ORIGINAL RESEARCH article
Front. Public Health
Sec. Public Health and Nutrition
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1661573
Evaluating correlates of healthy eating and dietary quality among older adults: a mixed methods approach to development and application of a new survey instrument
Provisionally accepted
- 1University of Nevada, Las Vegas, Las Vegas, United States
- 2University of Nevada Las Vegas School of Integrated Health Sciences, Las Vegas, United States
- 3Kansas State University College of Health and Human Sciences, Manhattan, United States
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Objectives: Community-dwelling older adults face unique challenges related to nutrition and health, but little is known about their barriers and facilitators for healthy eating behaviors. This study sought to develop and evaluate a new instrument to measure the capability, opportunity, and motivation for healthy eating behaviors (COM-HE) among community-dwelling older adults. Design: A mixed methods approach was used to obtain qualitative and quantitative data. Participants were aged 65 years or older, community-dwelling, and English-speaking. Participants engaged in focus groups (n = 12) and pilot-testing (n = 81) to evaluate the COM-HE instrument. The Rapid Eating Assessment for Participants – Shortened Version (REAP-S) questionnaire was utilized to examine correlations between the COM-HE instrument and self-reported dietary quality. Descriptive and inferential statistics were used to investigate acceptability, reliability, and validity. Results: The COM-HE instrument achieved acceptable internal consistency (Cronbach’s alpha = 0.847–0.986), displayed varying levels of uni-dimensionality based on multiple principal component analyses (total variance explained by three components = 86.72%), and was correlated with self-reported dietary quality scores (r = .409, adjusted R 2 = .099, p = .031). Preliminary data suggest that the scale was acceptable in terms of readability and understanding among a convenience sample of generally well-educated older adults. Conclusion: The new COM-HE instrument was acceptable, reliable, and valid among a homogenous sample of adults over 65 years of age. These results suggest a need for additional development, evaluation, and refinement of the instrument in more diverse groups of older adults.
Keywords: Behavioral assessment, instrument development, Nutrition barriers, psychometric evaluation, Healthy Ageing, Eating motivation
Received: 08 Jul 2025; Accepted: 29 Aug 2025.
Copyright: © 2025 Rosenkranz, Shahamati, Biggins, Mick, Acosta and Rosenkranz. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Sara K Rosenkranz, University of Nevada, Las Vegas, Las Vegas, United States
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