Assessment of a Calcium-Specific Food Frequency Questionnaire and Its Use in Telephone Interviews among Chinese Populations

Developing and validating new dietary assessment methods such as food frequency questionnaires (FFQs) is necessary for the Chinese population. China has conducted 4 nation-wide nutrition and health surveys since 1959. However, a brief semi-quantitative FFQ was not used until in the 2002 Chinese Nutrition and Health Survey. Meanwhile, the telephone interview is a very practical and respected tool, making surveys more rapid and cost-effective and adopted in many health surveys in other countries, but yet not in China. Under these circumstances the author chose the development of these dietary assessment methods for the Chinese population as the research interest. The overall goal of this study was to identify, test, and evaluate valid, reliable food frequency and telephone methods of collecting and processing Chinese dietary intake information, and analyze and disseminate survey results. We attempted to reach the above goal by carrying out a comprehensive dietary survey comparing two administration modes (telephone and in-person) and two dietary intake assessment tools (FFQ and 24-hour recall). The subjects were 334 healthy women aged 20--49, recruited from Beijing, Shanghai and Hong Kong during June--July 2002. Three dietary intake survey waves one month apart were conducted by trained interviewers using a calcium-specific FFQ. Subjects were randomly divided into two groups, with each receiving either a telephone or in-person interview during the first wave interview. The randomization allowed a cross-over design through the three interview waves. The 50% of subjects (n=171) receiving the in-person interview first additionally was administered a 24-hour dietary recall interview following each FFQ. Based on the consideration of variation in diet habits and food sources among respondents, two different FFQs- FFQ-BS and FFQ-HK---were developed for use in the two mainland cities and in Hong Kong. Paired-sample t -tests, Pearson's correlation coefficients, Intraclass Correlation Coefficients and Bland-Altman measure of Agreement were used in the agreement assessments. The validity of the FFQs was assessed by comparing results with those of 3-day dietary recalls as a reference method, and the reliability assessment was performed by comparing two administrations of FFQs. For the FFQ-BS, paired t -tests showed that the mean daily calcium intake was 591.7 mg measured by the FFQ-BS and 582.9 mg by 24-hour recall (P =0.6), with no significant difference found. (Abstract shortened by UMI.)

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