A Screening Instrument to Identify Adults with Nutritional Risks in a Family Medicine Practice

Family practice is the point of entry for many individuals seeking medical attention in the community. It is an ideal site for instituting preventative measures aimed at risk management. The objective of this study was to develop a valid, reliable instrument to screen adults for risk of suboptimal nutrition in a family practice population. A self-administered nutrition questionnaire was developed and sent to 50 registered dietitians in Alberta to establish face validity. The ability of the tool to identify nutritional risk was established by comparing the results of the screen to a dietitian's full assessment, that would include weight, weight changes, body mass index, adequacy of nutrition intake, available laboratory data, and medical and social factors that influence nutrition status. A score of 12 or higher on the screen was found to have an 80% sensitivity and defined the high-risk individuals who required immediate nutrition intervention (14% of our study population). At a score of seven, the screening instrument had a sensitivity of 67% and a specificity of 77%. This score was used to define moderate risk individuals, who required some nutrition advice. Screen scores below seven corresponded with individuals who were not at nutritional risk. The study has shown that a simple, self-administered screening tool can effectively identify the nutritional risk of adults in a family medicine practice.