Development of a Valid and Reliable Electronic Questionnaire to Evaluate Sports Nutrition Knowledge in Elite Australian Athletes

Abstract

Nutrition knowledge can assist athletes’ food selection to fuel strenuous training and can enhance performance. Dietitians conduct nutrition education as greater nutrition knowledge can improve dietary intake, but the effectiveness of these strategies is unknown. This thesis aims to review the effectiveness of nutrition education interventions in athletes and to develop a valid and reliable tool to evaluate the nutrition knowledge of Australian athletes. A systematic review of 32 nutrition education interventions in athletes found that although nutrition education was effective at improving knowledge, variability in assessment tools, and limited validity and reliability testing of these tools made conclusions difficult to draw. The ‘Platform to Evaluate Athlete Knowledge of Sports Nutrition Questionnaire’ (PEAKS-NQ) was then developed using focus group data from high-level sports dietitians, who completed a modified Delphi on draft questions. The PEAKS-NQ was piloted in developmental athletes and sports dietitians, demonstrating good content validity (Scale Content Validity Index = 0.88), known-groups (construct) validity (67.1±10.5% vs. 91.5±3.4%, athletes vs. dietitians) and reliability (paired Sign test, p=0.14, Cronbach’s α=0.86). The PEAKS-NQ was refined to 50 items using Rasch analysis, which demonstrated high item (0.91) and person reliability (0.92). The PEAKS-NQ was completed by 240 elite Australian athletes (mean score 70.7±10.5%), with females scoring higher across all sections (p<0.001) and identified weaknesses in knowledge of fats, recovery meals and body composition management. A process evaluation completed by 12 sports dietitians returned positive feedback. The PEAKS-NQ is a valid and reliable assessment tool with high acceptability and feasibility that can help determine which nutrition education strategies are most effective. The continued refinement of questions and development of further modules tailored to unique athlete requirements is needed.