(P23-075-23) Development & Validating of a Food Literacy Behavior Questionnaire for Adults With Type 2 Diabetes Mellitus

Objectives: Food literacy is the ability to plan, manage, select, prepare, and eat food. To date, food literacy questionnaires have not addressed behaviors of those with chronic disease. The purpose of this study was to create a food literacy instrument specific to individuals with Type 2 Diabetes Mellitus (T2DM).

Methods: This study developed and validated a survey, modified from the Eating and Food Literacy Behaviors Questionnaire (EFLBQ), containing additional statements about food-related behaviors practiced by those with T2DM. The new instrument was named the Eating and Food Literacy Behaviors Questionnaire for Diabetics (EFLBQ-D). Twelve diabetes-specific statements, developed in conjunction with subject-matter experts (content validity testing), were reviewed by 5 adults with T2DM to establish face validity. Exploratory factor analysis (EFA) was conducted on the 12 diabetes-specific statements. Confirmatory factor analysis (CFA) was conducted with the EFLBQ plus the diabetes-specific statements (EFLBQ-D). Both were administered by third-party provider Centiment via Qualtrics to adults with T2DM residing in 1 of the 13 USDA Southern region states. Reliability was assessed via point estimate reliability testing.

Results: The EFA produced 6 statements that clustered into 2 factors. One addressed carbohydrate counting and nutrition label reading; the other focused on healthy food preparation methods, portion control, and the inclusion of dietary fiber. The CFA of the EFLBQ-D indicated that instrument had good fit (x² = 584.910; degrees of freedom = 254; P < 0.0000; root mean square error of approximation = 0.065; comparative fit index = 0.912; Tucker-Lewis Index = 0.896; standardized root mean square residual = 0.058). Point estimate reliability for the EFLBQ-D factors ranged from 0.65 to 0.90: the first diabetes-related factor's reliability was 0.87 with the second being 0.68. This suggests that the EFLBQ-D factors are reliable.

Conclusions: The EFLBQ-D appears to be a valid and reliable instrument that can be used by researchers and professionals to better understand food behaviors and food literacy skills of those with T2DM. This is an important tool to help individualize medical nutrition therapy and improve patient care in this population.

Funding Sources: This project was funded by Hatch Project #LAB94331 and the LSU Ann Armstrong Peltier Professorship.