Validation of an iPad activity to measure preschool children's food and physical activity knowledge and preferences

Background: Preschool children's knowledge of, and preference for food and physical activity play an important role in the development of lifestyle behaviors throughout childhood. Valid and reliable instruments that are interactive and appealing to preschool children are needed, to obtain quality information in a way that actively engages children and encourages willing participation. The purpose of the current research is to assess the reliability and validity of an adapted computerized (iPad) version of the photo-pair food and exercise questionnaire (PPFEQ). Methods: The adaptation of the PPFEQ involved generating the questionnaire as an iPad-based tool, updating the photo-pairs within the questionnaire and testing for validity and reliability. This involved four phases of investigation to assess test-retest reliability, internal consistency, sensitivity to change and percent agreement of the questionnaire. Results: The adaption of the PPFEQ resulted in an 18-item questionnaire, titled the preschool food and play questionnaire (Pre-FPQ). The Pre-FPQ demonstrated acceptable reliability and sensitivity to change. Test-retest reliability and internal consistency improved with age, however, it was evident that the tool was not suitable for children younger than 4 years of age. Conclusions: Children encounter a dynamic world that shapes their knowledge, preferences, choices and behaviors. The Pre-FPQ is an innovative tool to measure preschool children's knowledge of and preference for food and physical activity. The questionnaire offers the advantage of being presented in a well-received modality for preschool children as well as being easy and inexpensive to administer. This new tool is likely to be useful for the assessment of the effectiveness of healthy lifestyle programs implemented in the childcare setting. Future work is needed to refine and improve measures of physical activity preference in preschool children.