Sports nutrition knowledge, attitude, and practice questionnaire for Indian adolescent athletes—an exploratory sequential mixed-method study

Purpose To develop, validate and apply a context-specific nutrition knowledge, attitude and practice questionnaire (KAP-Q) among adolescent Indian athletes. Method This study used the mixed-method sequential exploratory design using qualitative and quantitative approaches on adolescent athletes ( n = 170). The formative phase consisted of in-depth interviews (IDIs) with coaches ( n = 10). The validation phase included testing of the internal consistency ( n = 80) and test–retest reliability ( n = 25), followed by the administration ( n = 65) of the KAP-Q on adolescent athletes. Internal consistency was determined using Cronbach’s α , reliability using Bland–Altman plots and intra-class correlation (ICC) coefficient and the KAP-Q responses using the Chi-square test. Results The themes and items (> 90%) for KAP-Q were developed from the qualitative phase and literature review. KAP-Q exhibited a Cronbach’s α of 0.700 after removing 29 items. The Bland–Altman plots showed good agreement, with an ICC greater than 0.75. Greater than 71% of items exhibited good scores in the discrimination index, with greater than 50% showing moderate difficulty. The test–retest reliability (I-CVI) was > 0.80. On administering the KAP-Q, the knowledge scores relating to macronutrients, meal timing and supplement usage for training were lower among athletes. However, they exhibited knowledge relating to micronutrients and hygiene practices, with poor attitude/practice scores. Psychological stressors also influenced their food intake. Conclusion The newly developed context-specific KAP-Q is suitable for the impact evaluation of nutrition education interventions. The methodology adopted in the study supports translation in other contexts.