Comparison between web-based and paper versions of a self-administered anthropometric questionnaire.

Références

Eur J Epidemiol. 2010 25(5):287-96

Auteurs

Touvier M, Méjean C, Kesse-Guyot E, Pollet C, Malon A, Castetbon K, Hercberg S.

Résumé

Online data collection could advantageously replace paper-and-pencil questionnaires in epidemiological studies by reducing the logistic burden, the cost and the duration of data processing. However, there is a need for studies comparing these new instruments to traditional ones. Our objective was to compare the web-based version of the NutriNet-Santé self-administered anthropometric questionnaire to the paper-based version. The questionnaire included 17 questions divided into subquestions (55 variables in all) dealing with height, weight, hip and waist circumferences, weight history, restrictive diet and weight self-perception. Both versions of the questionnaire were filled out by 147 volunteers (paper version first, N = 76, or web-based version first, N = 71) participating in the SU.VI.MAX ("Supplémentation en VItamines Minéraux et AntioXydants") cohort (age-range: 49-75 years; men: 46.3%). At the end of the test, subjects filled in a "satisfaction" questionnaire giving their opinions and feelings about each version. Agreement was assessed by intraclass correlation coefficients (ICCs) and kappas. We also quantified the number of errors inherent in the paper version. Agreement between the two versions was high. ICCs ranged from 0.86 to 1.00. Kappas ranged from 0.69 to 1.00 for comparable variables. A total of 82 data entry mistakes (1.5% of total entries), 60 missing values (1.1%), 57 inconsistent values (1.1%) and 3 abnormal values (0.1%) were counted in the paper version (non-existent in the web-based version due to integrated controls). The web-based version was preferred by 92.2% of users. In conclusion, the quality of information provided by the web-based anthropometric questionnaire used in the NutriNet-Santé Study was equal to, or better than, that of the paper version, with substantial logistic and cost advantages.

The NutriNet-Sante Study : a web-based prospective study on the relationship between nutrition and health and determinants of dietary patterns and nutritional status.

Références

BMC Public Health, 2010,10: 242-246

Auteurs

Serge Hercberg, Katia Castetbon, Sebastien Czernichow, Aurelie Malon, Caroline Mejean, Emmanuelle Kesse, Mathilde Touvier and Pilar Galan.

Résumé

BACKGROUND:
Nutrition-related chronic diseases such as cardiovascular diseases and cancer are of multiple origin, and may be due to genetic, biologic, behavioural and environmental factors. In order to detangle the specific role of nutritional factors, very large population sample cohort studies comprising precisely measured dietary intake and all necessary information for accurately assessing potential confounding factors are needed. Widespread use of internet is an opportunity to gradually collect huge amounts of data from a large sample of volunteers that can be automatically verified and processed. The objectives of the NutriNet-Santé study are: 1) to investigate the relationship between nutrition (nutrients, foods, dietary patterns, physical activity), mortality and health outcomes; and 2) to examine the determinants of dietary patterns and nutritional status (sociological, economic, cultural, biological, cognitive, perceptions, preferences, etc.), using a web-based approach.
METHODS/DESIGN:
Our web-based prospective cohort study is being conducted for a scheduled follow-up of 10 years. Using a dedicated web site, recruitment will be carried out for 5 years so as to register 500 000 volunteers aged >/= 18 years among whom 60% are expected to be included (having complete baseline data) and followed-up for at least 5 years for 240 000 participants. Questionnaires administered via internet at baseline and each year thereafter will assess socio-demographic and lifestyle characteristics, anthropometry, health status, physical activity and diet. Surveillance of health events will be implemented via questionnaires on hospitalisation and use of medication, and linkage with a national database on vital statistics. Biochemical samples and clinical examination will be collected in a subsample of volunteers.
DISCUSSION:
Self-administered data collection using internet as a complement to collection of biological data will enable identifying nutrition-related risks and protective factors, thereby more clearly elucidating determinants of nutritional status and their interactions. These are necessary steps for further refining nutritional recommendations aimed at improving the health status of populations.

Comparison between an interactive web-based self-administered 24 h dietary record and an interview by a dietitian for large-scale epidemiological studies.

Références

Br J Nutr. 2011 Apr;105(7):1055-64

Auteurs

Touvier M, Kesse-Guyot E, Méjean C, Pollet C, Malon A, Castetbon K, Hercberg S.
 
Unité de Recherche en Epidémiologie Nutritionnelle (UREN), UMR U557 Inserm, U1125 Inra, Cnam, Paris 13, CRNH IdF, SMBH Paris 13, 74 rue Marcel Cachin, F-93017 Bobigny Cedex, France

Résumé

Online self-administered data collection, by reducing the logistic burden and cost, could advantageously replace classical methods based on dietitian's interviews when assessing dietary intake in large epidemiological studies. Studies comparing such new instruments with traditional methods are necessary. Our objective was to compare one NutriNet-Santé web-based self-administered 24 h dietary record with one 24 h recall carried out by a dietitian. Subjects completed the web-based record, which was followed the next day by a dietitian-conducted 24 h recall by telephone (corresponding to the same day and using the same computerised interface for data entry). The subjects were 147 volunteers aged 48-75 years (women 59·2 %). The study was conducted in February 2009 in France. Agreement was assessed by intraclass correlation coefficients (ICC) for foods and energy-adjusted Pearson's correlations for nutrients. Agreement between the two methods was high, although it may have been overestimated because the two assessments were consecutive to one another. Among consumers only, the median of ICC for foods was 0·8 in men and 0·7 in women (range 0·5-0·9). The median of energy-adjusted Pearson's correlations for nutrients was 0·8 in both sexes (range 0·6-0·9). The mean Pearson correlation was higher in subjects ? 60 years (P = 0·02) and in those who declared being 'experienced/expert' with computers (P = 0·0003), but no difference was observed according to educational level (P = 0·12). The mean completion time was similar between the two methods (median for both methods: 25 min). The web-based method was preferred by 66·1 % of users. Our web-based dietary assessment, permitting considerable logistic simplification and cost savings, may be highly advantageous for large population-based surveys.

Agreement between web-based and paper versions of a socio-demographic questionnaire in the NutriNet-Santé study.

Références

Int J Public Health. 2011 56(4):407-17

Auteurs

Vergnaud AC, Touvier M, Méjean C, Kesse-Guyot E, Pollet C, Malon A, Castetbon K, Hercberg S.

Résumé

OBJECTIVES:
Web-based studies nowadays raise a major interest as they can improve all steps involved in observational studies. Our objective was to compare the web-based version of the NutriNet-Santé self-administered socio-demographic and economic questionnaire with the traditional paper version.
METHODS:
Both versions of the questionnaire were sent to 170 volunteers and filled in by 147 of them (either paper first, n = 76, or web-based first, n = 71). Agreement between versions was assessed by intraclass correlations (ICC) and kappas.
RESULTS:
Agreement between both versions was high, with ICC and kappas ranging between 0.81-1.00 and 0.76-1.00, respectively, similarly across groups of administration order, age, gender and self-estimated web knowledge in general. The web-based version was the one preferred by 93.7% of the subjects and enabled to avoid 553 missing values (2.00% of the total entries), 24 inconsistent data (0.09%), 8 aberrant data (0.03%), 472 data entry errors (0.85%) and to save 2,800 (US $4,072) when sent to 170 subjects
CONCLUSION:
The web-based socio-demographic and economic questionnaire provided information of similar-to-superior quality compared to the traditional paper version, with substantial logistic and cost advantages

Development of a questionnaire to assay recalled liking for salt, sweet and fat.

Références

Food Qual Pref. 2012 23(2):110-124

Auteurs

Deglaire A, Méjean C, Castetbon K,  Kesse-Guyot E, Urbano C, Hercberg S, Schlich P

Résumé

Liking for a sweet, salty or fatty diet may induce overconsumption of simple carbohydrates, sodium or lipids. Measuring overall liking of the corresponding sensory sensations contributes to understanding the determinants of dietary behaviours. However, no standardized validated questionnaire assaying these sensations is currently available. In the present study, we developed a web-based questionnaire, “PrefQuest”, which measures recalled liking for the following four sensations: salt, fat and salt, sweet, fat and sweet. PrefQuest included four types of items: (1) liking for sweet, fatty-sweet and fatty-salty foods, (2) preferences in the level of seasoning by adding salt, sweeteners, or fat, (3) preferences for types of dishes in a restaurant menu and (4) overall questions about sweet-, salt- and fat-related behaviours. A development study (n = 198) demonstrated that PrefQuest was feasible, well-perceived, only lasted about 20 min and that items were repeatable (overall mean intra-class correlation coefficient: 0.77, SD 0.08). Construct validity was then evaluated on a larger population sample (n = 47 803). The underlying structure within each of the four sensations was determined by exploratory factor analysis and then internally validated by confirmatory factor analysis. After a selection of the most relevant items, the salt, fat-and-salt, sweet, and fat-and-sweet scales exhibited a theoretically meaningful factor structure, unidimensional for the salt scale and with interrelated sub-dimensions for the sweet, fat-and-salt, and fat-and-sweet scales. Based on the fat-and-sweet and fat-and-salt scales, a fat model was also unveiled. For each factor, internal consistency as well as convergent and divergent validities were demonstrated. Overall, PrefQuest is an internally valid and original tool that can be used to assay recalled liking for sweet, salt, and fat considered altogether or separately as fat and salt or fat and sweet, and can be applied to large population surveys.

Perception of front-of-pack labels according to social characteristics, nutritional knowledge and food purchasing habits.

Références

Public Health Nutr. 2013 16(3):392-402

Auteurs

Méjean C, Macouillard P, Péneau S, Hercberg S, Castetbon K.

Unité de Recherche en Epidémiologie Nutritionnelle, UMR U557 Inserm/U1125 Inra/Cnam/Paris 13, CRNH IdF, SMBH Université Paris 13

Résumé

OBJECTIVE:
To identify patterns of perception of front-of-pack (FOP) nutrition labels and to determine social factors, nutritional knowledge and attention to packaging features related to such patterns.
DESIGN:
Cross-sectional. Perception was measured using indicators of understanding and acceptability of three simple FOP labels (the 'Green Tick', the logo of the French Nutrition and Health Programme (PNNS logo) and 'simple traffic lights' (STL)) and two detailed formats ('multiple traffic lights' (MTL) and the 'colour range' logo (CR)). Associations of perception patterns with individual characteristics were examined using χ2 tests.
SETTING: 
Data from the French NutriNet-Santé cohort study.
SUBJECTS:
A total of 38,763 adults.
RESULTS:
Four perception patterns emerged. Poorly educated individuals were most often found in groups favouring simple formats. The 'favourable to CR' group had a high rate of men and older persons. Poor nutritional knowledge was more frequent in the 'favourable to STL' group, while individuals with substantial knowledge were proportionally more numerous in the 'favourable to MTL' group. The 'favourable to STL' group more frequently self-reported noting price and marketing characteristics during purchasing, while the 'favourable to MTL' and 'favourable to CR' groups declared more interest in nutritional information. The 'favourable to Green Tick and PNNS logo' group self-reported paying closer attention to claims and quality guarantee labels.
CONCLUSIONS: 
The 'favourable to MTL' cluster was most frequently represented in our survey. However, simple FOP formats may be most appropriate for increasing awareness of healthy eating among targeted groups with poor nutritional knowledge and little interest in the nutritional quality of packaged foods.

Consumer acceptability and understanding of front-of-pack nutrition labels.

Références

J Hum Nutr Diet. 2013 26(5):494-503

Auteurs

Mejean C, Macouillard P, Péneau S, Hercberg S, Castetbon K.

Paris 13 University, Sorbonne Paris Cité, UREN (Nutritional Epidemiology Research Unit), Inserm (U557), Inra (U1125), Cnam, Bobigny Cedex, France.

Résumé

BACKGROUND:
Front-of-pack (FOP) nutrition labelling has been proposed as a tool for helping consumers make healthy choices. Before determining its effects on consumer behaviour, factors involved in its use must be elucidated, i.e. understanding and acceptability on the part of the consumer. Among five FOP labels, we sought to determine which formats were most easily understood and accepted by a large sample of adults.
METHODS:
Among 39 370 adults who participated in the French Nutrinet-Santé cohort study, understanding and indicators of acceptability (attitude, liking, visual attractiveness and perceived cognitive workload) were measured for five FOP labels: The currently used 'multiple traffic lights' (MTL) and 'simple traffic lights' (STL), and the 'colour range' logo (CR), the 'green tick' and the PNNS logo. We investigated the contribution of the different elements to consumer perception of FOP labels using multiple correspondence analyses.
RESULTS:
Over half of the sample population showed a high level of understanding and perceived no discomfort in terms of the different logos. Label formats were positioned along an acceptability gradient ranging from acceptance to rejection, consisting of 'liking', 'attractiveness' and indicators of perceived cognitive workload. MTL was significantly more often liked and was viewed as reliable and informative. MTL, STL and the green tick performed better than the CR and PNNS logos in terms of ease of identification and comprehension. CR was clearly the least appreciated and it had the most complex format.
CONCLUSIONS:
Consumers prefer FOP labels which give complete, reliable and simplified information on the nutrient quality of foods.

Sociodemographic, lifestyle and dietary correlates of dietary supplement use in a large sample of French adults: results from the NutriNet-Santé cohort study.

Références

Br J Nutr. 2013 110(8):1480-91

Auteurs

Pouchieu C, Andreeva VA, Péneau S, Kesse-Guyot E, Lassale C, Hercberg S, Touvier M.Université Paris 13, Sorbonne Paris Cité, UREN (Nutritional Epidemiology Research Unit), Inserm (U557), Inra (U1125), Cnam, SMBH Paris 13

Résumé

Information on the determinants of dietary supplement (DS) use in France is largely lacking, especially in population subgroups such as smokers. Also, little is known about the role of health professionals in DS purchases. The aim of the present study was to describe DS use along with its sociodemographic, lifestyle and dietary correlates in a large sample of French adults (age 18+years) participating in the NutriNet-Santé cohort study. Data were collected by self-administered Internet questionnaires. Food intakes were assessed by 24 h dietary records. Data on DS use were available for 79 786 participants. Supplement users were compared with non-users by logistic regression. Current DS use at least three times/week was reported by 14·6 % of men and 28·1 % of women. Mg, and vitamins B6 and C were the most frequently consumed nutrients. DS were prescribed or recommended by a physician in 54·9 % of the cases. DS use was positively associated with knowledge of nutritional recommendations and organic product consumption, following a healthier diet and lifestyle (non-smoker, moderate leisure-time physical activity). Current smokers used less DS than did non-smokers, but their DS consumption was substantial (19·0 %) and they were more likely to self-medicate. The present study provides updated and detailed information on DS use determinants in a large French cohort, including a focus on smokers, for whom the long-term effects of DS use are poorly documented and could represent a risk. These findings pave the way for future aetiological studies.

Differential association between adherence to nutritional recommendations and body weight status across educational levels: a cross-sectional study.

Références

Prev Med. 2013 57(5):488-93

Auteurs

Lassale C, Galan P, Castetbon K, Péneau S, Méjean C, Hercberg S, Kesse-Guyot E.
Université Paris 13 Sorbonne Paris Cité UREN (Nutritional Epidemiology Research Unit) Inserm (U557), Inra (U1125), Cnam, CRNH IdF, SMBH

Résumé

OBJECTIVE:
The impact of diet quality and physical activity (PA) on weight might be different according to socioeconomic status. Our aim was to estimate associations between adherence to nutritional guidelines and BMI and the interaction with socioeconomic characteristics.
METHODS:
A total of 11,931 men and 39,737 women from the NutriNet-Santé cohort (France, 2009-2012) were included in cross-sectional analysis. The association between PNNS-GS (a score estimating adherence to French nutritional guidelines) and BMI was assessed by multivariate linear regression. A modified score (mPNNS-GS) separating diet quality from PA was also used.
RESULTS:
BMI, overweight and obesity displayed an inverse gradient from less to more educated groups, whereas PNNS-GS increased. A higher PNNS-GS was associated with a lower BMI, more importantly in the less educated: BMI decrease ranged from -1.1% in less educated to -0.7% in more educated men and from -0.6% to -0.3% in women. The effect of mPNNS-GS and PA in particular was also stronger among less educated subjects.
CONCLUSION:
Overall, better adherence to nutritional recommendations was inversely associated with BMI, and this association was stronger in the less educated groups. This suggests that nutritional policies should still concentrate on promoting access to a healthier diet and PA, especially among less educated individuals.

Validity of web-based self-reported weight and height: results of the nutrinet-santé study.

Références

J Med Internet Res. 2013 15(8):e152

Auteurs

Lassale C, Péneau S, Touvier M, Julia C, Galan P, Hercberg S, Kesse-Guyot E.

Université Paris 13, Sorbonne Paris Cité, UREN (Nutritional Epidemiology Research Unit), Inserm (U557), Inra (U1125), Cnam, Bobigny, France.

Résumé

BACKGROUND:
With the growing scientific appeal of e-epidemiology, concerns arise regarding validity and reliability of Web-based self-reported data.
OBJECTIVE:
The objectives of the present study were to assess the validity of Web-based self-reported weight, height, and resulting body mass index (BMI) compared with standardized clinical measurements and to evaluate the concordance between Web-based self-reported anthropometrics and face-to-face declarations.
METHODS:
A total of 2513 participants of the NutriNet-Santé study in France completed a Web-based anthropometric questionnaire 3 days before a clinical examination (validation sample) of whom 815 participants also responded to a face-to-face anthropometric interview (concordance sample). Several indicators were computed to compare data: paired t test of the difference, intraclass correlation coefficient (ICC), and Bland-Altman limits of agreement for weight, height, and BMI as continuous variables; and kappa statistics and percent agreement for validity, sensitivity, and specificity of BMI categories (normal, overweight, obese).
RESULTS:
Compared with clinical data, validity was high with ICC ranging from 0.94 for height to 0.99 for weight. BMI classification was correct in 93% of cases; kappa was 0.89. Of 2513 participants, 23.5% were classified overweight (BMI≥25) with Web-based self-report vs 25.7% with measured data, leading to a sensitivity of 88% and a specificity of 99%. For obesity, 9.1% vs 10.7% were classified obese (BMI≥30), respectively, leading to sensitivity and specificity of 83% and 100%. However, the Web-based self-report exhibited slight underreporting of weight and overreporting of height leading to significant underreporting of BMI (P<.05) for both men and women: -0.32 kg/m(2) (SD 0.66) and -0.34 kg/m(2) (SD 1.67), respectively. Mean BMI underreporting was -0.16, -0.36, and -0.63 kg/m(2) in the normal, overweight, and obese categories, respectively. Almost perfect agreement (ie, concordance) was observed between Web-based and face-to-face report (ICC ranged from 0.96 to 1.00, classification agreement was 98.5%, and kappa 0.97).
CONCLUSIONS:
Web-based self-reported weight and height data from the NutriNet-Santé study can be considered as valid enough to be used when studying associations of nutritional factors with anthropometrics and health outcomes. Although self-reported anthropometrics are inherently prone to biases, the magnitude of such biases can be considered comparable to face-to-face interview. Web-based self-reported data appear to be an accurate and useful tool to assess anthropometric data.