Assessing Face Validity of a Food Behavior Checklist for Limited-resource Filipinos.

Diet-related chronic health conditions are prevalent in the Filipino American community; however, there is a lack of rigorously validated nutrition education evaluation tools in Tagalog for use in this population. This study aimed to develop and evaluate the face validity of a Tagalog-language food behavior checklist (FBC). A multi-step method was used, involving translation of questionnaire text from English to Tagalog by a team of professionals, creation of accompanying color photographs, cognitive testing with the target population, final review by the team of professionals, and assessment of readability. Subjects for cognitive testing were men (n=6) and women (n=14) 18 years or older in Hawai'i who received or were eligible to receive Supplemental Nutrition Assistance Program (SNAP) benefits, self-identified as Filipino, and preferred Tagalog rather than English. Participants were recruited from churches, the Filipino Center, and other community sites. Cognitive interviews revealed several issues with text and photographs, such as preferences for specific terms, and images that did not adequately illustrate the text. Image changes were made to reflect items most commonly consumed. The team of professionals agreed with participant suggestions. Assessment of readability revealed a reading level appropriate for a low-literacy population of grade 5.9. The multi-step process, which allowed members of the target audience to reveal the appropriateness of the questionnaire, yielded a Tagalog-language FBC found to have adequate face validity. After further evaluation of validity and reliability, this tool may be used to evaluate behavior change resulting from the United States Department of Agriculture's (USDA) nutrition education programs.