Multivariable logistic regression was used to identify significant explanatory variables for SRH. Of the 54% of participants with low SRH, 43% had nutrition insecurity and 66% had one or more chronic disease. For participants with high SRH, 25% had nutrition insecurity and 32% had one or more chronic disease. Household income, fruit and vegetable intake, and scratch-cooked meals consumption were protective against low SRH (5%–16% decrease in odds). Participants with low SRH were 1.8 and 4.3 times as likely to have nutrition insecurity and one or more chronic disease, respectively than participants with high SRH. Perceptions of one's health are positively associated with healthful dietary habits and negatively associated with nutrition insecurity and presence of chronic disease.

This study’s purpose was to compare socioeconomic, dietary choice, and nutrition environment variables associated with food and nutrition security in USA households with and without children. Data were collected in 2021 and consisted of households at risk of or experiencing food insecurity. Multivariable logistic regression was used to identify significant explanatory variables for food and nutrition security by household type—with or without children (<18 years of age). Food insecurity rates were 74% and 64% in households with and without children, respectively. Nutrition insecurity rates were 38% and 30% in households with and without children, respectively. For both household types, greater dietary choice increased odds (4–15 times) of food and nutrition security. In households with children, more fast-food meals increased the odds (60%) of food security, while more processed meals and greater utilization barriers to healthful meals decreased the odds (40–50%). Greater utilization barriers also decreased the odds (20%) of food security in households without children. In households with children, higher income and greater healthfulness choice increased the odds (20% and 3 times) of nutrition security, while low (vs. high) perceived limited availability of foods doubled the odds in households without children. Dietary choice is an influential and crucial factor of food and nutrition security.

Background.: The purpose of this study was to collect updated school food service purchasing practices from K-12 public school food service directors (SFSD) in Mississippi and to determine their current abilities, experiences, and desires to engage in Farm to School (F2S) activities. Methods.: The online survey was created using questionnaire items from existing F2S surveys. The survey opened in October 2021 and closed in January 2022. Descriptive statistics were used to summarize the data. Results.: Of the 173 SFSD sent email invitations, 122 (71%) completed the survey. The most common fresh fruit and vegetable purchasing practices included Department of Defense Fresh Program (65%) and produce vendor (64%). Forty-three percent of SFSD purchased at least one locally sourced fruit and 40% purchased at least one locally sourced vegetable, while 46% did not purchase any locally sourced foods. The most common challenges for purchasing from farmers included no relationship with farmers (50%) and food safety regulations (39%). Sixty-four percent of SFSD were interested in at least one F2S activity. Conclusions.: Most SFSD do not purchase local foods directly from farmers and almost half do not purchase any local foods regardless of source. Lack of connection with local farmers is a significant challenge to F2S. Recently proposed framework by USDA for shoring up the food supply chain and transforming the food system may help reduce or remove ongoing challenges to F2S participation.