Obesity perception survey among youth in Turkey: instrument development and testretest reliability
Obesity perception survey among youth in Turkey: instrument development and testretest reliability
Background/aim: We aimed to develop an instrument that can assess the perceptions and opinions of young people regarding the causesand consequences of obesity and the role of individuals, families, communities, and government in addressing obesity.Materials and methods: A 36-question (101-item) survey was developed by adopting, translating, and revising multiple-choice or Likertscale questions from existing surveys to assure construct cross-cultural validity. A two-factor mixed-effects model estimated the intraclasscorrelation coefficient (ICC) to measure the test-retest reliability of questions administered 2 weeks apart to a convenient sample ofİstanbul high school and university students, aged 15–25 years (n = 122).Results: The mean ICC for university and high school was 0.70 and 0.63, respectively. University students were more consistent in relatingthe problem to society and public policy preferences. High school students were more consistent in relating the problem and solutionto themselves and their immediate environments. Using a 0.5 cutoff for the ICC’s lower 95% confidence limit, followed by reevaluationof the question flow, a 19-question (36-item) survey was retained for adolescents and a 26-question (52-item) survey for young adults.Conclusion: While the survey items have moderate to excellent reliability for high school and university students, it can be administeredlongitudinally to suggest changes to policies and interventions, and after cross-cultural validation, it can be utilized to compare obesityperceptions across different populations.
___
- 1. Afshin A, Forouzanfar MH, Reitsma MB, Sur P, Estep K et al.
Health effects of overweight and obesity in 195 countries over
25 years. New England Journal of Medicine 2017; 377 (1): 13-
27.
- 2. Finucane MM, Stevens GA, Cowan MJ, Danaei G, Lin JK et al.
National, regional, and global trends in body-mass index since
1980: systematic analysis of health examination surveys and
epidemiological studies with 960 country-years and 9.1 million
participants. Lancet 2011; 377 (9765): 557-567.
- 3. Kelly T, Yang W, Chen CS, Reynolds K, He J. Global burden of
obesity in 2005 and projections to 2030. International Journal
of Obesity 2008; 32 (9): 1431-1437.
- 4. Popkin B, Monteiro C, Swinburn B. Overview: Bellagio
conference on program and policy options for preventing
obesity in the low- and middle-income countries. Obesity
Reviews 2013; 14: 1-8.
- 5. Wyatt SB, Winters KP, Dubbert PM. Overweight and obesity:
Prevalence, consequences, and causes of a growing public
health problem. American Journal of the Medical Sciences
2006; 331 (4): 166-174.
- 6. Keith SW, Redden DT, Katzmarzyk PT, Boggiano MM, Hanlon
EC et al. Putative contributors to the secular increase in
obesity: exploring the roads less traveled. International Journal
of Obesity 2006; 30 (11): 1585-1594.
- 7. Finkelstein EA, Ruhm CJ, Kosa KM. Economic causes and
consequences of obesity. Annual Review of Public Health 2005;
26 (1): 239-257.
- 8. WHO Regional Office for Europe. Nutrition, Physical Activity
and Obesity: Turkey. Geneva, Switzerland: WHO; 2013.
- 9. Erem C. Prevalence of overweight and obesity in Turkey. IJC
Metabolic & Endocrine 2015; 8: 38-41.
- 10. Bagriacik N, Onat H, Ilhan B, Tarakci T, Oşar Z et al. Obesity
profile in Turkey. International Journal of Diabetes and
Metabolism 2009; 17: 5-8.
- 11. Evans WD, Renaud JM, Finkelstein E, Kamerow DB, Brown
DS. Changing perceptions of the childhood obesity epidemic.
American Journal of Health Behavior 2006; 30 (2): 167-176.
- 12. Evans WD, Finkelstein EA, Kamerow DB, Renaud JM. Public
perceptions of childhood obesity. American Journal of
Preventive Medicine 2005; 28 (1): 26-32.
- 13. Worsley A, Wang W, Sarmugam R, Pham Q, Februhartanty J et
al. Family food providers’ perceptions of the causes of obesity
and effectiveness of weight control strategies in five countries
in the Asia Pacific region: a cross-sectional survey. Nutrients
2017; 9 (1): 13.
- 14. Rendon-Macias ME, Rosas-Vargas H, Villasis-Keever MA,
Perez-Garcia C. Children’s perception on obesity and quality of
life: a Mexican survey. BMC Pediatrics 2014; 14: 8.
- 15. King LA, Loss JHM, Wilkenfeld RL, Pagnini DL, Booth ML
et al. Australian GPs’ perceptions about child and adolescent
overweight and obesity - the Weight of Opinion study. British
Journal of General Practice 2007; 57 (535): 124-129.
- 16. Covic T, Roufeil L, Dziurawiec S. Community beliefs about
childhood obesity: its causes, consequences and potential
solutions. Journal of Public Health 2007; 29 (2): 123-131.
- 17. Odum M, McKyer ELJ, Tisone CA, Outley CW. Elementary
school personnel’s perceptions on childhood obesity:
pervasiveness and facilitating factors. Journal of School Health
2013; 83 (3): 206-212.
- 18. Aljunaibi A, Abdulle A, Nagelkerke N. Parental weight
perceptions: a cause for concern in the prevention and
management of childhood obesity in the United Arab Emirates.
PLoS One 2013; 8 (3): e59923.
- 19. Timperio A, Salmon J, Telford A, Crawford D. Perceptions of
local neighbourhood environments and their relationship to
childhood overweight and obesity. International Journal of
Obesity 2005; 29 (2): 170-175.
- 20. Rivera-Soto WT, Rodriguez-Figueroa L. Childhood obesity
among Puerto Rican children: discrepancies between child’s
and parent’s perception of weight status. International Journal
of Environmental Research and Public Health 2012; 9 (4):
1427-1437.
- 21. EASO. The European Association for the Study of Obesity.
2015. Obesity: Perception and Policy – Multi-Country Review
and Survey of Policymakers. Teddington, UK: European
Association for the Study of Obesity; 2015.
- 22. EASO. The European Association for the Study of Obesity.
2016. Obesity: An Underestimated Threat. Teddington, UK:
European Association for the Study of Obesity; 2016.
- 23. Agiesta J, Benz J, Brewer KH, Bye LL, Junius DD et al. Obesity
in the United States: Public Perceptions. The Associated PressNORC Center for Public Affairs Research. Chicago, IL, USA:
University of Chicago Press; 2013.
- 24. United Nations Educational Scientific and Cultural
Organization. Education and Literacy - Turkey. Montreal,
Canada: UNESCO Institute for Statistics; 2018.
- 25. Organisation for Economic Cooperation and Development.
Education at a Glance - Population with Tertiary Education.
Online Library of OECD. Paris, France: OECD; 2019.
- 26. Cronbach LJ, Meehl PE. Construct validity in psychological
tests. Psychological Bulletin 1955; 52 (4): 281-302.
- 27. Kane MT. Validating the interpretations and uses of test scores.
Journal of Educational Measurement 2013; 50 (1): 1-73.
- 28. Sobngwi E, Mbanya JCN, Unwin NC, Aspray TJ, Alberti
K. Development and validation of a questionnaire for the
assessment of physical activity in epidemiological studies in
Sub-Saharan Africa. International Journal of Epidemiology
2001; 30 (6): 1361-1368.
- 29. Koo TK, Li MY. A guideline of selecting and reporting
intraclass correlation coefficients for reliability research.
Journal of Chiropractic Medicine 2016; 15 (2): 155-163.
- 30. StataCorp. Stata Statistical Software: Release 14. College
Station, TX, USA: StataCorp LP; 2015.
- 31. Tabachnick BG, Fidell LS. Using Multivariate Statistics. 6th ed.
Boston, MA, USA: Allyn and Bacon; 2013.
- 32. Weir JP. Quantifying test-retest reliability using the intraclass
correlation coefficient and the SEM. Journal of Strength and
Conditioning Research 2005; 19 (1): 231-240.
- 33. Bluher M. The myth of innocent obesity. Nature Reviews
Endocrinology 2017; 13 (12): 691-692.
- 34. West GF, Hayden MR, Benjamin CR. Accuracy of adults’
perception of childhood obesity in a military environment.
Public Health Nursing 2013; 30 (4): 343-350.
- 35. Jayawardene W, Lohrmann D, Youssef Agha A. Discrepant
body mass index: behaviors associated with height and weight
misreporting among US adolescents from the National Youth
Physical Activity and Nutrition Study. Childhood Obesity
2014; 10 (3): 225-233.