title: A measure of stages of change in fruit and vegetable consumption among fourth- and fifth-grade school children: reliability and validity.
abstract: OBJECTIVE
  We developed, pilot-tested, and field-applied a stages of change questionnaire regarding fruit and vegetable (F&V) consumption among fourth- and fifth-grade students.
  
  
  METHODS
  The design included cross-sectional assessment of internal consistency and construct validity, and 2-week and 7-week longitudinal assessment of test-retest reliability. Subjects included 134 students from one school for pilot-testing and 252 from two schools for field application. Thirty-two questions from McConnaughy et al's stages of change questionnaire were adapted and pilot-tested; minor revisions were made for field application. Statistical analyses included principal components analysis to identify subscales; cluster analysis to identify subgroups within students; Cronbach's alpha coefficient to assess internal consistencies; Pearson product-moment correlations to assess test-retest reliabilities; and oneway ANOVA's by F&V stages of change clusters with actual F&V consumption, F&V self-efficacy subscales, F&V preferences, and F&V outcome expectations subscales to determine construct validity.
  
  
  RESULTS
  Principal components analysis from the field application indicated two subscales (precontemplation and beyond precontemplation) accounting for 39.5% of variance. Cluster analysis indicated 6 interpretable clusters; 2 (n = 63) provided responses inconsistent with the stages of change theory and 4 (n = 189) provided responses consistent with the theory. Internal consistencies and test-retest reliabilities were acceptable. Students in the "beyond precontemplation" clusters had higher levels of self-efficacy and outcome expectations regarding eating F&V.
  
  
  CONCLUSIONS
  Measuring stages of change other than the precontemplation stage in F&V consumption among elementary school children is problematic. Perhaps the theoretical concept does not apply to children, or elementary school children lack the ability to comprehend the questions measuring the concept, or the approach used was not entirely appropriate.
authors.affiliation: Georgia Prevention Institute Department of Pediatrics, Medical College of Georgia, Augusta 30912-3715, USA.
authors.forename: S B
authors.initials: SB
authors.lastname: Domel
authors.forename: T
authors.initials: T
authors.lastname: Baranowski
authors.forename: H C
authors.initials: HC
authors.lastname: Davis
authors.forename: W O
authors.initials: WO
authors.lastname: Thompson
authors.forename: S B
authors.initials: SB
authors.lastname: Leonard
authors.forename: J
authors.initials: J
authors.lastname: Baranowski
mesh_terms: D001294:Attitude to Health; D002648:Child; D016000:Cluster Analysis; D005502:Food; D005638:Fruit; D006293:Health Promotion; D006801:Humans; D010865:Pilot Projects; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires; D014675:Vegetables