Mini Nutritional Assessment tool validation project

Background: The health status of older people is usually overlooked in
many low-income countries like Ethiopia. Appropriate nutritional
assessment improves the health of old age people. The Mini Nutritional
Assessment tool is a noninvasive and cheap practical evaluation tool that
provides a simple and quick method of evaluating the nutritional status of
old age people. The tool has multiple versions of confirmed validity in
diverse languages, except in Amharic. Furthermore, the tool has still not
been properly validated for Ethiopian old age people. Objective: The
purpose of this study was to translate the Mini Nutritional Assessment
tool into the Amharic language and validate it among old age people in
Bahir Dar City. Methods: This tool translation and validation study
followed normal COSMIN Study design and reporting guidelines. The study
was conducted in three stepwise phases from January 16 to March 13, 2021.
The first phase was reviewing and selecting nutritional assessment tools
for old age people. In the second phase, the selected Mini Nutritional
Assessment tool was translated and reviewed by experts. Using the
heterogenous purposive sample, ten healthcare specialists with
professional experience in the care of old age people were chosen for this
step. The experts examined the face and content validity of the Amharic
version of the instrument in two rounds of the Delphi technique. Finally,
after incorporating the experts’ suggestions and comments, a
cross-sectional study was conducted among old age people for psychometric
validation. The participant-to-variables ratio of the 10:1 rule of thumb
was followed for the minimum sample size. Since the Mini Nutritional
Assessment tool has 18 items, 180 community-dwelling old-age people were
selected in multistage cluster sampling from Belay Zeleke, one of the
sub-cities of Bahir Dar City. Principal component analysis was used to
measure construct validity while Cronbach's alpha was employed to
assess internal consistency reliability. Results: As experts reviewed, all
items in the translated tool are socially acceptable and have no taboo or
sensitive words. The translated tool's content validity ratio was
0.93, and its scale validities (S-CVI/Ave and S-CVI/AU) were 0.97 and
0.83, respectively. Moreover, 180 community-dwelling old age people aged
60 to 90 years old participated in a psychometric evaluation study.
Construct validity of the tool was confirmed with factor loadings ranging
from 0.47 to 0.89 with a Cronbach’s alpha of 0.65. The tool had a
sensitivity and specificity of 97% and 83%, respectively. Conclusion: The
Amharic version of the Mini Nutritional Assessment tool showed good
cross-cultural adaption, internal consistency reliability, and construct
validity in Bahir Dar community-dwelling old age people. The tool can be
used in regular care activities for aged people.