Development of the Canadian Food Intake Screener to assess alignment of adults' dietary intake with the 2019 Canada's Food Guide healthy food choices recommendations

The objective of this project was to develop a brief self-administered dietary screener, in English and French, to rapidly assess alignment of adults' dietary intake with the 2019 Canada's Food Guide healthy food choices recommendations. In consultation with Health Canada and external advisors (n=15), foundational principles were defined. Existing screeners were scanned, and the healthy food choices recommendations were mapped to inform questions and response options. Cognitive interviews were conducted in English (n=17) and French (n=16) with adults aged 18-65 years from April to June 2021 to assess understanding of questions and face validity; recruitment emphasized variation in sociodemographic characteristics. Face and content validity were assessed with experts in nutrition, surveillance, and public health (n=13 English, 3 French) from April to May 2021. The testing indicated that the screener was well-understood overall but informed refinements to improve comprehension of the questions and their alignment with the healthy food choices recommendations. The resulting Canadian Food Intake Screener/Questionnaire court canadien sur les apports alimentaires includes 16 questions to rapidly assess alignment of intake with the 2019 Canada's Food Guide healthy food choices recommendations, including healthy foods and foods to limit, in situations in which comprehensive dietary assessment is not feasible.