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Validation Information: School-Based Nutrition Monitoring (SBNM) questionnaire

Hoelscher 2003

Reproducibility and validity of the secondary level School-Based Nutrition Monitoring student questionnaire

Objective To evaluate the reproducibility and validity of the School-Based Nutrition Monitoring (SBNM) secondary level student questionnaire. Design Reproducibility was evaluated using a test-retest study design by administering the questionnaire on the same day (morning and afternoon, n254) and, when appropriate, 9 to 14 days apart (n259). Validity was assessed by comparing foods selected on the questionnaire with foods reported from a single 24-hour recall covering the same referent period(yesterday) in 209 students.

Subjects/setting Eighth grade students in middle schools from central Texas were used: male and female, approximately 75% white, for the reproducibility study, with 15% Hispanic, 6% African American; for the validation study, approximately 38% white, 41% Hispanic, and 17% African American.

Statistical analysis Spearman rank order correlation, kappa statistic, and percentage agreement were used for both reproducibility and the validation.

Results For the reproducibility study, agreement for questions about food intake “yesterday” were 70% to 98%, with kappa statistics ranging from 0.54 to 0.93 and correlations between 0.66 and 0.97. Questions on recent physical activity had high agreement (66% to 89%) as did “usual” physical activity items, weight loss, and food selection behaviors. Nutrition knowledge items showed relatively weaker reliability: agreements ranged from 47% to 92%, with kappa statistics between 0.30 and 0.56. Attitude questions had weaker agreement (50% to 87%), kappa statistics (0.27 to 0.52), and correlations (0.33 to 0.63). For the validation study, correlation coefficients ranged from 0.32 for breads to 0.68 for milk and beans. Percentage agreement ranged from 38% for breads to 89% for gravy.

Applications/conclusions Most questions on the SBNM secondary questionnaire were found to have acceptable reproducibility, whereas validation of food choice behaviors showed results similar to or better than other dietary assessment instruments for this age group. This questionnaire is a useful epidemiologic tool for surveillance, assessing broad intervention effects among groups or providing needs assessment data on selected nutrition and physical activity-related constructs.

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Validation Information

Year of Publication

Tool Information

Dietary Exposure Measured
Food Groups
Tool Type
Food Frequency Questionnaire
Timeframe Tool Measures info
Portion Size Measures info
Portion sizes were not assigned
Reporting Method info
Retrospective; Usual
Format info
Supplements Measured
Not reported
Administration Method info
Interviewer adminstered

Study Information

Study Location
Central Texas, USA
Associated Nutrient Database
Not reported
Comparator Validated Against
24hr Recall


Sample Size
Adolescents (8th graders)
Age of Population
Not reported
Other Notable Characteristics
Eighth grade students in middle schools from central Texas were used. 38%, 41% and 17% were white, Hispanic and African American

Total number of nutrients validated: 0 info

Not all of the nutrients validated in the validation studies are included in the table below, as statistical data was only selected to be displayed for a number of nutrients, this included:

  • Energy
  • Fat
  • Saturated Fat
  • Mono-unsaturated Fat
  • Poly-unsaturated Fat
  • Carbohydrates
  • Protein
  • Sugar
  • Non‐starch polysaccharides(NSP)
  • Sodium
  • Calcium
  • Iron
  • Zinc
  • Retinol
  • Folate
  • Folic Acid
  • Vitamin B12
  • Vitamin C
  • Fruit & Vegetables
  • Urinary Nitrogen

To find information on the other validated nutrients please read the validation study.

  • Macronutrients: 0
  • Micronutrients: 0
Comparator Lifestage Sex Nutrient Measured info Mean Difference Standard Deviation info Correlation Coefficient info Cohen's Kappa Coefficient Percentage Agreement Percentage Agreement Categories info Lower Limits of Agreement Upper Limits of Agreement
24hr Recall Adolescents (8th graders) Both Fruits 0.53 (S) 0.33 55
Vegetables 0.57 (S) 0.32 51

Some results have been calculated using statistical techniques based on the published data.

For further information on statistical terms click on Statistical tests used in validation studies

All correlations coefficients in the table are unadjusted unless stated otherwise. For adjusted correlation coefficients and other statistical methods used in the study e.g. paired t-tests, please read the validation articles.

  • # Adjusted
  • † Energy adjusted.
  • ‡ For loge-transformed, energy-adjusted nutrient intakes.
  • ^ Adjacent included.
  • ᵟ Participants provided identical responses.
  • (w) = Weighted.

Hoelscher DM, Day RS, Kelder SH, Ward JL. Reproducibility and validity of the secondary level School-Based Nutrition Monitoring student questionnaire. Journal of the American Dietetic Association. 2003 Feb 28;103(2):186-94.