Food literacy, food environments and monitoring and surveillance in public health

Thompson, C., Adams, J., & Vidgen, H.A



While many aspects of the food environment, such as affordability, accessibility and availability have been extensively explored and evaluated, there is still a limited understanding of the relationship between these aspects and consumer behaviours. Consumer behaviours consist of food acquisition, preparation, meal practices and storage; all elements encompassed within food literacy. The most frequently cited and agreed upon definition of food literacy, that of Vidgen & Gallegos (2014) is supported by a conceptual framework, consisting of 11 components of food literacy organised into four inter-related domains of planning and managing, selecting, preparing, and eating. Of the existing 66 measures assessing components of food literacy, none comprehensively assessed all domains and components, only one used cognitive interview methods with adults to determine items for inclusion and exclusion and all varied in their ability to capture totality of eating. Therefore, this study aimed to determine items for inclusion and exclusion in a food literacy item pool and capture the general public’s interpretation of everyday food literacy practices. A comprehensive food literacy questionnaire is needed to investigate its relationship to various food-related outcomes such as diet quality, nutrition behaviours, social connectedness and food security.


Beginning with an item pool from previous studies, cognitive interviews were conducted using think-aloud and verbal probing methods.  Data were first analysed for applicability, clarity, ambiguity, and logic, then for emergent themes to ensure items captured the totality of the participant’s eating. Australian residents over 18 years of age recruited via Facebook residential groups (n=20).


Of the original 116-items, 11 items had limited applicability; 13 items had unclear references; 32 items had lexical problems and 11 items had logical problems.  In total, 29 items were deleted, 31 retained and 56 revised.  Thematic analysis revealed participants limited their responses to consider only conventional practices such as grocery shopping, cooking and planned meals rather than the totality of their eating.  An additional 84 items were developed to address eating out, incidental eating occasions and inconsistencies between participants assumed correct knowledge and that of public health guidelines.  This resulted in a refined 171-item pool.


This study progressed the development toward a comprehensive, validated food literacy questionnaire that may provide further insight into the relationship between aspects of the food environment and people’s diets. Further, this study identified important elements of people’s interpretations of food and eating that should be considered when evaluating and monitoring in public health nutrition.


Thompson, C., Adams, J., & Vidgen, H.A. (2021, December 14-16). Food literacy, food environments and monitoring and surveillance in public health. In 2021 Global Food Governance Conference.


Dr Courtney Stewart (RNutr, FHEA)

BNutrSc, BBiomedSc(Hons), PhD
Director, NPR Consulting

Join our mailing list for monthly health and nutrition insights