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Accepted manuscript

Testing and adapting dietary habits and food security questions for a national nutrition survey using cognitive interviews and expert consultation

Published online by Cambridge University Press:  06 October 2025

Berit Follong Open the ORCID record for Berit Follong [Opens in a new window] ,
Caitlin Haliburton ,
Jacqueline Grey ,
Maria Maiquez ,
Sally Mackay Open the ORCID record for Sally Mackay [Opens in a new window] ,
Lisa Te Morenga  and
Cliona Ni Mhurchu
Berit Follong*
Affiliation:
National Institute for Health Innovation, School of Population Health, University of Auckland, Auckland 1023, New Zealand; Epidemiology and Biostatistics, School of Population Health, University of Auckland, Auckland 1023, New Zealand; The Centre for Translational Health Research: Informing Policy and Practice (TRANSFORM), University of Auckland, Auckland 1023, New Zealand;
Caitlin Haliburton
Affiliation:
National Institute for Health Innovation, School of Population Health, University of Auckland, Auckland 1023, New Zealand; Epidemiology and Biostatistics, School of Population Health, University of Auckland, Auckland 1023, New Zealand;
Jacqueline Grey
Affiliation:
National Institute for Health Innovation, School of Population Health, University of Auckland, Auckland 1023, New Zealand;
Maria Maiquez
Affiliation:
National Institute for Health Innovation, School of Population Health, University of Auckland, Auckland 1023, New Zealand;
Sally Mackay
Affiliation:
Epidemiology and Biostatistics, School of Population Health, University of Auckland, Auckland 1023, New Zealand;
Lisa Te Morenga
Affiliation:
Research Centre for Hauora and Health, Massey University, Wellington 6140, New Zealand
Cliona Ni Mhurchu
Affiliation:
Epidemiology and Biostatistics, School of Population Health, University of Auckland, Auckland 1023, New Zealand; The Centre for Translational Health Research: Informing Policy and Practice (TRANSFORM), University of Auckland, Auckland 1023, New Zealand;
*
Corresponding author: Berit Follong, Email: berit.follong@auckland.ac.nz, Address: The University of Auckland, 85 Park Road, Grafton, Auckland 1023, New Zealand.
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Abstract

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Objective:

To cognitively test questions for inclusion in a national nutrition survey, ensuring the questions are interpreted as intended and to inform further improvements.

Design:

A draft nutrition survey questionnaire was developed based on existing questionnaires and expert input. Twelve questions on dietary habits and food security were selected for cognitive testing as these were newly developed, amended from existing questions, or identified to no longer reflect the current food environment or concepts. Cognitive interviews were conducted using both think-aloud and probing techniques to capture respondents’ thought processes used to arrive at an answer. Interviews were audio recorded and transcribed verbatim. Qualitative data were analysed for recurring patterns and unique discoveries across the survey questions.

Setting:

New Zealand.

Participants:

Sixty-eight participants aged 11 years and older representing diverse socio-demographics including gender, ethnicity, and education level.

Results:

Three main cognitive challenges were identified: 1) interpreting ambiguous terms, 2) understanding of dietary or technical terms, and 3) following complex or unclear instructions. Questions were refined based on the study findings and further advice from experts in nutrition and survey design to enhance participant understanding and accuracy.

Conclusion:

The cognitive testing findings and expert input led to the refinement and potential improvement of selected questions for inclusion in a national nutrition survey. Changes included simplified terminology, clearer instructions, improved examples, and better question order. Our methodological approach and findings may be valuable for those designing similar questions for dietary surveys.

Keywords

Nutritionsurvey designcognitive interviewing methodsdietary habitsfood security

Information

Type
Research Paper
Information
Public Health Nutrition , Accepted manuscript , pp. 1 - 37
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.
Copyright
© The Author(s), 2025. Published by Cambridge University Press on behalf of The Nutrition Society

Footnotes

*

Authors contributed equally.