Development of Brief Child Nutrition and Physical Activity Screening Questions for Electronic Health Record Use

Area of Science:

• Pediatric Health
• Public Health Nutrition
• Behavioral Science

Background:

• Brief screening tools are needed to guide nutrition and physical activity counseling for children aged 2-11 years.
• Existing tools require validation for pragmatic use in clinical settings and population health studies.

Purpose of the Study:

• To develop and validate a brief nutrition and physical activity screening tool for children aged 2-11 years.
• To create a pragmatic screener for tailoring counseling and tracking behavior change.

Main Methods:

• Literature review to identify existing screening questions.
• Crowdsourcing survey (Amazon Mechanical Turk) to assess response variation and concurrent validity.
• Cognitive interviews with healthcare providers and parents to evaluate usability and perceived value.

Main Results:

• Identified 260 questions; 20 selected based on criteria.
• 1147 survey responses yielded 6 items with adequate variation and concurrent validity.
• Cognitive interviews led to the elimination of 3 items, resulting in a final 3-item screener.

Conclusions:

• A brief, 3-item nutrition and physical activity screener was developed and validated.
• The screener is suitable for integration into electronic health records for well-child care.
• This tool can inform tailored counseling and support population health research.