BACKGROUND A poor quality diet is a well-known risk factor for many chronic diseases. However, eating a healthful diet is not always simple as many underlying factors can impede adherence. Individuals with fewer barriers are more likely to eat a healthful diet than those who have more barriers. Accurately measuring barriers to eating a healthful diet could inform personalized interventions, particularly those aiming to prevent chronic diseases. The aim of this study was to establish content validity for selected items obtained from the National Health and Nutrition Examination Survey (NHANES) database to be considered for inclusion as items on the conceptualized Dietary Health Status (DHS) instrument, which is designed to measure barriers to eating a healthful diet in adults. METHODS The Behavioral Change Wheel hub COM-B and the Theoretical Domains Framework (TDF) were the two theoretical frameworks underpinning the development of the DHS instrument. Seven steps were conducted to create the instrument: 1) development of operational definitions for each TDF domain; 2) identification of items from the NHANES database 2011-2012; 3) screening of items to ensure inclusion of all relevant items; 4) assigning items to a theory-based domain; 5) evaluation of the items against inclusion/exclusion criteria; 6) solicitation of feedback from expert reviewers to reach consensus on inclusion into a domain; and 7) validation of items. RESULTS A total of 170 items representing twelve domains were identified as potential barriers to eating a healthful diet-- knowledge, optimism, beliefs about consequences, beliefs about capabilities, reinforcement, memory, attention and decision processes, environmental context and resources, social influences, emotion, behavioral regulation, health identity, and functional status. CONCLUSION Expert review consultation and a consensus approach established content validity for 12 theory-based domains comprised of 170 items identified as potential barriers to eating a healthful diet. The use of these explanatory domains may: assist researchers to better understand barriers to adult dietary practices; inform the development of a screening tool that could be used in a community setting to measure barriers to eating a healthful diet; and inform individualized interventions.

中文翻译：

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建立用于衡量成人饮食健康饮食障碍的概念化工具的内容有效性：一种共识方法。

背景技术不良饮食是许多慢性疾病的众所周知的危险因素。但是，饮食健康并不总是那么简单，因为许多潜在因素可能会阻碍依从性。障碍较少的人比障碍较多的人更可能饮食健康。准确测量饮食健康饮食的障碍可以为个性化干预提供依据，尤其是那些旨在预防慢性疾病的干预。这项研究的目的是确定从美国国家健康和营养检查调查（NHANES）数据库中获得的选定项目的内容有效性，这些内容将被考虑作为概念化饮食健康状况（DHS）仪器中的项目纳入研究，该仪器旨在测量障碍在成年人中饮食要健康。方法行为改变轮毂COM-B和理论领域框架（TDF）是DHS仪器开发的两个理论框架。为创建该工具进行了七个步骤：1）为每个TDF域开发操作定义；2）从NHANES数据库2011-2012中识别项目；3）筛选项目以确保包括所有相关项目；4）将项目分配给基于理论的领域；5）根据纳入/排除标准评估项目；6）征求专家审稿人的反馈，以就纳入领域达成共识；7）物品验证。结果共有170个项目代表12个领域，被认为是饮食健康饮食的潜在障碍-知识，乐观，对后果的信念，对能力的信念，强化，记忆，注意力和决策过程，环境背景和资源，社会影响，情感，行为调节，健康身份和功能状态。结论专家评审咨询和共识方法为12个基于理论的领域建立了内容有效性，该领域由170个项目构成，被确定为饮食健康饮食的潜在障碍。这些解释性领域的使用可以：帮助研究人员更好地理解成人饮食习惯的障碍；告知开发一种筛查工具，该工具可在社区环境中用于测量饮食健康饮食的障碍；并告知个性化干预措施。和功能状态。结论专家评审咨询和共识方法为12个基于理论的领域建立了内容有效性，该领域由170个项目构成，被确定为饮食健康饮食的潜在障碍。这些解释性领域的使用可以：帮助研究人员更好地理解成人饮食习惯的障碍；告知开发一种筛查工具，该工具可在社区环境中用于测量饮食健康饮食的障碍；并告知个性化干预措施。和功能状态。结论专家评审咨询和共识方法为12个基于理论的领域建立了内容有效性，该领域由170个项目构成，被确定为饮食健康饮食的潜在障碍。这些解释性领域的使用可以：帮助研究人员更好地理解成人饮食习惯的障碍；告知开发一种筛查工具，该工具可在社区环境中用于测量饮食健康饮食的障碍；并告知个性化干预措施。告知开发一种筛查工具，该工具可在社区环境中用于测量饮食健康饮食的障碍；并告知个性化干预措施。告知开发一种筛查工具，该工具可在社区中用于测量饮食健康饮食的障碍；并告知个性化干预措施。