RESUMO
AIM: To adapt the validated Canadian Nutrition Screening Tool for Every Pre-schooler (NutriSTEP), for use in New Zealand and test its reliability to identify nutrition risk in pre-school children aged 2-5 years, as a parent administered questionnaire. METHODS: Adaptations to the Canadian NutriSTEP were undertaken by three registered dietitians (expert review), followed by intercept interviews with pre-schooler parents (n = 26). A second expert review was conducted to finalise the adaptions for online reliability testing. A further 79 pre-schooler parents completed online administrations of the Canadian and adapted NutriSTEP tools, 4 weeks apart in a blinded manner. Intraclass correlation coefficients (ICCs) were used to verify test-retest reliability between the administrations. Individual questionnaire items were verified for reliability between administrations through Cohen's κ statistic (κ), Pearson's χ2 value and Fisher's exact test. RESULTS: Online administrations of the Canadian and adapted NutriSTEP tools were determined to be reliable (ICC = 0.91; P < 0.001). Between NutriSTEP administrations, 13 out of 17 questionnaire items had adequate (κ > 0.5) agreement, one item had excellent agreement (κ > 0.75) with a significant relationship (P < 0.05) between all items. Sensitivity for the adapted NutriSTEP was higher for pre-schoolers at nutrition risk (31.6%) versus the Canadian version (20.3%). Risk items were highest for low intake of breads and cereals (58.2%), milk and milk products (51.9%), meat and meat alternatives (40.5%), child controlling the amount consumed (35.4%) and vegetable intake (34.2%). CONCLUSION: The Canadian NutriSTEP and the adapted NutriSTEP were reliable between online administrations when completed by parents in the community. The adapted NutriSTEP identified an additional nine preschoolers at increased nutrition risk, demonstrating increased sensitivity in comparison to the Canadian NutriSTEP. Nutrition risk can be identified in early childhood to prevent the development of chronic disease. The adapted NutriSTEP should be considered for future use to identify preschoolers at increased nutrition risk and guide appropriate nutrition intervention.