Development of an instrument measuring the perceived attributes of using a healthy diet innovation
The Lower Mississippi Delta (LMD) is a rural region that is rich in agricultural resources but is one of the most impoverished areas in the US. Prior research has indicated LMD adults as having higher rates of obesity and diet-related chronic diseases as compared to US adults. While the need for dietary intervention in the LMD is evident, the first step in designing effective interventions is the assessment of one's perceptions of dietary behaviors. The purpose of this research was to develop a valid and reliable instrument to assess individuals' perceived attributes of using a healthy diet. Using the Diffusion of Innovations (DOI) theory as a conceptual framework, this descriptive study employed qualitative and quantitative research methods and consisted of three phases. Phase 1 and 2 included qualitative research methods consisting of group panel discussions and card sorts to assist in the initial development of the instrument. Phase 2 included pilot and field testing of the instrument followed by quantitative analyses of the data. Data analyses techniques included content analysis and identification of common themes of group discussions; analysis of face and content validity of the items; and descriptive statistics, item and factor analyses, and reliability estimates of pilot and field test survey data. The DOI attributes relative advantage, compatibility, complexity, trialability, and observability of a healthy diet were explored in phase 1. As a result, portability, protective, and generational attributes of a healthy diet were identified. All attribute definitions were established and verified. Sixty nine items were created for the card sorts, which resulted in 37 remaining items. Item evaluation and pilot testing of the instrument resulted in the 39-item field test instrument. Thirty five of the 39 items were subjected to factor analysis, resulting in a four-factor solution with 21 items that accounted for 45% of the shared variance. This instrument can be used to assess individuals' perceptions of a healthy diet. Furthermore, knowing which attributes of a healthy diet that have the greatest influence on adoption and implementation can be valuable when planning nutrition interventions and key educational messages.