Endocrine Abstracts

Introduction: Unhealthy eating behaviors are common in children. Therefore, assessing children nutritional knowledge is crucial. The QuesCA, a validated French tool, serves this purpose. Our study aimed to develop and validate an Arabic version of QuesCA.

Methods: We conducted a multicenter cross-sectional study from December 2021 to June 2022. Our study was conducted at the National Center for School and University Medicine in Tunis and five randomly selected nurseries in Ariana governorate. Six hundred children aged from 9 to 15 years were included.

Results: Our study was conducted in two phases. The first phase focused on the development and validation of the Arabic version. Initially, two independent forward translations were conducted. One by a committee of Tunisian nutrition experts (focus group), and the second by a sworn translator. The focus group reviewed the obtained Arabic versions, identifying errors, detecting divergences, and adapting them to Tunisian specificities. Subsequently, a French national proficient in both French and literary Arabic performed a backward translation of the questionnaire. Using the Delphi procedure, the focus group compared the back-translation with the original version, producing thus a consensus translation deemed suitable for children in Tunisia. After the Delphi procedure, we sought opinions from primary and secondary school teachers regarding the obtained Arabic version. Then, a pre-test was conducted on 30 randomly selected students aged 9 to 15 in a primary school in Gabes governorate using the Arabic version. Ultimately, we obtained a final translated Arabic version through the development and revision process by the focus group. The second phase aimed to evaluate the reliability and validity of the finalized Arabic version. The 600 participants were debriefed for phrasing or comprehension issues, with noted comments and questions. Post-questionnaire, participants received correct answers and nutritional education sessions. For the reliability analysis, the global Cronbach’s alpha was 0.3, below the threshold (0.7). Despite recalculations after removing items with low correlations, the alpha value remained below the threshold. Thus, we decided to keep the questionnaire unchanged with the same number of items. After reliability analysis, validity analysis was tested. Construct validity was not assessed given the single-item representation of each questionnaire theme, while content validity was thoroughly evaluated by the focus group.

Conclusion: Our study developed a validated Arabic version of the QuesCA questionnaire. Challenges, like a low reliability coefficient, emphasize the need for further research to refine the questionnaire