Dietary Risk Assessment in the WIC Program (2002) / Chapter Skim
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4 Framework for Evaluating Tools to Assess Dietary Risk
4 Framework for Evaluating Tools to Assess Dietary Risk
Pages 49-56
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From page 49... ...
. This chapter outlines eight characteristics that together provide a framework for evaluating the usefulness and effectiveness of a dietary risk assessment tool in the WIC setting.
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From page 50... ...
The purpose is to conclude whether the individual "meets" or "does not meet" the Dietary Guidelines. For such vulnerable populations as pregnant women, postpartum women, and children ages 2 to 5 years, the committee decided that many criteria could be set, any one of which would provide evidence that the individual fails to meet either the Food Pyramid guideline or the physical activity guideline (see Chapters 3, 5, and 6~.
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From page 51... ...
Random error could be caused by such conditions as the respondent or interviewer being upset at the time of assessment, multiple interviewers, excessive noise during assessment, the limitations of memory, or a person's inability to properly average intake to provide a desired response on a food frequency questionnaire. Random error is always present, therefore, the question when evaluating a tool is whether the level of random error present is acceptable for the intended purpose.
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From page 52... ...
That is, does it provide an unbiased estimate of usual dietary intake? Bias Also known as systematic error If biased, the estimated mean intake is not equal to the true mean intake Reliability Refers to the ability of the estimate to be reproduced when the measure is repeated The inability of the measure to be reproduced is a function of the amount of random error in the assessment procedure Reproducibility See Reliability Random error Variability in the measure when assessed over time Increases the variance around the mean of the measure, but does not affect the estimate of the mean Random error is inversely related to reliability Between- Variability across individuals in their usual dietary intakes individual Considered the true variability when estimating intakes of groups variability Within-individual Variability in dietary intakes within an individual from day to day variability Reduces the reliability of the measurement of usual intake Measurement error Refers to error in dietary intake estimation due to the measurement or imprecision process itself Includes interviewer differences, food composition database errors Reduces the reliability and validity of the measurement of usual intake Misclassification Quantification of error within the context of classifying individuals as being at dietary risk Quantified in terms of Sensitivity and Specificity of the measure Sensitivity Refers to the proportion or percent of individuals with dietary risk who are identified by the assessment tool as being at dietary risk Specificity Refers to the proportion or percent of individuals not at dietary risk who are identified by the assessment tool as not being at dietary risk Positive predictive Refers to the proportion or percent of individuals identified at value dietary risk who are truly at dietary risk Negative Refers to the proportion of individuals identified to not be at dietary predictive value risk who are truly not at dietary risk
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From page 53... ...
It is true that standardized 24-hour recalls and food records capture cultural preferences and foods consumed, provided that the interviewer is knowledgeable about reported foods, follows standard methods, and uses a food composition database that includes the foods. Thus, the need to consider specific development of tools for different cultural groups refers to the use of food frequency methods to determine usual dietary intakes.
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From page 54... ...
and states to track program operations and uses of dietary risk assessment in WIC. For example, a few years ago, states were interested in having a common tool to assess the risk of food insecurity/hunger.
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From page 55... ...
, be suitable for the culture and language of the population served, be responsive to operational constraints in the WIC setting, be standardized across states and agencies, and allow prioritization within the category of dietary risk.
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