Quantitative Data Collection

Quantitative data was collected through a cross-sectional survey involving use of survey questionnaires (Appendix 1) and quantitative physical measurements (anthropometric measures). To ensure ethical compliance at the onset, the researcher introduced themselves and provided an explanation around the study purpose and participants role in the research. In addition, the participants were asked to sign a consent form if they were willing to participate

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in the study. To maintain confidentiality all sensitive issues pertaining to participant attributes i.e. weight, meal type consume etc. were kept electronically and paper version used during the data gathering kept in a folder after each participant completed the survey. The data was kept in a locked filing cabinet accessible only by the researcher. No participant was identified by name to maintain anonymity.

3.9.1.1 Questionnaire Development

Griffee (1997) explains a questionnaire as a tool or instrument for obtaining study information from respondents. For questionnaire efficacy, this study established main variables for integration in the questionnaire and how they are measured. Using MRC guidelines, a literature search on previously used and validated questionnaires that were administered in a similar setting was conducted. The use of a literature search was crucial for capturing significant variables and their measure (Parsian, 2009). The literature search was specific to school-based obesity interventions and prevention conducted at school and/or home, involving children and/or parents and covering diet/nutrition and/or physical activity. Shepherd (2003) suggests that if a questionnaire is found that can serve the investigator’s purpose, there may be no need to test it for reliability. However, the questionnaire must be administered in a similar manner to the original questionnaire, otherwise a new questionnaire will need to be developed, pilot tested and validated (Shepherd, 2003).

From the search, previous questionnaires were not available to support the aim of the current study report and the interests of the reviewed questionnaire literature did not match those of this current study. Therefore, a new questionnaire was developed which evaluated by pre- pilot test before collecting the final data. The main items developed in the questionnaire and the areas explored in relation to obesity included physical activity with focus on activity types, frequency and duration on a weekly basis; sedentary behaviours such as daily time spent watching television, internet use, and playing video games. In addition, the participants dietary habits that include food type eaten and frequency, healthy and unhealthy food intake were also considered (see Appendix 1 for the whole questionnaire).

3.9.1.2 Validity and Reliability of Developed Questionnaire

According to Shepherd (2003) questionnaire surveys are appropriate for collecting data from large populations and where self-reporting is needed along with convenience and lack of intrusiveness. The questionnaire method is considered useful in obtaining data at low cost, but it lacks reliability and validity (Prince et al., 2008). According to Jones et al. (2001), validity can be described as the degree to which an assessment effectively measures what it is

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designed to measure. Parsian (2009) postulated that the purpose of validating a questionnaire is to make sure that it accurately measures what it aims to do, regardless of the responder. Thus, validating this study’s questionnaire was aimed at collecting quality data with high comparability, and reducing errors while increasing the credibility of the results.

The common characteristics that were used as best practice in developing the questionnaire for this thesis include: simplicity and viability, capability to measure change, reflecting underlying theory, wording reliability and precision, and adequacy for the problem intended to measure (Parsian, 2009). The questionnaire was developed to be at the level understandable and perceivable to participants: children and parents. Questionnaire wording was constructed in a simplified manner for parents or sponsors to easily understand after factoring the possible educational levels and culture factors that would influence the response to the items in the questionnaire. In order to achieve that, this study used the Collingridge questionnaire validation procedure as outlined by Krishnaswamy and colleagues (2012), shown in Figure 6.

Figure 6. Colling ridge questionnaire validation procedure and process adopted from Krishna Swamy and colleagues (2012).

This thesis report was validated based on the Collingridge procedure. Mr Mahmoud Nahhas an academic expert in the field of obesity from the University of Edinburgh helped to convene three panel members with knowledge and experience in obesity related cases from Taibah University in the College of family sciences. Among the key aspects of their role was to evaluate the item structure and compare it with theoretical concepts and to check the adequacy of the items used to evaluate the effectiveness of an education intervention programme on childhood obesity. They were also asked to provide feedback on the clarity of the questions and the language, precision of instruction and order of items and responses. In addition, the professionals were asked to rank each item for its clarity and representativeness

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based on an ordinal scale: (1) Item not representative/not clear (2) item requires major revision to be representative/clear (3) item requires minor revision to be representative/clear (4) item is representative/clear.

The three-member panel rating of items was captured onto a spreadsheet, with each member’s rating against the ordinal scale and the overall rates summed. ‘Item requires minor revision to be representative/clear’ was found to have the highest index, indicating that the questionnaire was averagely satisfactory according to the panel. After a discussion meeting with the panel, the items were amended according to the recommendations to meet a satisfactory outcome. Some items were also suggested to be re-arranged in order to offer better effect and reliability in the research were also affected. Further, to ensure the internal reliability of the questionnaires and the diet and nutrition statements, Cronbach's Alpha tests were carried out using The BMI SPSS statistic software in order to check for internal reliability. The Cronbach's Alpha values for the internal consistency of the scale and the items were all above standard agreed measures for good internal consistency (i.e., greater than 0.70) (Jones-Smith & Popkin, 2010). A pilot study was conducted by collecting data with the improved questionnaire and there were no data entry errors or measures observed.

3.9.1.3 Children’s Self-Reported Questionnaires

Questionnaires issued to children included questions about their nutrition and obesity- related knowledge; dietary intake and assessment; physical activity and sedentary behaviour; and behavioural change (Appendix 1). These self-report questionnaires included 54 items in total, with three sections, as described in the form.

3.9.1.4 Parent’s Self-Report Questionnaires

Self-reported questionnaires were also used with the parents of the participating children, and included questions relating to diet, nutrition and household surroundings (Appendix 2). The questionnaires were translated into Arabic prior to distribution. As a means of checking answers of participating children, the parents were asked to respond to a questionnaire that would validate on their children’s responses. The parents were asked questions regarding their perceptions of their daughter's physical activities, sedentary behaviour and dietary habits (Appendix 2). This included comparisons of the parents' perceptions of daily time spent by their daughters on watching television, on the computer, internet use, and playing video games.

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3.9.1.5 Anthropometric Measurements

Measurements included the weight and height of participants. Children were weighed barefoot and with minimal clothes on. A calibrated measuring scale with an accuracy of ±100 g was used. The height of participants was measured to the nearest centimetre using a tape measure. Participants were asked to stand straight, bare foot and with shoulders in a relaxed position. The recorded weight and height was used to calculate BMI (the ratio of the weight in kilograms and the height in meters square) (James, 2004). Cut off-points standard for BMI for obesity by sex recommended by IOTF (Cole et al., 2007) were adopted for identification of obese participants (Appendix 3).