Development and Validation of an Instrument to Assess the Cognitive, Behavioral, and Environmental Factors Related to Sodium Intake in Adult Canadians: The Behavioral Assessment Instrument for Dietary Sodium
Bibliographic record
Abstract
Background High sodium intake is a major risk factor for non-communicable diseases, with most Canadians exceeding recommended levels. Population-wide sodium reduction interventions include monitoring sodium knowledge, attitudes and behaviours (KAB) as a core activity. However, there is a lack of developed instruments incorporating qualitative research and behavioural theories, accompanied by robust validation methods and psychometric testing. Objective This study aimed to develop and validate a comprehensive instrument, the Behavioural Assessment Instrument for dietary Sodium (BAIS), assessing cognitive, behavioural, and environmental influences on sodium intake among Canadian adults. Methods Item development was informed by a prior national sodium survey, a Canadian qualitative study, relevant literature, and behavioural theories. Content validity was assessed by 11 experts over two rounds and evaluated by computing the content validity index (CVI) for individual items (I-CVI) and scale average (S-CVI/Ave). Face validity was verified through one-on-one interviews with 10 Canadian adults (>18 years). Item response theory (IRT) assessed knowledge items, while exploratory and confirmatory factor analyses (EFA/CFA) validated the remaining constructs (n=3,236; 51.2% women; mean age 49.5±17.7 years). Reliability analyses included intraclass correlation coefficients (ICC) for ordinal questions, Gwet's first-order agreement coefficient (AC1) for binary questions, and Cronbach's alpha. Results Expert review led to iterative revisions, with round two achieving S-CVI/Ave=1, indicating high content validity. Cognitive interviews (50% male, 23–62 years) confirmed item clarity. IRT results showed acceptable difficulty and discrimination of knowledge variables. EFA and CFA supported a six-factor structure: Nutrition labelling behaviours, Hedonic influences, Perceived control and self-efficacy, Priority and concern, Delayed concern, and Sodium reduction practices. Internal consistency ranged from acceptable to excellent. ICC was moderate for most ordinal variables, and AC1 was moderate to very good. Conclusions The BAIS represents the first validated Canadian instrument to assess multidimensional, theory-based drivers of sodium intake, supporting improved surveillance, policy development, and targeted interventions.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.019 | 0.024 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.003 | 0.004 |
| Science and technology studies | 0.003 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".