Improving measurement in nutrition literacy research using Rasch modelling: examining construct validity of stage-specific 'critical nutrition literacy' scales.

OBJECTIVE: Critical nutrition literacy (CNL), as an increasingly important area in public health nutrition, can be defined as the ability to critically analyse nutrition information, increase awareness and participate in action to address barriers to healthy eating behaviours. Far too little attention has been paid to establishing valid instruments for measuring CNL. The aim of the present study was to assess the appropriateness of utilizing the latent scales of a newly developed instrument assessing nursing students' 'engagement in dietary habits' (the 'engagement' scale) and their level of 'taking a critical stance towards nutrition claims and their sources' (the 'claims' scale). DESIGN: Data were gathered by distributing a nineteen-item paper-and-pencil self-report questionnaire to university colleges offering nursing education. The study had a cross-sectional design using Rasch analysis. Data management and analysis were performed using the software packages RUMM2030 and SPSS version 20. SETTING: School personnel handed out the questionnaires. SUBJECTS: Four hundred and seventy-three students at ten university colleges across Norway responded (52% response rate). RESULTS: Disordered thresholds were rescored, an under-discriminating item was discarded and one item showing uniform differential item functioning was split. The assumption of item locations being differentiated by stages was strengthened. The analyses demonstrated possible dimension violations of local independence in the 'claims' scale data and the 'engagement' scale could have been better targeted. CONCLUSIONS: The study demonstrates the usefulness of Rasch analysis in assessing the psychometric properties of scales developed to measure CNL. Qualitative research designs could further improve our understanding of CNL scales.

Exploring predictors of health sciences students' attitudes towards complementary-alternative medicine.

This study demonstrated that a less scientific worldview predicted health science (HS) students' positive attitude towards complementary-alternative medicine (CAM), independently of important background characteristics as gender, pre-college science immersion, age, and type of HS education of the students. A total of 473 students in their final 3rd year of education in the health sciences (nursing, physiotherapy, social educator, and radiography) participated in teh study, which was based on a questionnaire consisting of items mapping student background characteristics and their attitudes towards worldview reflecting statements in constructs. The results showed that large fractions of the HS students were positive towards the use of CAM treatments. Multiple regression analysis demonstrated that 24 % of the total variance in HS students' positive attitude towards the use of CAM than the HS students' background characteristics alone, which accounted for only 2 % of the total variance. HS students' Paranormal beliefs, and their Willingness to include CAM in HS education were the most important predictors. The study results suggest stronger emphasis on teaching about epistemologies in HS educations.