The American journal of clinical nutrition · 2026
Validity and reliability of a targeted nutrition-risk screening tool for mental health services.
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Teasdale Scott B, Ardill-Young Oliver, Anderson Amanda, Bastin Chadia, Bruce Kylie, Carter Alexandra, Crawford Patricia, Dalton Katie, Ellis Aleshia, Hennessy Erikka, Hsu Michelle, Inall Bronwyn, Jensen Chloe, Johnston Donni, Lancaster Rebecca, McQualter Kathryn, Millett Olivia, Pearson Abbey, Tingay Sophie, Curtis Jackie, Müller-Stierlin Annabel S, Ward Philip B, Rosenbaum Simon
Аннотация
BACKGROUND: Existing nutrition-risk screening tools focus primarily on undernutrition and do not capture the broader risks experienced in mental health settings.
OBJECTIVES: This study aimed to evaluate the measurement properties of a targeted nutrition-risk screening tool developed for mental health and alcohol and other drug (AOD) services.
METHODS: A multicenter validation study was conducted in 12 public and private mental health and AOD services in Australia. People receiving care in inpatient, community, forensic, and residential mental health settings and 1 AOD setting were recruited through convenience sampling. The NutriMental Screener was administered at 3 time points to assess interrater reliability (2 healthcare professionals within 24 h) and test-retest reliability (repeat administration ∼1 wk later). Concurrent criterion validity was examined through comparison with a dietitian-completed nutrition assessment incorporating established measures of constipation, malnutrition risk, eating disorder symptomatology, and food insecurity. Reliability was evaluated using Cohen's κ coefficients, and sensitivity and specificity analyses were conducted for domain-specific validity. Feasibility was assessed using completion time and referral outcomes. Findings were reviewed through a structured expert consultation process to refine tool instructions, scoring response layers, and referral processes and frameworks.
RESULTS: A total of 207 participants completed the initial screening, with 198 completing all assessments. Test-retest and interrater reliability demonstrated moderate to almost perfect agreement across items (κ = 0.421-0.939, all P < 0.001). Domain-specific concurrent validity analyses showed clinically acceptable sensitivity-specificity trade-offs across constructs. Median completion time was ∼5 min. Screening generated a dietitian referral in 40.1% of cases and prompted clinical team discussion in a further 34.8% of cases. Expert-informed refinement resulted in minor modifications to wording and referral framework, producing a clinically ready tool.
CONCLUSIONS: The NutriMental Screener demonstrated acceptable reliability, clinically meaningful validity, and high feasibility. This tool provides an alternative to undernutrition-focused screening tools currently employed in mental health settings and preliminary evidence for use in AOD services.
OBJECTIVES: This study aimed to evaluate the measurement properties of a targeted nutrition-risk screening tool developed for mental health and alcohol and other drug (AOD) services.
METHODS: A multicenter validation study was conducted in 12 public and private mental health and AOD services in Australia. People receiving care in inpatient, community, forensic, and residential mental health settings and 1 AOD setting were recruited through convenience sampling. The NutriMental Screener was administered at 3 time points to assess interrater reliability (2 healthcare professionals within 24 h) and test-retest reliability (repeat administration ∼1 wk later). Concurrent criterion validity was examined through comparison with a dietitian-completed nutrition assessment incorporating established measures of constipation, malnutrition risk, eating disorder symptomatology, and food insecurity. Reliability was evaluated using Cohen's κ coefficients, and sensitivity and specificity analyses were conducted for domain-specific validity. Feasibility was assessed using completion time and referral outcomes. Findings were reviewed through a structured expert consultation process to refine tool instructions, scoring response layers, and referral processes and frameworks.
RESULTS: A total of 207 participants completed the initial screening, with 198 completing all assessments. Test-retest and interrater reliability demonstrated moderate to almost perfect agreement across items (κ = 0.421-0.939, all P < 0.001). Domain-specific concurrent validity analyses showed clinically acceptable sensitivity-specificity trade-offs across constructs. Median completion time was ∼5 min. Screening generated a dietitian referral in 40.1% of cases and prompted clinical team discussion in a further 34.8% of cases. Expert-informed refinement resulted in minor modifications to wording and referral framework, producing a clinically ready tool.
CONCLUSIONS: The NutriMental Screener demonstrated acceptable reliability, clinically meaningful validity, and high feasibility. This tool provides an alternative to undernutrition-focused screening tools currently employed in mental health settings and preliminary evidence for use in AOD services.