Improving Food Frequency Questionnaires : A Qualitative Approach Using Cognitive Interviewing - 12/09/11

Doi : 10.1016/S0002-8223(95)00217-0

AMY F SUBAR, PhD, RD ^a,⁎, FRANCES E THOMPSON, PhD, MPH ^a, ALBERT F SMITH, PhD ^b,^f, JARED B JOBE, PhD ^c,^f, REGINA G ZIEGLER, PhD, MPH ^a, NANCY POTISCHMAN, PhD ^a, ARTHUR SCHATZKIN, MD, PhD ^a, ANNE HARTMAN, MS ^a, CHRISTINE SWANSON, PhD, RD ^a, LAURA KRUSE, MPH, RD ^d,^f, RICHARD B HAYES, PhD ^a, DENISE RIEDEL LEWIS, PhD ^e,^f, LINDA C HARLAN, PhD ^a
^a A.F. Subar is a nutritionist, F.E. Thompson and L. C. Harlan are epidemiologists, A. Hartman is a statistician, and A. Schatzkin is a physician in the Division of Cancer Prevention and Control, R. G. Ziegler, N. Potischman, and R.B. Hayes are epidemiologists and C. Swanson is a nutritionist in the Division of Cancer Etiology at the National Cancer Institute, Bethesda, Md, USA
^b A.F. Smith is a psychologist in the Department of Psychology, Cleveland State University, Cleveland, Ohio, USA
^c J.B. Jobe is a psychologist with the Behavioral and Social Research Program at the National Institute on Aging, Bethesda, Md, USA
^d L. Kruse is a nutritionist with the Health Resources and Services Administration, HIV/ Substance Abuse Branch, Rockville, Md, USA
^e D.R. Lewis is an epidemiologist with the Environmental Protection Agency, Research Triangle Park, NC, USA
^f At the time of the study, A.F. Smith was a psychologist in the Department of Psychology, State University of New York at Binghamion; J.B. Jobe was a psychologist at the National Center for Health Statistics, Office of Research and Methodology, Hyattsville, Md; L. Kruse was a nutritionist in the Division of Cancer Prevention and Control, National Cancer Institute; and D.R. Lewis was an epidemiologist with the Nova Research Company, Bethesda, Md, USA

^*Address correspondence to: Amy F. Subar, PhD, MPH, National Cancer Institute, Division of Cancer Prevention and Control, EPN 313, 6130 Executive Blvd, MSC 7344, Bethesda, MD 20892-7344.

Abstract

In an attempt to improve data quality and ease of administration of standard self-administered food frequency questionnaires, various alternative approaches were tried for inquiring about frequency of consumption, portion size, seasonal intake, and food preparation. Evaluation consisted of a cognitive interviewing method in which respondents verbalize their thought process while completing several variations of a questionnaire. Interviewers observed and asked follow-up probe questions to evaluate problems or inconsistencies verbalized by respondents. Consensus and judgment by interviewers and observers suggested several problematic features of food frequency questionnaires: formatting of questions about frequency and portion size; computing average frequencies for aggregated food items or for foods eaten seasonally; comprehension of many items; and ordering of foods. These findings led to cognitive refinement and innovations, which included detailed questions regarding preparation or use of low-fat varieties or other alternatives to help better describe specifics of intake for some foods; questions on seasonal intake for several foods; inclusion of portion size ranges; and additional response categories for frequency of intake. Cognitive interviewing is an important step in pinpointing cognitive problems in dietary questionnaires. J Am Diet Assoc. 1995; 95:781-788.

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