# The relative validity of the updated Menzies Remote Short-Item Dietary Assessment Tool (MRSDAT) for use with remote Aboriginal and Torres Strait Islander children and adults

## TL;DR

This study validates a dietary assessment tool for remote Indigenous communities in Australia, showing it provides reliable dietary quality scores comparable to detailed 24-hour recall methods.

## Contribution

The updated MRSDAT tool is shown to be a valid and practical alternative to 24-hour recalls for assessing dietary quality in remote Indigenous populations.

## Key findings

- MRSDAT scores were 0.31/100 points higher than 24-h recall scores for participants with ≥2 recalls.
- Lin’s concordance correlation coefficient (CCC) showed moderate agreement (Rc = 0.58) between MRSDAT and 24-h recall methods.
- The MRSDAT is a practical and efficient tool for dietary assessment in remote Indigenous communities.

## Abstract

This study aimed to determine the relative validity of dietary quality index scores estimated using the updated version of the Menzies Remote Short-item Dietary Assessment Tool (MRSDAT), a food frequency questionnaire developed for use with remote Indigenous communities in Australia.

This validation study compares scores derived from the updated MRSDAT with those derived from 24-h recalls. Participants from nine remote communities across three discrete regions of Australia (Central Australia, North Northern Territory and Cape York) participated in June–September 2021, or May–July 2022. Participants were Indigenous children aged six months to five years, pregnant and/or breastfeeding Indigenous women, and overweight adult Indigenous males and females. The agreement between methods was explored using Lin’s concordance correlation coefficient (CCC), Bland–Altman plots, weighted Cohen’s kappa, paired samples t-tests and Wilcoxon signed-rank tests. Primary comparisons were completed for the whole sample, and primary and secondary comparisons for only participants with ≥ 2 × 24 h recalls.

Ninety-nine participants were recruited. The MRSDAT estimated dietary quality index scores 0.31/100 points higher than 24-h recall estimates for participants with ≥ 2 × 24-h recalls, and 0.18/100 points higher for all participants, with consistent results for adults and children (CCC = Rc 0.58, 95% CI 0.39, 0.72).

Updates to the MRSDAT have resulted in dietary quality index scores highly comparable to those derived from 24-h recalls. The MRSDAT has the practical advantages of speed and convenience for research purposes, and the built-in instant dietary feedback feature has application to service delivery settings given the robust results demonstrated in this validation study.