Abstract
Program evaluation is most meaningful when accurate, consistent, and responsive to participant needs, including language, literacy level, and cultural context. Content and face validity were previously established for a 25-item, Food and Physical Activity Behavior Checklist (FBC) with accompanying images for English- and Spanish-speaking respondents. A key next step in determining the FBC utility was assessing its reliability.
To evaluate FBC temporal stability and internal consistency for use in government-funded nutrition education programs delivered in English and Spanish.
Adults with low income (n = 209; 87% female; 78% Hispanic) were recruited from fall 2024 to spring 2025 from community-based programs. Participants completed the self-administered FBC 2 times (T1 and T2) 4 weeks apart in English (T1: n = 108; T2: n = 94) or Spanish (T1: n = 101; T2: n = 91).
Reliability was assessed using 2 approaches: (1) temporal stability, using Kendall’s tau-b; and (2) internal consistency, evaluated with Cronbach’s α for 3 behavioral domains (diet quality: 11 items; food resource management: 10 items; physical activity: 3 items). Analyses were conducted with the full sample and by language to assess equivalence.
Item-level temporal stability was moderate, ranging from tau = 0.42–0.70 (English tau = 0.43–0.75, Spanish tau = 0.34–0.66), with all P < 0.001. Items with the strongest stability for both languages included using coupons, drinking milk, and drinking water. Items with lower stability included buying whole grains, buying healthy foods on a budget, and trying to move more. Items demonstrated acceptable to strong internal consistency reliability. For the diet quality subscale, Cronbach’s α was 0.77 (Spanish: 0.81; English: 0.74), food resource management was 0.82 (Spanish: 0.87; English: 0.82), and physical activity was 0.76 (Spanish: 0.79; English: 0.71).
Findings provide evidence of an internally and temporally reliable FBC in English and Spanish. The tool shows promise for consistent program evaluation and tailoring interventions. An educator implementation guide is available to support consistent use.
Supplemental Nutrition Assistance Program-Education