Development and Scoring of a Diet Quality Screener for Hispanic/Latino Adults Using National Health and Nutrition Examination Survey Data: The SABE Lo Que Come? Tool

Background Few dietary screeners are available for use with Hispanic/Latino adults in clinical or research settings, despite this group having a disproportionate burden of diet-related chronic disease risk amenable to nutrition intervention and counseling. We previously developed the 36-item Penn Healthy Diet (PHD) screener, which correlates with the Healthy Eating Index (HEI), and adapted it culturally and linguistically for use among Hispanic/Latino adults as the Screener of Alimentary Behaviors and Eating (SABE). Objective We aimed to develop a scoring algorithm for the SABE screener using data from Hispanic/Latino adults in the National Health and Nutrition Examination Survey (NHANES). Methods We used NHANES 2017-2018 dietary recall data from 1,126 Hispanic/Latino adults to simulate responses to SABE screener items. Using Spearman rank correlations, we examined the association between simulated SABE items and HEI-2020 components and validation using the Alternative Healthy Eating Index (AHEI)-2010. Items achieving {rho} [≥] 0.3 with any HEI-2020 component were retained in a simple scoring algorithm. A regression-weighted algorithm was then derived using ordinary least squares regression of all screener items on HEI-2020 total score. Reproducibility was evaluated in an independent validation sample of 1,633 Hispanic/Latino adults from NHANES cycle 2015-2016. Results Twelve of 24 screener items were moderately or strongly associated with HEI-2020 components, forming a simple scoring algorithm with a range of 0-60 points. The simulated SABE score was strongly correlated with HEI-2020 ({rho} [≥] = 0.73-0.74) and moderately correlated with AHEI-2010 ({rho} [≥] = 0.64-0.67). The regression-weighted algorithm improved HEI-2020 correlations ({rho} [≥] = 0.80) but not for AHEI-2010 ({rho} [≥] = 0.62-0.65). Conclusions The SABE screener is a brief and feasible dietary screener with demonstrated strong validity and reproducibility for assessing diet quality in Hispanic/Latino adults. Further validation of this screener is needed in Hispanic/Latinos subgroups of diverse heritage and acculturation level, and in real-world populations.