Background on the Development of the FNPA Tool
The FNPA tool was developed by researchers with the Physical Activity and Health Promotion Lab at Iowa State University based on in collaboration with the Academy of Nutrition and Dietetics following a comprehensive evidence analysis examining the influence of physical activity, sport participation, television viewing and video games for their influence on child adiposity. From this analysis, ten constructs were formulated which are now included in the FNPA.
These constructs include
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Foundation of the FNPA
Foundational Concepts
The need for a behaviorally based screening tool was identified by researchers affiliated with the Academy of Nutrition and Dietetics. Click here to access the original manuscripts describing the vision for the tool |
Original Validation of the FNPA
The original FNPA was a 21-item questionnaire evaluating ten established constructs, or topic areas, identified by the evidence analysis. Initial validation was performed in a sample of 854 first grade children and their parents from 37 of 39 elementary schools in a large Midwestern urban school district (Des Moines, IA). Anthropometric data were obtained by trained school nurses and parents completed the FNPA survey. Correlational analysis and logistic regression were used to examine associations among FNPA factors and the relationship between these factors and child weight status. Significant correlations were found between BMI and seven of the ten constructs (breakfast/family meals, modeling nutrition, high calorie beverage intake, television in the bedroom, parent physical activity, child physical activity and sleep schedule) as well as between BMI and the overall FNPA score.
The predictive validity of the FNPA tool was examined using a longitudinal design in a large sample of youth. A one-year follow-up was conducted with the original validation sample of urban elementary school children. Anthropometric measurements were repeated by school nurses one year later and change in BMI percentile was calculated. Over half of the participants exhibited increases in BMI percentile for age and gender with the FNPA score explaining unique variance in BMI at follow-up (β = -0.017), suggesting that an increase of 10 points on the FNPA corresponds to a decrease of 0.17 BMI units. While the independent effect of the FNPA score is small, it does suggest an impact of modifiable home environment factors.
The predictive validity of the FNPA tool was examined using a longitudinal design in a large sample of youth. A one-year follow-up was conducted with the original validation sample of urban elementary school children. Anthropometric measurements were repeated by school nurses one year later and change in BMI percentile was calculated. Over half of the participants exhibited increases in BMI percentile for age and gender with the FNPA score explaining unique variance in BMI at follow-up (β = -0.017), suggesting that an increase of 10 points on the FNPA corresponds to a decrease of 0.17 BMI units. While the independent effect of the FNPA score is small, it does suggest an impact of modifiable home environment factors.
Online Version of the FNPA
An online version of the FNPA tool was developed by the Academy of Nutrition and Dietetics (AND) to facilitate use by clinicians and research groups. The assessment directly links to parenting resources from the Kids Eat Right web page. Visit the Kids Eat Right website to learn more about healthy eating for kids of all ages. Click below to access the online version or to contact the AND about customization. The online tool is managed by the AND and is not coordinated by our team so questions about the availability and potential applications should go to the AND.
Updates to the FNPA: Cognitive Testing and Reliability
The wording of some items on the FNPA tool were updated in 2017 to capture the changing descriptions related to phone use, social media and references to commercial products. We retained the same 10 evidence-based constructs but cognitive testing revealed the need to make some adjustments in the wording. For example, the original FNPA only asks about television in the screen time questions. New forms of media such as video games and cell phones had to be added to these items. We also systematically evaluated two different response scales - one based on subjective reports of frequency (e.g. "typically") and another based on more objective reports in a typical week (e.g. "3 days" / "4 days"). This study showed support for the existing subjective response scale. This work was published in 2020 and provides the best citation for the current version of the FNPA tool.
Peyer KL, Bailey-Davis L, Welk G. Development, Applications, and Refinement of the Family Nutrition and Physical Activity (FNPA) Child Obesity Prevention Screening. Health Promot Pract. 2021 Jul;22(4):456-461. doi: 10.1177/1524839920922486. Epub 2020 May 19. PMID: 32429704.
Peyer KL, Bailey-Davis L, Welk G. Development, Applications, and Refinement of the Family Nutrition and Physical Activity (FNPA) Child Obesity Prevention Screening. Health Promot Pract. 2021 Jul;22(4):456-461. doi: 10.1177/1524839920922486. Epub 2020 May 19. PMID: 32429704.
