Journal of Nutrition and Health

The Korean Nutrition Society (한국영양학회)
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Development of dietary behavior items available in Korea National Health and Nutrition Examination Survey

국민건강영양조사에 활용 가능한 식생활 조사항목 개발 및 유용성 검증

  • Lim, A-Hyun (Department of Food Science and Nutrition, Dankook University) ;
  • Choi, Suk-Young (Department of Food Science and Nutrition, Dankook University) ;
  • Shim, Jae-Eun (Department of Food and Nutrition, Daejeon University) ;
  • Hwang, Ji-Yun (Nutrition Education Major, Graduate School of Education, Sangmyung University) ;
  • Moon, Hyun-Kyung (Department of Food Science and Nutrition, Dankook University) ;
  • Kim, Kirang (Department of Food Science and Nutrition, Dankook University)
  • 임아현 (단국대학교 식품영양학과) ;
  • 최숙영 (단국대학교 식품영양학과) ;
  • 심재은 (대전대학교 식품영양학과) ;
  • 황지윤 (상명대학교 교육대학원 영양교육전공) ;
  • 문현경 (단국대학교 식품영양학과) ;
  • 김기랑 (단국대학교 식품영양학과)
  • Received : 2015.09.15
  • Accepted : 2015.10.01
  • Published : 2015.10.31
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Abstract

Purpose: Given that the indicators related to chronic diseases are important to evaluating goals of the national health policy, the aim of this study was to develop dietary behavior items available in the Korea National Health and Nutrition Examination Survey. Methods: The dietary behavior items were developed based on the literature reviews, need assessment of the field, expert focus-group interviews, and expert advisory meeting. Questions for each dietary behavior item were developed by reflecting on environmental, personal, and behavior factors of the ecological frame and then revised through expert focus-group interview and expert advisory meeting. The understanding and reliability of the developed questionnaire were assessed by cognitive interview and test-retest reliability. Results: The developed items were sodium and salt intake, added and simple sugar intake, enough time to consume a meal for all ages, caffeine drinks and fresh/healthy food intake for children and adolescents, and limited dietary intake, fresh/healthy food intake for seniors. In most questions except some questions on sodium and salt intake, subjects understood over 70% and consistency of responses based on the kappa values was acceptable. Conclusion: Developed dietary behavior items are expected to be useful for evidence-based nutrition policy, interventions and research targeting dietary patterns through investigating and monitoring dietary behavior patterns.

본 연구는 국민건강영양조사의 식생활 조사영역에서 만성질환의 요인을 파악할 수 있는 항목의 개발 및 보완의 필요성이 제기됨에 따라 국내 및 국외에서 실시하고 있는 식생활 조사항목을 고찰하였다. 고찰된 결과를 기반으로 국민 식생활 패턴이 반영되면서 국가 정책의 평가 지표로 활용될 수 있는 식생활 조사항목을 국민건강영양조사에서 활용 가능하도록 개발하였다. 연구결과를 요약하면 다음과 같다. 1) 개발 및 보완된 식생활조사항목은 국내외 식생활 관련 연구 및 정책에서 사용한 식생활 조사항목을 고찰한 결과를 기반으로 후보 항목을 도출하였고, 전문가 포커스 그룹 조사 및 수요도 조사를 통해 검토되어 8개의 식생활 조사 항목이 선정되었다. 2) 전문가 포커스 그룹 조사 및 수요도 조사 결과에서 선정된 8개의 조사 항목 중에서 조사 필요성 및 타당성에 대해 전문가 의견의 합의가 있는 항목을 최종 선정한 결과, 전체 대상으로는 소금 및 나트륨 섭취, 가당 및 단순당 섭취, 충분한 식사시간 확보 및 식사속도에 대한 항목이 선정되었고, 아동 및 청소년 대상에서는 전체 대상 조사 항목에 추가적으로 카페인 음료 섭취, 간식 및 건강한 식품섭취 항목이 추가되었고, 노인 대상에서는 섭취 제한, 간식 및 건강한 식품섭취 항목이 추가되었다. 3) 최종 선정된 식생활 조사 항목별 설문 문항을 구성하기 위하여 생태학적 모델을 기반으로 한 사회인지이론에 적용하여 각 조사 항목별로 환경, 개인적 요인, 행동의 영역으로 구분하여 문항을 개발하였다. 4) 개발된 식생활 조사 항목별 설문 문항은 학계 전문가들을 대상으로 안면 타당도를 검증하였고 일반인을 대상으로 인지조사를 통해 이해도 평가와 신뢰도 평가를 측정한 결과 적합한 것으로 나타났다. 5) 최종적으로 국민건강영양조사 영양조사 담당자 및 영양분과위원회의 회의 및 검토를 통하여 설문문항이 확정되었다. 이 연구에서 개발된 조사 문항의 활용성을 높이기 위한 제언은 다음과 같다. 첫째, 개발된 조사 영역 중 국민건강영양조사 대상자로 pilot study를 수행하여 신뢰도 및 타당도가 높게 나타난 영역부터 우선적으로 적용될 수 있으며 향후 우선순위에 따라 순환 조사를 할 수 있다. 둘째, 식생활 조사 시, 각 영역별의 환경, 개인적 요인, 행동 문항은 같이 조사하여 서로 문항 간의 상관성 및 유효성에 대한 검토가 필요할 것이다. 셋째, 개발된 신규 조사 문항은 현재 중요한 영양 이슈 중심의 항목으로 개발되었으므로 향후 추가적인 영양문제로 새로운 항목 개발 시에도 좀 더 구체적인 원인 파악을 위해서는 생태학적 모델을 적용한 문항을 이용하여 현황을 파악하고, 그 결과를 근거로 정책 마련에 활용해야 하겠다.

Keywords

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