Exploring Self-Report Dietary Assessment Tools Validated for Indigenous Populations Globally: A Scoping Review

Abstract

Health promotion for Indigenous populations commonly centres around diet-mediated chronic diseases and is often evaluated with self-report (personal recall)-based tools. Accurate dietary assessment methods are crucial for the evaluation of these health promotion outcomes. Dietary assessment tools may require cultural, contextual and language adaptation, as well as validation within Indigenous populations to ensure efficacy and reliability. Due to the limited literature available for Aboriginal and Torres Strait Islander peoples, this review aimed to explore the range of self-report dietary assessment tools that have undergone validation or reliability testing for Indigenous adult populations globally and their adherence to gold-standard Indigenous research principles. This scoping review was conducted as per the Joanna Briggs Institute (JBI) method. Seven electronic databases were searched with no date or language restrictions. Screening, data extraction and quality appraisal with a validated Aboriginal and Torres Strait Islander research Quality Appraisal Tool (QAT) were undertaken by two reviewers, with a third reviewer engaged for resolving discrepancies. Twenty-five articles describing 31 instances of validity and reliability testing on 28 unique self-report dietary assessment tools were included in the review. Studies were predominantly conducted in the USA (n = 13), followed by Australia (n = 4), Canada (n = 3) and Greenland (n = 3). The most common method of validation was relative validity (n = 23). Tools were primarily interviewer-administered food frequency questionnaires (FFQs) validated against multiple 24-h dietary recalls. Tools commonly assessed energy, carbohydrate, fat and protein intake; however, they achieved varying strengths of correlation (r = 0-0.82). Tools were predominately paper-based; however, six studies validated a device-based tool; no web-browser app-based tools were validated in the included literature. Interviewer-administered food frequency questionnaires are the most prevalent self-report dietary assessment method validated within Indigenous populations globally. Browser-based e-tools, which are portable and cost-effective, may hold promise for dietary assessment among Indigenous populations. The acceptability and validity of such tools for Indigenous population groups should be explored through future research. Tools validated to capture added sugar, sodium and food group intake may provide for more meaningful evaluation of health promotion programmes for Indigenous peoples. Tools that have been validated for use with Indigenous peoples are essential for supporting a reliable and accurate evaluation of health promotion activities. Validating dietary assessment tools to adequately capture the predominant outcome measures targeted in nutritional health promotion strategies within Indigenous populations may contribute a more meaningful evaluation of health promotion programmes for Indigenous peoples.