Valid and Reliable Questionnaire for Assessing Nutrition and Physical Activity Practices in Early Care and Education

Valid, reliable, and comprehensive instruments enable early care and education (ECE) sites to self-assess nutrition and physical activity practices and policies, but availability is limited. Therefore, we developed and assessed the test-retest reliability and convergent validity of the Site-Level Assessment Questionnaire (SLAQ).

Reliability testing compared questionnaires completed by ECE personnel at 2 time points (reliability pairs). Convergent validity testing compared questionnaires completed by ECE personnel with questionnaires completed by researchers (validity pairs). Semistructured interviews with personnel who completed the SLAQ informed revisions.

California Supplemental Nutrition Assistance Program Education-eligible ECE sites.

Convenience sample of 32 ECE sites (18 school districts; 14 Head Starts).

Seventy-six items assessing wellness policies, federal food program participation, meals, snacks, beverages, food environment, feeding practices, nutrition education, gardens, physical activity, screen time, family involvement, and breastfeeding support.

Weighted κ test statistics and percent agreement were calculated for each item to assess agreement between reliability pairs and validity pairs.

Eighty-eight percent of items showed moderate or higher reliability; 52% had moderate or higher validity. On the basis of these results and interview findings, the SLAQ was revised to address issues identified.

Findings suggest acceptable validity and reliability of the SLAQ for assessing policies and practices at SNAP-Ed-eligible ECE sites in California. Further testing with larger, randomly selected, and geographically and socioeconomically diverse populations could broaden its application. As is, the comprehensive assessment data the SLAQ provides can be used to identify opportunities for improving ECE practices and policies that support children's health.