Development, reliability, and validity of Nutrition Supports Scale for paid caregivers in community homes

People with intellectual disabilities (ID) have a higher prevalence of overweight and obesity compared to general population with highest rates among people living in community settings. As paid caregivers, direct support professionals (DSPs) are key in promoting sound nutrition and informed choice for people with ID. A paucity of information and lack of validated instruments exist concerning meal planning, food purchase, and preparation among DSPs. A three-phase exploratory mixed-method design was used to develop a reliable and valid measurement scale to evaluate nutrition supports needed among DSPs. This design used qualitative methodologies, including focus groups (Phase 1), expert panel review and cognitive interviews (Phase 2) to inform a third phase, quantitative survey (Phase 3). Two hundred individuals (n=200) (DSPs, individuals with ID, family members, and management) from community-based organizations in Illinois and New Mexico participated in the study. The final Nutrition Supports Scale (NSS) consists of 45 items and six domains (Financial, Preparation and Storage, Knowledge, Cultural Values and Lifestyles, Organizational Culture, and Time). NSS meets psychometric criteria for reliability and construct validity using Factor Analysis and Rasch Analysis. Six domains had unidimensional psychometric properties and can be used independently. Understanding available nutrition supports among staff working in community homes can increase knowledge of how to improve diet and strategies for developing training and improving workforce development in order to decrease health disparities of people with ID.