Feasibility and reliability of the Self Administrated Children Lifestyle Assessment (SACLA), a new tool to measure children’s lifestyle behaviors: The VIF Program


Lifestyle questionnaire; Children; Health; Reliability, Feasibility


Introduction: To develop a self administrated Children Health-related behaviours assessment suitable, and to test its feasibility and reliability in  French children.

Methods: A sample of 216 children participated in the first stage of this study. An independent sample of 99 children participated in the assessment of reliability. Test and retest of the questionnaire were carried out to investigate test–retest reliability.

Results: Missing or inappropriate responses on different parts of the questionnaire ranged from 0% to 35%. Some questions about drink intake have been modified or removed due to the high percentages of reported problems on these items. No problems were reported on the dimensions of physical activity habits and sedentary behaviors. The mean percentage of agreement in test–retest reliability for the questionnaire dimensions was 78% (47%–99%). Overall, kappa coefficients were good.

Discussion: This instrument as an acceptable and reliable instrument for assessing lifestyle habits in French children.



1. Wijnhoven TM, van Raaij JM, Spinelli A, Rito AI, Hovengen R, Kunesova M, Starc G, Rutter H, Sjöberg A, Petrauskiene A, O'Dwyer U, Petrova S, Farrugia Sant'angelo V, Wauters M, Yngve A, Rubana IM, Breda J. WHO European Childhood Obesity Surveillance Initiative 2008: weight, height and body mass index in 6-9-year-old children. Pediatr Obes 2013;8(2):79-97. doi: 10.1111/j.2047-6310.2012.00090.x.
2. Garrido-Miguel M, Cavero-Redondo I, Álvarez-Bueno C, Rodríguez-Artalejo F, Moreno LA, Ruiz JR, Ahrens W, Martínez-Vizcaíno V. Prevalence and Trends of Overweight and Obesity in European Children From 1999 to 2016: A Systematic Review and Meta-analysis. JAMA Pediatr 2019;173(10):e192430. doi: 10.1001/jamapediatrics.2019.2430.
3. Vanhelst J, Baudelet JB, Thivel D, Ovigneur H, Deschamps T. Trends in the prevalence of overweight, obesity and underweight in French children, aged 4-12 years, from 2013 to 2017. Public Health Nutr 2020; 23(14):2478-2484. doi: 10.1017/S1368980020000476.

4. Hruby A, Manson JE, Qi L, Malik VS, Rimm EB, Sun Q, Willett WC, Hu FB. Determinants and Consequences of Obesity. Am J Public Health 2016; 106(9):1656-62. doi: 10.2105/AJPH.2016.303326.

5. Llewellyn A, Simmonds M, Owen CG, Woolacott N. Childhood obesity as a predictor of morbidity in adulthood: a systematic review and meta-analysis. Obes Rev 2016; 17(1):56-67. doi: 10.1111/obr.12316.

6. Karalexi MA, Mitrogiorgou M, Georgantzi GG, Papaevangelou V, Fessatou S. Non-Nutritive Sweeteners and Metabolic Health Outcomes in Children: A Systematic Review and Meta-Analysis. J Pediatr 2018; 197:128-133.e2. doi: 10.1016/j.jpeds.2018.01.081.

7. Thompson OM, Ballew C, Resnicow K, Must A, Bandini LG, Cyr H, Dietz WH. Food purchased away from home as a predictor of change in BMI z-score among girls. Int J Obes Relat Metab Disord 2004; 28(2):282-9. doi: 10.1038/sj.ijo.0802538.

8. Ludwig DS, Peterson KE, Gortmaker SL. Relation between consumption of sugar-sweetened drinks and childhood obesity: a prospective, observational analysis. Lancet 2001; 357(9255):505-8. doi: 10.1016/S0140-6736(00)04041-1.

9. Venturelli F, Ferrari F, Broccoli S, Bonvicini L, Mancuso P, Bargellini A, Giorgi Rossi P. The effect of Public Health/Pediatric Obesity interventions on socioeconomic inequalities in childhood obesity: A scoping review. Obes Rev 2019; 20(12):1720-1739. doi: 10.1111/obr.12931.

10. Contento IR, Randell JS, Basch CE. Review and analysis of evaluation measures used in nutrition education intervention research. J Nutr Educ Behav 2002; 34(1):2-25. doi: 10.1016/s1499-4046(06)60220-0.

11. Kunaratnam K, Halaki M, Wen LM, Baur LA, Flood VM. Reliability and comparative validity of a Diet Quality Index for assessing dietary patterns of preschool-aged children in Sydney, Australia. Eur J Clin Nutr 2018; 72(3):464-468. doi: 10.1038/s41430-017-0020-y.
12. Lanzarote-Fernández MD, Lozano-Oyola JF, Gómez-de-Terreros-Guardiola M, Avilés-Carvajal I, Martínez-Cervantes RJ, Moreno JP. Spanish Version of the Family Health Behavior Scale: Adaptation and Validation. Int J Environ Res Public Health 2019; 16(5):810. doi: 10.3390/ijerph16050810.

13. Perry CP, Keane E, Layte R, Fitzgerald AP, Perry IJ, Harrington JM. The use of a dietary quality score as a predictor of childhood overweight and obesity. BMC Public Health 2015; 15:581. doi: 10.1186/s12889-015-1907-y.

14. Flood VM, Wen LM, Hardy LL, Rissel C, Simpson JM, Baur LA. Reliability and validity of a short FFQ for assessing the dietary habits of 2-5-year-old children, Sydney, Australia. Public Health Nutr 2014; 17(3):498-509. doi: 10.1017/S1368980013000414.

15. Baxter SD, Paxton-Aiken AE, Royer JA, Hitchcock DB, Guinn CH, Finney CJ. Misclassification of fourth-grade children's participation in school-provided meals based on parental responses relative to administrative daily records. J Acad Nutr Diet 2014; 114(9):1404-10. doi: 10.1016/j.jand.2014.04.024.

16. Paxton-Aiken AE, Baxter SD, Tebbs JM, Finney CJ, Guinn CH, Royer JA. How accurate are parental responses concerning their fourth-grade children's school-meal participation, and what is the relationship between children's body mass index and school-meal participation based on parental responses? Int J Behav Nutr Phys Act 2012; 9:30. doi: 10.1186/1479-5868-9-30.

17. Guinn CH, Baxter SD, Thompson WO, Frye FH, Kopec CT. Which fourth-grade children participate in school breakfast and do their parents know it? J Nutr Educ Behav 2002; 34(3):159-65. doi: 10.1016/s1499-4046(06)60085-7.
18. Borys JM, Le Bodo Y, Jebb SA, Seidell JC, Summerbell C, Richard D, De Henauw S, Moreno LA, Romon M, Visscher TL, Raffin S, Swinburn B; EEN Study Group. EPODE approach for childhood obesity prevention: methods, progress and international development. Obes Rev 2012 ; 13(4):299-315. doi: 10.1111/j.1467-789X.2011.00950.x.
19. Cohen J. A Coefficient of Agreement for Nominal Scales . Educ Psychol Meas. 1960; 20: 37–46. https://doi.org/10.1177/001316446002000104

20. Fleiss JL, Reliability of Measurement. In: The Design and Analysis of Clinical Experiments. Hoboken, NJ, USA: John Wiley & Sons, Inc .; 1986; 1-32.
21. Saunders TJ, Vallance JK. Screen Time and Health Indicators Among Children and Youth: Current Evidence, Limitations and Future Directions. Appl Health Econ Health Policy 2017; 15(3):323-331. doi: 10.1007/s40258-016-0289-3.

22. Van Cauter E, Knutson KL. Sleep and the epidemic of obesity in children and adults. Eur J Endocrinol 2008; 159 Suppl 1(S1):S59-66. doi: 10.1530/EJE-08-0298.

23. St-Onge MP. Sleep-obesity relation: underlying mechanisms and consequences for treatment. Obes Rev 2017;18 Suppl 1:34-39. doi: 10.1111/obr.12499.

24. Bayon V, Leger D, Gomez-Merino D, Vecchierini MF, Chennaoui M. Sleep debt and obesity. Ann Med 2014; 46(5):264-72. doi: 10.3109/07853890.2014.931103.

25. Arble DM, Bass J, Behn CD, Butler MP, Challet E, Czeisler C, Depner CM, Elmquist J, Franken P, Grandner MA, Hanlon EC, Keene AC, Joyner MJ, Karatsoreos I, Kern PA, Klein S, Morris CJ, Pack AI, Panda S, Ptacek LJ, Punjabi NM, Sassone-Corsi P, Scheer FA, Saxena R, Seaquest ER, Thimgan MS, Van Cauter E, Wright KP. Impact of Sleep and Circadian Disruption on Energy Balance and Diabetes: A Summary of Workshop Discussions. Sleep. 2015; 38(12):1849-60. doi: 10.5665/sleep.5226.
26. Fatima Y, Doi SA, Mamun AA. Sleep quality and obesity in young subjects: a meta-analysis. Obes Rev 2016; 17(11):1154-1166. doi: 10.1111/obr.12444.

27. Gance-Cleveland B, Schmiege S, Aldrich H, Stevens C, Scheller M. Reliability and Validity of HeartSmartKids: A Survey of Cardiovascular Risk Factors in Children. J Pediatr Health Care 2018; 32(4):381-386. doi: 10.1016/j.pedhc.2018.01.003.

28. Forrestal SG. Energy intake misreporting among children and adolescents: a literature review. Matern Child Nutr 2011; 7(2):112-27. doi: 10.1111/j.1740-8709.2010.00270.x.

29. Vanhelst J, Béghin L, Duhamel A, De Henauw S, Ruiz JR, Kafatos A, Androutsos O, Widhalm K, Mauro B, Sjöström M, Kersting M, Gottrand F. Do adolescents accurately evaluate their diet quality? The HELENA study. Clin Nutr 2017; 36(6):1669-1673. doi: 10.1016/j.clnu.2016.10.019.

30. Hebert JR, Ma Y, Clemow L, Ockene IS, Saperia G, Stanek EJ 3rd, Merriam PA, Ockene JK. Gender differences in social desirability and social approval bias in dietary self-report. Am J Epidemiol 1997; 146(12):1046-55. doi: 10.1093/oxfordjournals.aje.a009233.