Development and preliminary evaluation of a food literacy measure for use with young people in Canada.

Background: This paper presents the culmination of a multi-year research project aimed at creating a comprehensive food literacy framework and corresponding measure. Specifically, this paper documents the development and validation of a food literacy measure for young people facing social inequities.

Objectives: This study aimed to: 1) identify items to measure 12 attributes of food literacy 2) test the measure with the identified target groups, considering attribute, face, and content validity, inter-rater reliability and test-retest reliability; and 3) refine the measure.

Design: The study's design consisted of a five-phase approach, which included drafting the food literacy measure, expert review, cognitive interviews, pilot testing, and validity and reliability testing.

Participants/setting: Seven international experts provided feedback on the measure and 25 individuals aged 16-25 years old participated in cognitive interviews. Two-hundred and fifty-five (255) young people completed the test survey and 147 completed a retest survey two weeks later. These surveys identified food literacy factors. To further evaluate the validity of these factors. 193 participants completed a confirmatory test, which was used for confirmatory factor analysis (CFA) to assess the final model's fit. Interview participants were recruited from local programs and services from across Ontario, Canada, while survey participants were recruited from across Canada via social media. The research study was conducted between January 2018 and December 2019.

Main outcome measures: The main outcome measures were validity and reliability scores for a food literacy measurement tool, which consisted of 50 questions across 10 attributes of food literacy.

Statistical analyses performed: Interview analyses were guided by the four stages of cognitive processing. Exploratory factor analysis (EFA) was used to identify the factors that improved the Cronbach alpha of the food literacy measure. Test-retest reliability was assessed using percent agreement, Cohen Kappa, and weighted Kappa. Confirmatory factor analysis (CFA) was used to produce an acceptable final model with an RMSEA estimate.

Results: The final food literacy measure consisted of 50 questions addressing 10 food literacy attributes. EFA showed an improvement in Cronbach alpha when compared to the initial attribute construction. Test-retest reliability showed percent agreement ranging from 64% to 97%, with most items having fair (0.21-0.40) to moderate (0.41-0.60) Kappa values. CFA produced an acceptable final model with an RMSEA estimate of 0.0437.

Conclusions: The food literacy measure is a comprehensive tool for assessing food literacy among young people. Additional research is needed to explore the measure's modularity, its use as an evaluation tool, and its suitability for use with diverse samples, including individuals from varied gender, geographic locations, ethnicities and cultural backgrounds.