[Development and preliminary validation of the "Skill Checklist" to enhance lifestyle modification skills among...

Objective　To improve the effectiveness of nutritional interventions by registered dietitians (RDs) in preventing and managing lifestyle-related diseases, this study developed and evaluated the "Skill Checklist," a tool supporting the structured individual-based lifestyle education (SILE) lifestyle improvement program based on the Nutrition Care Process.Methods　The "Skill Checklist" enables RDs to conduct seven self-assessments across 12 weeks at each SILE program stage. Twenty-five RDs were assessed for Nutrition Skill Score reliability and validity and inter-rater reliability of three independent evaluators. Construct validity was examined through score differences by experience level. Reproducibility was tested in 21 RDs using Spearman's correlation at 1-week intervals. A nutritional counseling survey was conducted at baseline and 12 weeks.Results　Of the 24 RDs who completed the study, 75% worked in pharmacies. Experience level (< 3 vs. ≥ 3 years) and monthly counseling frequency (< 10 vs. ≥ 10) were balanced. Cronbach's alpha for the Nutrition Skill Score was 0.907. Construct validity was supported by significantly higher evaluator scores for more experienced RDs (P = 0.024, P = 0.023). Inter-rater reliability (ICC (2,1)) was 0.758 (95% CI: 0.610-0.906). Reproducibility was confirmed (n = 21, r = 0.689, P < 0.001). Week-12 scores were significantly higher than baseline in self-assessments and evaluator ratings (P = 0.004, P < 0.001), remaining significant after covariate adjustment (P = 0.002, P < 0.001). RDs reporting successful counseling increased from 25.0% to 58.3%, while those reporting difficulty perceiving effectiveness decreased from 83.3% to 45.8%.Conclusion　This study demonstrated the reliability and validity of the "Skill Checklist." The tool may help RDs visualize and strengthen nutritional intervention and lifestyle modification competencies.