Cultural Adaptation, Validation, and Primary Application of a Questionnaire to Assess Intentions to Eat Low-Glycemic Index Foods among Rural Chinese Women

Mingshu Li; Fang Li; Qian Lin; Jingzheng Shi; Jing Luo; Qing Long; Qiping Yang; Yufeng Ouyang; Hanmei Liu; Rhonda C Bell; Jia Guo

doi:10.3390/ijerph17207577

Cultural Adaptation, Validation, and Primary Application of a Questionnaire to Assess Intentions to Eat Low-Glycemic Index Foods among Rural Chinese Women

Int J Environ Res Public Health. 2020 Oct 18;17(20):7577. doi: 10.3390/ijerph17207577.

Authors

Mingshu Li¹, Fang Li², Qian Lin¹, Jingzheng Shi², Jing Luo¹, Qing Long³, Qiping Yang¹, Yufeng Ouyang¹, Hanmei Liu¹, Rhonda C Bell⁴, Jia Guo³

Affiliations

¹ Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, Changsha 410078, China.
² Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha 410078, China.
³ Xiangya School of Nursing, Central South University, Changsha 410013, China.
⁴ Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, AB T6G 2H6, Canada.

Abstract

Different lines of evidence indicate that knowledge of low-glycemic index (GI) foods and the practice of eating them play important roles in blood glucose management and preventing T2DM in women with prior gestational diabetes mellitus (GDM). According to the theory of planned behavior (TPB), intention is a critical factor in complying with health-related behaviors. However, an instrument for assessing the intention to eat low-GI foods is lacking in China. We aimed to (1) adapt and validate a Chinese version of the intentions to eat low-GI foods questionnaire (CIELQ) and (2) apply the CIELQ among rural Chinese women to explore the associations between CIELQ scores and glycemic status. A cross-sectional study was conducted on 417 nondiabetic, nonpregnant participants with a history of GDM in Hunan, China. After cultural adaptation and validation, the CIELQ was applied in a target population. Glycemic status, anthropometric variables, dietary intake, and physical activity were measured; a self-developed, standard questionnaire was applied to collect relevant information. The CIELQ showed good internal consistency; model fitness was acceptable based on the confirmatory factor analysis results. Awareness of the glycemic index was low among the study population. TPB factors were found to be associated with each other; education level and parents' diabetes history were associated with specific factors. The score for instrumental attitude showed a positive association with the risk for a high level of the 2-h 75-g oral glucose tolerance test (odds ratio, OR = 1.330), while the score for perceived behavior control (PBC) showed a negative association with the risk for a high level (OR = 0.793). The CIELQ was determined to be a valid instrument for assessing the intention to eat a low-GI diet among the study population. The awareness of the GI was poor among the study population. The score for instrumental attitude showed a positive association with the risk of a high level on the 2-h 75-g oral glucose tolerance test (OGTT), and the score for PBC showed a negative association with the risk for a high level on OGTT.

Keywords: Chinese version of the intentions to eat low-glycemic index foods questionnaire (CIELQ); Hunan; application; cross-culture adaptation; rural area; validation; women with previous gestational diabetes mellitus (GDM).

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Asian People / psychology*
China
Cross-Sectional Studies
Diabetes, Gestational / prevention & control*
Diabetes, Gestational / psychology
Dietary Fiber / administration & dosage*
Feeding Behavior / psychology*
Female
Food
Glycemic Index*
Health Behavior*
Humans
Intention*
Pregnancy
Rural Population
Surveys and Questionnaires / standards*

Substances

Dietary Fiber