Improving communication about dietary fats: development and validation of the Fats-Related Attitude Scale based on...

To develop and validate a scale measuring individual attitudes toward high-fat products to aid health care professionals in understanding patients' beliefs and practices.

We conducted a two-phase study involving culturally diverse countries: Brazil, China, Croatia, Poland, and Spain. Phase 1 involved interviews exploring laypeople's experiences, which were the basis for inductive item generation. We generated common and country-specific items. Next, nine nutrition experts from the studied countries reviewed 25 common items and assessed their relevance to the presented categories. Phase 2 involved psychometric testing and validation. Within the framework of classical test theory, exploratory and confirmatory factor analyses were conducted, and internal consistency was assessed using McDonald's omega. Item response theory was also applied.

We tested a self-reported questionnaire on a convenience sample of 3599 students and staff from universities in five countries-Brazil (799), China (643), Croatia (257), Poland (1594), and Spain (306)-using the Computer-Assisted Web Interview technique. We found a three-dimensional structure and identified the Fat Elimination Subscale, Fat Awareness Subscale, and Trans Fat Avoidance Subscale. Internal consistency varied across country-specific versions. The highest McDonald's omega values were observed in Brazil (0.61-0.70), indicating moderate reliability, whereas the lowest values were found in China (0.43-0.66), reflecting low to moderate reliability.

The Fats-Related Attitude Scale identifies individual dietary beliefs and practices, which may influence long-term lifestyle changes. It provides initial insights into patients' willingness to adopt dietary changes, supporting tailored interventions in the health care setting.