Innovation in Measurement for Diet-Related Disease Research: Optimizing Utility and Reach to Reduce Health Disparities

心脏病、癌症和糖尿病是美国十大死亡原因中的三大， 都是与饮食有关的疾病。拉丁裔是美国最大的移民人口，但他们的收入不均衡。 慢性疾病负担，包括心血管疾病、肥胖和糖尿病的风险。了解 与疾病风险相关的因素和制定文化上适当的人群干预措施， 减少健康差距。然而，这种研究往往受到缺乏测量工具的阻碍， 具体的，适当的，有效的不同人群;穷人的测量工具云我们的理解， 这可能导致对干预措施的影响得出不确定或错误的结论。 高质量的测量工具是理解和管理所需的基本基础设施的一部分， 评估人口健康和促进饮食相关疾病的科学。尽管有无数因素影响着 与饮食相关的慢性疾病风险，在美国家庭消费的食物占所有食物支出的一半 成人和代表最接近和可改变的因素，影响食物和营养素， 人们每天都在消费。然而，很少有有效的家庭食品环境评估工具存在， 已经在大量移民或低识字率人口中得到验证（即，有限的理解/使用 （一个人的母语）。2008年，我们的团队开发并验证了家庭食品清单 (HFI)使用清单格式评估家庭食物环境的健康和肥胖风险。我们 用户管理的HFI仪器已被我们的团队广泛用于NIH资助的研究领域 和其他许多人.引文基准统计数据表明，我们的验证研究文章在全球排名前2% 与类似的文章相比。然而，最初的HFI只能用于讲英语的人群， 长时间和纸质的。我们目前的目标是通过开发一种无障碍的 家庭食品环境评估工具包，包括有效和可靠的纸张和多媒体电子 针对已知影响饮食相关健康的食物的工具，可供不同文化水平的用户使用 还有英语和西班牙语我们的具体目标是：1）减少原来的家庭食品库存（HFI）， 简化的高频输入核心工具，最大限度地提高效用和效率，最大限度地减少参与者的负担， 保留对饮食相关健康影响最大的食物; 2）评估HFI核心（英文和西班牙文文件 通过评估可用性、可接受性、有效性和可靠性，并根据需要进行修改; 3）开发 电子HFI核心工具（eHFI），为讲英语的人提供食物的音频和视频表示， 以母语讲西班牙语的人克服语言和识字问题; 4）评估eHFI和 通过评估可用性、可接受性、可靠性和有效性，并根据需要进行修改;以及5）促进广泛的 通过一个永久和易于访问的存储平台使用仪器，并提供支持和 未来语言调整和测试的技术援助平台。

Heart disease, cancer and diabetes are three of the 10 leading causes of death in the United States (US) and all are diet-related diseases. Latinos are the largest immigrant population in the US but they share an uneven burden of chronic disease including risk for cardiovascular disease, obesity and diabetes. Understanding the factors related to disease risk and developing culturally-appropriate population-level interventions are critical to reduce health disparities. Yet, such research is often stymied by the lack of measurement tools that are specific, appropriate, and valid for diverse populations; poor measurement tools cloud our understanding of disease-risk factors and may lead to inconclusive or wrong conclusions regarding the impact of interventions. High-quality measurement tools are part of the essential infrastructure needed for understanding and evaluating population health and advance the science of diet-related diseases. While myriad factors influence diet-related chronic disease risk, food consumed at home accounts for half of all food expenditures among US adults and represent the most proximal and modifiable factors that influence the foods and nutrients that people consume on a daily basis. However, few valid home food environment assessment tools exist and none have been validated with large, immigrant or low-literacy populations (i.e., limited understanding/use of the written form of one’s native language). In 2008, our team developed and validated a Home Food Inventory (HFI) to assess the healthfulness and obesity risk of home food environments using a checklist format. Our user-administered HFI instrument has been used extensively in the field for NIH-funded studies by our team and many others. Citation benchmarking statistics indicate our validation study article is in the top 2% globally compared to similar articles. Yet, the original HFI can only be used with English-speaking populations, is quite lengthy and paper-based. Our present objective is to further advance the science by developing an accessible home food environment assessment toolkit that includes valid and reliable paper and multi-media electronic tools targeting foods known to impact diet-related health that can be user-administered across literacy levels and in English and Spanish. Our specific aims are to: 1) Reduce the original Home Food Inventory (HFI) into a streamlined HFI-core instrument, maximizing utility and efficiency and minimizing participant burden while retaining foods most impactful on diet-related health; 2) Evaluate the HFI-core (English and Spanish paper versions) by assessing usability, acceptability, validity and reliability, and modify as needed; 3) Develop electronic HFI-core tools (eHFI) that present audio and visual representation of foods for English speakers and Spanish speakers in their native language to overcome language and literacy issues; 4) Evaluate both eHFI tools by assessing usability, acceptability, reliability and validity, and modify as needed; and 5) Facilitate broad use of the instruments through a permanent and easily-accessible storage platform and provide support and a technological assistance platform for future language adaptations and testing.