DIETARY ASSESSMENT USING A PICTURE-SORT APPROACH

Food-frequency questionnaires are usually administered as a list of fo ods to be checked off by the respondent or interviewer. Techniques in which participants sort into categories cards on which names or pictur es of foods are printed can also be used to assess food intake. Food-f requency scores were obtained from a five-category picture sort admini stered to 4643 men and women aged greater than or equal to 65 y in the Cardiovascular Health Study (CHS). This one-step (qualitative) assess ment yielded significant associations in expected directions between f requency scores and sex, age, race or ethnicity, body mass index, and use of a special diet. In the two-step (semiquantitative) version of t his instrument, an interviewer documented specific frequencies and por tion-size information for the foods in each sorting category. A substu dy of the two-step version with 96 CHS participants indicated relative validity similar to that of conventionally administered food-frequenc y questionnaires. The one-step version may be broadly applicable to si tuations in which general food-pattern data can be informative and cos t and time limitations are great. When it is feasible, the two-step pi cture sort may offer certain methodologic advantages because responden ts have a chance to change their responses and the format may simplify the cognitive-response task. Sorting or picture-sort procedures deser ve systematic attention in research on dietary assessment methods.