CONFERENCE PROCEEDING
PREG-NFS-Q: Development, face and content validation of an instrument to
measure maternal nutrition and food safety knowledge in pregnancy
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1
Department of Food Sciences and Nutrition, University of Malta, Msida, Malta
2
Department of Midwifery, University of Malta, Msida, Malta
Publication date: 2025-10-24
Eur J Midwifery 2025;9(Supplement 1):A104
ABSTRACT
Background:
Suboptimal dietary intake during pregnancy is associated with various adverse health outcomes.
Many pregnant women lack sufficient knowledge of both nutrition and food safety, which can
impact their food choices. Currently, no culturally relevant tool exists to assess these areas of
knowledge specifically for Mediterranean populations, highlighting the need for such an
instrument.
Objective:
This study aims to develop and validate the Pregnancy Nutrition and Food Safety Questionnaire
(PREG-NFS-Q), designed to measure maternal nutrition and food safety knowledge in pregnant
women in a Mediterranean setting.
Methods:
The study involved two phases: instrument design and judgmental evidence. The domain was
determined through a comprehensive literature review, alignment with international dietary
guidelines, expert consultation, and an evaluation of existing assessment tools, followed by
sampling (item generation) and the formation of the initial 55-item instrument. For content
validation, a panel of six experts evaluated the questionnaire to assess the relevance and clarity
of the items. The content validity ratio (CVR) and content validity index (CVI) were calculated.
Face validation was evaluated qualitatively based on feedback from nine participants, comprising
six experts and three individuals from the target population.
Results:
Initial versions of the tool demonstrated strong content validity for individual items (I-CVI
range: 0.83 to 1.00) and moderate to high overall content validity for the PREG-NFS-Q (S-CVI
Average range: 0.96 to 0.99; S-CVI Relevance = 0.93; S-CVI Clarity range: 0.75 to 0.87). Items
were removed due to low CVR, insufficient clarity, and conceptual overlap. Through qualitative
methods, the items were refined until saturation was reached. The final tool comprises 4 domains
and 45 questions.
Conclusions:
The PREG-NFS-Q is a tool demonstrating high item content validity for assessing maternal
nutrition and food safety knowledge in a Mediterranean setting, with potential to inform targeted
nutrition interventions to improve maternal and fetal health outcomes.