NutriSTEP® is Reliable for Internet and Onscreen Use
Bianca Carducci1, Maria Reesor2, Helen Haresign3
1a Human Health and Nutritional Sciences, University of Guelph, Guelph, ON.
Insights
The NutriSTEP® screening tool for preschooler nutritional risk is reliable in both Internet and Onscreen formats. These digital versions offer dependable results comparable to paper, enhancing accessibility for assessing child nutrition.
Area of Science:
- Pediatric Nutrition
- Health Screening Tools
- Digital Health
Background:
- NutriSTEP® is a validated tool for identifying nutritional risk in preschoolers aged 3-5 years.
- Historically, NutriSTEP® has only been available in paper format, limiting its accessibility and ease of use.
- The development of digital versions aims to broaden access and streamline the screening process.
Purpose of the Study:
- To evaluate the reliability of the NutriSTEP® screening tool when administered via Internet and Onscreen digital platforms.
- To compare the consistency of results between digital NutriSTEP® versions and the traditional paper format.
- To determine the suitability of digital NutriSTEP® for widespread use in assessing preschooler nutritional status.
Main Methods:
- Two studies were conducted with parents in Ontario, Canada, utilizing both Internet (n=63) and Onscreen (n=64) versions of NutriSTEP®.
- Parents completed the digital versions, followed by the alternate mode two weeks later to assess test-retest reliability.
- Reliability was statistically analyzed using Intraclass Correlations (ICC), Pearson Correlations (PC), Kappa coefficients (κ), and the Wilcoxon Signed Rank Test.
Main Results:
- High reliability was observed for total scores, with Internet ICCs of 0.94 and Onscreen ICCs of 0.91.
- Attribute scores demonstrated strong reliability, with ICCs ranging from 0.69-0.91 for Internet and 0.81-0.92 for Onscreen.
- Agreement for risk categories was substantial (κ=0.58 for Internet, κ=0.50 for Onscreen), and individual question agreement was adequate to excellent for most items.
Conclusions:
- The Internet and Onscreen digital versions of the NutriSTEP® screening tool demonstrate reliable performance.
- These digital formats are suitable alternatives to the paper version for assessing nutritional risk in preschoolers.
- The findings support the expanded use of digital NutriSTEP® to improve screening accessibility and efficiency.
Purpose:
NutriSTEP(®) screens for nutritional risk in preschoolers (3-5 years of age). Availability has been limited to paper versions. The objective is to test reliability for Internet and Onscreen use.
Methods:
Two studies were conducted with parents in several Ontario Early Years Centres (Internet (n = 63)) and in the community and schools in Timmons, Guelph, and Ottawa, Ontario (Onscreen (n = 64)). Parents completed NutriSTEP(®) either on paper or using Internet or Onscreen versions. Two weeks later, the alternate mode was completed. Reliability was assessed using Intraclass Correlations (ICC) and Pearson Correlations (PC) on total and attribute scores, Kappa coefficients (κ) for risk, and Wilcoxon Signed Rank Test for responses on individual questions.
Results:
For total scores, Internet and Onscreen ICCs were 0.94 and 0.91, respectively, with PCs of 0.89 and 0.84, respectively. Attribute scores were 0.69-0.91 (ICC) and 0.70-0.84 (PC) for Internet, and 0.81-0.92 (ICC) and 0.68-0.85 (PC) for Onscreen. κ amongst risk categories was 0.58 (P = 0.000) for Internet and 0.50 (P = 0.000) for Onscreen. For individual dichotomized questions, 5 of 17 (Onscreen and Internet) were excellent (κ > 0.75); 11 of 17 (Internet) and 9 of 17 (Onscreen) were adequate (0.40 < κ > 0.75); 0 of 17 (Internet) and 2 of 17 (Onscreen) questions were poor (κ < 0.4) in agreement between modes.
Conclusions:
Internet and Onscreen versions of NutriSTEP(®) are reliable.
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