title: Development and validity of a questionnaire to test the knowledge of primary care personnel regarding nutrition in obese adolescents.
abstract: BACKGROUND
  In light of its epidemic proportions in developed and developing countries, obesity is considered a serious public health issue. In order to increase knowledge concerning the ability of health care professionals in caring for obese adolescents and adopt more efficient preventive and control measures, a questionnaire was developed and validated to assess non-dietitian health professionals regarding their Knowledge of Nutrition in Obese Adolescents (KNOA).
  
  
  METHODS
  The development and evaluation of a questionnaire to assess the knowledge of primary care practitioners with respect to nutrition in obese adolescents was carried out in five phases, as follows: 1) definition of study dimensions 2) development of 42 questions and preliminary evaluation of the questionnaire by a panel of experts; 3) characterization and selection of primary care practitioners (35 dietitians and 265 non-dietitians) and measurement of questionnaire criteria by contrasting the responses of dietitians and non-dietitians; 4) reliability assessment by question exclusion based on item difficulty (too easy and too difficult for non-dietitian practitioners), item discrimination, internal consistency and reproducibility index determination; and 5) scoring the completed questionnaires.
  
  
  RESULTS
  Dietitians obtained higher scores than non-dietitians (Mann-Whitney U test, P < 0.05), confirming the validity of the questionnaire criteria. Items were discriminated by correlating the score for each item with the total score, using a minimum of 0.2 as a correlation coefficient cutoff value. Item difficulty was controlled by excluding questions answered correctly by more than 90% of the non-dietitian subjects (too easy) or by less than 10% of them (too difficult). The final questionnaire contained 26 of the original 42 questions, increasing Cronbach's α value from 0.788 to 0.807. Test-retest agreement between respondents was classified as good to very good (Kappa test, >0.60).
  
  
  CONCLUSIONS
  The KNOA questionnaire developed for primary care practitioners is a valid, consistent and suitable instrument that can be applied over time, making it a promising tool for developing and guiding public health policies.
authors.affiliation: Health Sciences Postgraduate Program, State University of Montes Claros (Unimontes), Montes Claros, MG, Brazil. lucineiapinho@hotmail.com
authors.forename: Lucinéia
authors.initials: L
authors.lastname: de Pinho
authors.forename: Paulo Henrique Tolentino
authors.initials: PH
authors.lastname: Moura
authors.forename: Marise Fagundes
authors.initials: MF
authors.lastname: Silveira
authors.forename: Ana Cristina Carvalho
authors.initials: AC
authors.lastname: de Botelho
authors.forename: Antônio Prates
authors.initials: AP
authors.lastname: Caldeira
mesh_terms: D000293:Adolescent; D000328:Adult; D001938:Brazil; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D052756:Nutritional Sciences / Q000193:education*; D064686:Nutritionists / Q000523:psychology / Q000706:statistics & numerical data; D010349:Patient Compliance; D063766:Pediatric Obesity / Q000175:diagnosis* / Q000628:therapy; D058007:Physicians, Primary Care / Q000193:education / Q000523:psychology* / Q000706:statistics & numerical data; D011320:Primary Health Care / Q000592:standards; D025341:Principal Component Analysis; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires / Q000592:standards*