DOI: 10.5061/dryad.2z34tmpr9
title: Mini Nutritional Assessment tool validation project

description: Background: The health status of older people is usually overlooked in
 many low-income countries like Ethiopia. Appropriate nutritional
 assessment improves the health of old age people. The Mini Nutritional
 Assessment tool is a noninvasive and cheap practical evaluation tool that
 provides a simple and quick method of evaluating the nutritional status of
 old age people. The tool has multiple versions of confirmed validity in
 diverse languages, except in Amharic. Furthermore, the tool has still not
 been properly validated for Ethiopian old age people. Objective: The
 purpose of this study was to translate the Mini Nutritional Assessment
 tool into the Amharic language and validate it among old age people in
 Bahir Dar City. Methods: This tool translation and validation study
 followed normal COSMIN Study design and reporting guidelines. The study
 was conducted in three stepwise phases from January 16 to March 13, 2021.
 The first phase was reviewing and selecting nutritional assessment tools
 for old age people. In the second phase, the selected Mini Nutritional
 Assessment tool was translated and reviewed by experts. Using the
 heterogenous purposive sample, ten healthcare specialists with
 professional experience in the care of old age people were chosen for this
 step. The experts examined the face and content validity of the Amharic
 version of the instrument in two rounds of the Delphi technique. Finally,
 after incorporating the experts’ suggestions and comments, a
 cross-sectional study was conducted among old age people for psychometric
 validation. The participant-to-variables ratio of the 10:1 rule of thumb
 was followed for the minimum sample size. Since the Mini Nutritional
 Assessment tool has 18 items, 180 community-dwelling old-age people were
 selected in multistage cluster sampling from Belay Zeleke, one of the
 sub-cities of Bahir Dar City. Principal component analysis was used to
 measure construct validity while Cronbach's alpha was employed to
 assess internal consistency reliability. Results: As experts reviewed, all
 items in the translated tool are socially acceptable and have no taboo or
 sensitive words. The translated tool's content validity ratio was
 0.93, and its scale validities (S-CVI/Ave and S-CVI/AU) were 0.97 and
 0.83, respectively. Moreover, 180 community-dwelling old age people aged
 60 to 90 years old participated in a psychometric evaluation study.
 Construct validity of the tool was confirmed with factor loadings ranging
 from 0.47 to 0.89 with a Cronbach’s alpha of 0.65. The tool had a
 sensitivity and specificity of 97% and 83%, respectively. Conclusion: The
 Amharic version of the Mini Nutritional Assessment tool showed good
 cross-cultural adaption, internal consistency reliability, and construct
 validity in Bahir Dar community-dwelling old age people. The tool can be
 used in regular care activities for aged people.
description: Study design and period A cross-sectional
 study design was conducted from January 16 to March 13, 2021.
 Study population This study utilized two
 groups of the population. The first group was health care experts used for
 content validation, and the second group was community-dwelling old age
 people for psychometric validation. Sample size and
 sampling procedures For the expert judgment, 10
 healthcare experts were selected based on the guideline recommendation for
 the Delphi technique. Two health care professionals each from human
 nutrition and clinical pharmacy trained at masters’ degree level, nurses
 trained at BSc level, general medical practitioners, and internists were
 selected as the panelists. These professionals were selected based on the
 maximum variation or heterogeneous purposive sampling for their
 professional experience in the care of old age people. Furthermore, their
 familiarity with research (at least in his/her graduate paper) and a
 minimum of one year of working experience were considered as inclusion
 criteria. For the psychometric validation, a
 participant-to-variables ratio of 10:1 was followed as a rule of thumb.
 The rule states that at least 10 participants are required for each
 questionnaire item for factor analysis. Since MNA has 18 items, a minimum
 of 180 study participants were selected for this validity test.
 Community-dwelling old age people selected in multistage cluster sampling
 from Belay Zeleke, one of the sub-cities of Bahir Dar City, were used for
 this study. Community-dwelling old age people who fulfill the following
 inclusion criteria were selected for the study: age 60 years and above,
 living in the city administration at least for six months, being capable
 of describing their lived experience, and being able to understand and
 speak the Amharic (local) language. This study excluded participants who
 had significant spine curvature (scoliosis or kyphosis) and had both
 extremities amputated.
description: The International Business Machines Corporation Statistical
 Package for the Social Sciences (IBM SPSS) version 23 was used to analyze
 the data.