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Design and results of the pretest of the IDEFICS study
M Suling1, A Hebestreit, J Peplies
1Institute for Prevention Research and Social Medicine, University of Bremen, Germany.
Insights
The IDEFICS study pretested survey methods for children's health. Refinements were crucial for accurate data collection on diet and lifestyle in pediatric research.
Area of Science:
- Pediatric research
- Public health
- Childhood obesity
Background:
- The Identification and prevention of dietary- and lifestyle-induced health effects in children and infants (IDEFICS) study aimed to develop and pretest standardized survey procedures.
- Procedures included instruments, examinations, biological sampling, and software tools for feasibility, robustness, and acceptability.
Purpose of the Study:
- To evaluate the feasibility, robustness, and acceptability of standardized survey procedures for a large-scale pediatric health study.
- To refine methods for accurate data collection on diet and lifestyle factors in children.
Main Methods:
- A pretest involving 119 children aged 2-9 years across nine European centers.
- Utilized novel techniques like ultrasound for fat/bone assessment, heart rate monitors with accelerometers, and sensory taste tests.
- Included biological sampling, physical examinations, questionnaires, and dietary recalls.
Main Results:
- Minor amendments were needed for most procedures, but physical fitness tests required significant adaptation.
- Callipers were preferred over ultrasonography for skinfold measurements due to better agreement.
- Accelerometer/heart rate monitor combination was feasible only in school children; dietary recall development was intensive.
Conclusions:
- Balancing scientific value with feasibility and acceptability was essential.
- Extensive pretesting, training, and method refinement were necessary for valid and reliable data collection in fieldwork.
- Modifications ensured the integrity of results for identifying diet- and lifestyle-induced health effects in children.
Background:
During the preparatory phase of the baseline survey of the IDEFICS (Identification and prevention of dietary- and lifestyle-induced health effects in children and infants) study, standardised survey procedures including instruments, examinations, methods, biological sampling and software tools were developed and pretested for their feasibility, robustness and acceptability.
Methods:
A pretest was conducted of full survey procedures in 119 children aged 2-9 years in nine European survey centres (N(per centre)=4-27, mean 13.22). Novel techniques such as ultrasound measurements to assess subcutaneous fat and bone health, heart rate monitors combined with accelerometers and sensory taste perception tests were used.
Results:
Biological sampling, physical examinations, sensory taste perception tests, parental questionnaire and medical interview required only minor amendments, whereas physical fitness tests required major adaptations. Callipers for skinfold measurements were favoured over ultrasonography, as the latter showed only a low-to-modest agreement with calliper measurements (correlation coefficients of r=-0.22 and r=0.67 for all children). The combination of accelerometers with heart rate monitors was feasible in school children only. Implementation of the computer-based 24-h dietary recall required a complex and intensive developmental stage. It was combined with the assessment of school meals, which was changed after the pretest from portion weighing to the more feasible observation of the consumed portion size per child. The inclusion of heel ultrasonometry as an indicator of bone stiffness was the most important amendment after the pretest.
Discussion:
Feasibility and acceptability of all procedures had to be balanced against their scientific value. Extensive pretesting, training and subsequent refinement of the methods were necessary to assess the feasibility of all instruments and procedures in routine fieldwork and to exchange or modify procedures that would otherwise give invalid or misleading results.
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