Abstract
Background & aims: Qualitative studies suggest that malnutrition awareness is poor in older adults. The aim of this study was to develop a questionnaire to quantitatively assess malnutrition awareness in community-dwelling older adults aged 60+ years. Methods: The Malnutrition Awareness Scale (MAS) was developed based on the awareness phase of the Integrated-Change model, and included four domains: knowledge, perceived cues, risk perceptions, and cognizance. Twenty-six scale items were developed using results from mainly qualitative research and the expertise of the authors. Items were piloted in 10 Dutch older adults using the Thinking Aloud method to optimize wording. In a feasibility study, annoyance, difficulty and time to complete the MAS and its comprehensibility were tested. After final revisions, the MAS was applied to a large sample to test its psychometric properties (i.e., inter-item correlations, Cronbach's alpha, score distribution) and relevance of the items was rated on a 5-point scale by 12 experts to determine content validity. Results: The feasibility study (n = 42, 55 % women, 19 % 80+ y) showed that the MAS took 12 ± 6 min to complete. Most participants found it not (at all) annoying (81 %) and not (at all) difficult (79 %) to complete the MAS, and found it (very) comprehensible (83 %). Psychometric analyses (n = 216, 63 % women, 28 % 80+ y) showed no redundant items, but two items correlated negatively with other items, and one correlated very low. After removal, the final MAS consists of 23 items with a min–max scoring range from 0 to 22 (with higher scores indicating higher awareness) and an overall Cronbach's alpha of 0.67. The mean MAS score in our sample (n = 216) was 14.8 ± 3.2. The lowest obtained score was 6 (n = 3) and the highest 22 (n = 1), indicating no floor or ceiling effects. Based on the relevance rating, the overall median across all 22 items was 4.0 with IQR 4.0–5.0. Conclusion: The Malnutrition Awareness Scale is a novel, feasible and reliable tool with good content validity to quantitively assess malnutrition awareness in community-dwelling older adults. The scale is now ready to identify groups with poor malnutrition awareness, as a basis to start interventions to increase malnutrition knowledge and awareness.
| Original language | English |
|---|---|
| Pages (from-to) | 446-452 |
| Number of pages | 7 |
| Journal | Clinical Nutrition |
| Volume | 43 |
| Issue number | 2 |
| Early online date | 1 Jan 2024 |
| DOIs | |
| Publication status | Published - Feb 2024 |
Bibliographical note
Publisher Copyright:© 2023
Funding
We would like to thank the older volunteers who participated in our studies, the Nutrition and Dietetics students of the Hanze University of Applied Sciences, Groningen and the Health Sciences students from the Vrije Universiteit Amsterdam who contributed to the data collection, and the volunteers who helped us translate and culturally adapt the MAS from the Dutch language into the English language. We also thank the independent malnutrition experts for rating the relevance of the MAS items for measuring malnutrition awareness in older adults. This project originates from working group activities of the Dutch ‘Partnernetwerk Ondervoeding Ouderen’, which was initiated by the Dutch Malnutrition Center of Expertise.
| Funders | Funder number |
|---|---|
| Dutch Malnutrition Center of Expertise | |
| Vrije Universiteit Amsterdam | |
| Hanzehogeschool Groningen |
Keywords
- Aging
- Awareness
- Integrated-change model
- Questionnaire
- Undernutrition