基于多维项目反应理论的儿童饮食行为量表编制及评价方法研究

The eating behavior problems of children are widespread, and they can influence children’s dietary structure and nutritional status, Unhealthy eating behaviors are one of the key risk factors for nutritional diseases, such as obesity, diabetes, anemia, rickets, coronary heart disease. Recent advances in this field have implicated that childhood diet behavior may be closely related to the eating behavior in adulthood. Because the children's eating behavior connotation is rich and the performance characteristics are various, identification and evaluation of them therefore need the tools of scale. But at present, there is no any internationally conceptual model of children's eating behavior which has been generally accepted. In this context, development of the scale with the method of item screening, reliability and validity evaluation which based on the classical theory of measurement should lead to degree of differentiation, validity, reliability of scale changed according to the specific sample to be tested. Although Multidimensional Item Response Theory (MIRT), which is developed within recent years, can overcome these disadvantages, but there has not developed a perfect evaluation methods system for higher dimensional，multilevel scored scale. To this end, in the current study, we intend to build a conceptual model which is conformity with the Chinese diet culture and habits of children's eating behavior, and subsequently based on this, with the theory of MIRT, through computer simulation and empirical analysis, we also try to create a new item screening and reliability and validity of evaluation methods, and to develop evaluation questionnaires suitable for our country children's eating behavior. The results can not only provide new methods for item selecting and scale quality evaluating to develop abundant evaluation questionnaires or scale in medical field, but should also provide reliable measuring tools for assessment and early recognition of children's poor eating behaviors.

饮食行为决定膳食结构，影响营养状况，不健康饮食行为是营养相关性疾病的关键危险因素。儿童期是饮食行为形成的关键时期，这一时期的饮食行为可持续终生。儿童饮食行为内涵丰富、表现多样，其识别与评价需借助量表从不同方面综合测量。由于国内外尚无普遍接受的儿童饮食行为概念模型，且现有量表均采用传统的条目筛选和信度、效度评价方法编制，导致量表结构不一，信度、效度等随被测样本而变化。多维项目反应理论能克服现有方法不足，但对于高维多级评分量表尚未形成满意的评价方法体系。本研究拟通过质性研究、专家咨询、内容分析等定性和定量方法，构建符合我国饮食文化与习惯的儿童饮食行为概念模型；基于多维项目反应理论，通过计算机模拟和实证分析，创建一套新的量表条目筛选方法；在此基础上编制适合我国儿童的饮食行为评价量表。研究结果不仅可为医学领域各类量表的编制提供新理论和新方法，而且可为儿童饮食行为评价提供可靠的测量工具。

饮食行为决定膳食结构，影响营养状况，是营养相关性疾病的重要危险因素之一。儿童饮食行为内涵丰富、表现特征多样，其识别与评价需借助量表从多个维度测量。目前，国内外尚无普遍接受的儿童饮食行为概念模型，且现有量表均采用传统的条目筛选和信度、效度评价方法编制，导致量表结构不一，信度、效度等随被测样本而变化。本研究率先将多维项目反应理论（MIRT）引入儿童饮食行为等量表开发领域，提出了量表条目筛选应在经典测量理论（CTT）条目筛选方法的基础上，需进一步通过MIRT的难度系数、区分度系数、猜测系数，及概化理论（GT）的概化系数、可靠性指数、信噪比等指标进一步评价，以克服CTT在条目筛选中的不足。在方法学探讨的基础上，通过质性研究、专家咨询、内容分析等定性和定量方法，构建了符合我国饮食文化与习惯的儿童饮食行为、照护人喂养行为概念模型，并采用标准的量表开发流程，编制出了《学龄儿童饮食行为量表》、《学龄前儿童照护人喂养行为量表》。采用MIRT、GT对《学龄前儿童饮食行为量表》、《学龄儿童饮食行为量表》进行了进一步验证和评价，同时，将伦敦大学Clare H.Llewellyn博士编制的《婴儿饮食行为量表》进行了中文版标化。最后，利用所开发的量表，进一步探索了饮食行为与喂养行为的相关性，以及饮食行为、喂养行为与儿童体重的关系。研究结果不仅可解决传统CTT在量表编制及评价中的诸多不足，为医学领域大量评价量表的编制、完善修订提供新理论和新方法，对推动MIRT在各领域量表开发中的应用具有重要意义；同时，可为我国儿童饮食行为、喂养行为的评价及不良饮食行为、喂养行为的早期识别提供可靠的测量工具，从而推进我国饮食行为相关研究的发展，对改善儿童营养状况、提高人群健康水平和人口素质意义重大。本项目在国内外期刊发表科研论文32篇，其中国外期刊SCI收录11篇。主编专著1部，副教材主编1部，参编4部。以第一申请人获软件著作权6项。培养研究生7名。