Table_2_Use of a focus group-based cognitive interview methodology to validate a cooking behavior survey among African-American adults.DOCX

Disparities in diet-related diseases persist among African-Americans despite advances in risk factor identification and evidence-based management strategies. Cooking is a dietary behavior linked to improved dietary quality and cardiometabolic health outcomes. However, epidemiologic studies suggest that African-American adults report a lower frequency of cooking at home when compared to other racial groups, despite reporting on average cooking time. To better understand cooking behavior among African-Americans and reported disparities in behavior, we sought to develop a survey instrument using focus group-based cognitive interviews, a pretesting method that provides insights into a survey respondent’s interpretation and mental processing of survey questions. A comprised survey instrument was developed based on input from a community advisory board, a literature review, and a content review by cooking behavior experts. The cognitive interview pretesting of the instrument involved African-American adults (n = 11) at risk for cardiovascular disease who were recruited from a community-based participatory research study in Washington, D.C., to participate in a focus group-based cognitive interview. Cognitive interview methodologies included the verbal think-aloud protocol and the use of retrospective probes. Thematic analysis and evaluation of verbalized cognitive processes were conducted using verbatim transcripts. Five thematic themes related to the survey were generated: (1) Clarity and relevancy of question items; (2) influence of participants’ perspectives and gender roles; (3) participant social desirability response to questions; (4) concern regarding question intent. Eleven survey items were determined as difficult by participants. Cooking topics for these items were: cooking practices, cooking skills, cooking perception (how one defines cooking), food shopping skills, and socialization around cooking. Question comprehension and interpreting response selections were the most common problems identified. Cognitive interviews are useful for cooking research as they can evaluate survey questions to determine if the meaning of the question as intended by the researcher is communicated to the respondents—specific implications from the results that apply to cooking research include revising questions on cooking practice and skills. Focus-group-based cognitive interviews may provide a feasible method to develop culturally grounded survey instruments to help understand disparities in behavior for culturally relevant diet behaviors such as cooking.

尽管与饮食相关疾病的风险因素识别及循证管理策略已取得诸多进展，但非裔美国人群体中此类疾病的患病差异仍持续存在。烹饪作为一种饮食行为，与改善饮食质量及心脏代谢健康结局密切相关。然而，流行病学研究显示，尽管非裔美国成年人自述的平均烹饪时长与其他种族群体无显著差异，但他们自述的在家烹饪频率更低。为更好地了解非裔美国人的烹饪行为及其相关的行为差异，我们尝试通过基于焦点小组的认知访谈（focus group-based cognitive interviews）法开发一款调查工具——该预测试方法可深入了解受访者对调查问题的解读与心理加工过程。研究团队结合社区咨询委员会的意见、文献综述结果以及烹饪行为领域专家的内容审核，最终形成了一套适配的调查工具。该工具的认知访谈预测试环节，招募了来自华盛顿特区社区参与式研究项目的11名心血管疾病高危非裔美国成年人参与焦点小组式认知访谈。认知访谈方法包含有声思维协议（verbal think-aloud protocol）与回顾性探查（retrospective probes）。研究基于逐字转录稿开展了主题分析与受访者口头认知过程评估，最终提炼出与该调查工具相关的五大核心主题：(1) 问题条目清晰度与相关性；(2) 参与者视角与性别角色的影响；(3) 参与者在答题时的社会期许性反应；(4) 对问题意图的担忧。参与者共指出11项存在理解难度的调查条目，涉及的烹饪相关主题包括：烹饪实践、烹饪技能、烹饪认知（即个体对烹饪的定义）、食品采购技能以及围绕烹饪的社交活动。研究发现最常见的问题为问卷题目的理解难度以及对作答选项的解读障碍。认知访谈法在烹饪研究中具有重要应用价值，可用于评估调查问题是否能将研究者的意图准确传达给受访者。本研究结果对烹饪研究的具体启示包括：修订与烹饪实践及技能相关的调查问题。基于焦点小组的认知访谈法或可成为开发具备文化适配性的调查工具的可行路径，助力理解与烹饪这类具有文化相关性的饮食行为相关的行为差异。