The Nutrition Literacy Assessment Instrument is a Valid and Reliable Measure of Nutrition Literacy in Adults with Chronic Disease

Abstract

Objective: To test the reliability and validity of the Nutrition Literacy Assessment Instrument (NLit) in adult primary care and identify the relationship between nutrition literacy and diet quality.

Design: This instrument validation study included a cross-sectional sample participating in up to 2 visits 1 month apart.

Setting/participants: A total of 429 adults with nutrition-related chronic disease were recruited from clinics and a patient registry affiliated with a Midwestern university medical center.

Main outcome measures: Nutrition literacy was measured by the NLit, which was composed of 6 subscales: nutrition and health, energy sources in food, food label and numeracy, household food measurement, food groups, and consumer skills. Diet quality was measured by Healthy Eating Index-2010 with nutrient data from Diet History Questionnaire II surveys.

Analysis: The researchers measured factor validity and reliability by using binary confirmatory factor analysis; test-retest reliability was measured by Pearson r and the intraclass correlation coefficient, and relationships between nutrition literacy and diet quality were analyzed by linear regression.

Results: The NLit demonstrated substantial factor validity and reliability (0.97; confidence interval, 0.96-0.98) and test-retest reliability (0.88; confidence interval, 0.85-0.90). Nutrition literacy was the most significant predictor of diet quality (β = .17; multivariate coefficient = 0.10; P < .001).

Conclusions: The NLit is a valid and reliable tool for measuring nutrition literacy in adult primary care patients.

Keywords: chronic disease; health literacy; nutrition literacy; patient education; primary health care.

Copyright © 2017 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Figures

Figure 1

Excerpts and One Example Question from Each Subscale of the Nutrition Literacy Assessment Instrument. The University of Kansas holds the copyright of the Nutrition Literacy Assessment Instrument (used with permission).