{"paper_id":"99420599-8a5d-4660-9f4a-165bbdcdf136","body_text":"Validation of a sports nutrition knowledge questionnaire for track and field athletes | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Validation of a sports nutrition knowledge questionnaire for track and field athletes Ranil Jayawardena, Kalani Weerasinghe, Gina Trakman, Terrence Madhujith, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-3891666/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Proper validation of a newly developed sports nutrition knowledge questionnaire is crucial to ensure that health professionals and coaches can confidently assess athletes' nutrition knowledge, which is known to impact athletes' food choices. This study aims to validate the Athletic-Sports Nutrition Knowledge Questionnaire (A-SNKQ), specifically tailored for Sri Lankan track and field athletes. Methods Content validity was determined by translating the ratings of items by sports nutrition experts into a content validity index. Face validity was assessed via in-depth telephone interviews with elite track and field athletes, using a retrospective think-out-loud protocol. Three groups—doctors with post-graduate qualifications in human nutrition (NTG), banking professionals (NNTG), and elite or semi-elite track and field athletes (AG)—were engaged for the execution of construct validity. Cronbach's alpha was calculated to assess internal consistency, and the correlation coefficient between the two test attempts (test-retest reliability) was determined to evaluate reproducibility. Results The final tool comprised 123 individual items, formulated as 32 questions within 12 sub-sections. Content validity was confirmed by fully integrating 49 out of 70 comments received for each sub-section and partially integrating 4 comments. Face validity was established by fully integrating 33 comments out of the total (n = 40) received from 16 athletes. Construct validity was confirmed using the Kruskal-Wallis test, indicating significant differences in the total scores achieved as a percentage of the A-SNKQ among the NTG (462.5, 92.5%), NNTG (223.5, 44.7%), and AG (235, 47.0%; p < 0.001). Reproducibility was established by strong test-retest reliability between individuals' scores on two test attempts, three weeks apart (r = 0.98, p < 0.05). Internal reliability for each sub-section met psychometric reliability requirements (Cronbach's α > 0.7). Conclusion The A-SNKQ meets all psychometric measures, providing a new, valid, and reliable tool to assess general and sports nutrition knowledge among Sri Lankan track and field athletes. Sports nutrition knowledge track and field athlete questionnaire validation Sri Lanka Figures Figure 1 Introduction In the specific context of Sri Lanka, the assessment of Sports Nutrition Knowledge (SNK) among track and field athletes has led to the development of an evidence-based and culturally acceptable tool, A-SNKQ (Athletic-Sports Nutrition Knowledge Questionnaire), as described elsewhere [ 1 ]. Appropriate validation of this tool is critical if it is to be used by health staff and coaches to assess the SNK of athletes, which may ultimately influence athlete eating behaviour and subsequent sports performance. The validation of a newly developed questionnaire is of key importance, serving as a crucial step in ensuring its efficacy and applicability for the intended target population [ 2 ]. During the validation stage, the questionnaire can be further refined to a degree that minimizes potential statistical errors in the final outcome [ 3 ]. Content validity assesses a questionnaire's ability to comprehensively cover all relevant aspects of the concept being measured [ 4 ]. Face validity assesses how well the items in a questionnaire reflect the construct being measured at first glance [ 4 ]. Construct validity assesses whether the questionnaire scores align with predefined hypotheses (such as differences between relevant groups) when we assume the questionnaire accurately measures the intended construct [ 4 ]. The validation process of any questionnaire should take into account not only the accuracy of its content but also its relevance to the target population [ 5 ]. Concerning a sports nutrition knowledge questionnaire (SNKQ), content validity should specifically focus on evaluating evidence-based sports nutrition guidelines and cultural dietary practices. Conversely, the face validity of the SNKQ relies on two key factors: firstly, aspects linked to the questionnaire itself, such as clarity and readability, and secondly, the level of literacy and nutrition knowledge within the athletic population [ 6 ]. Construct validity reflects both the theoretical framework and the practical understanding of the subject matter by the target population [ 7 ]. In addition to validity, repeated measurements are essential to assess the reliability of any newly developed questionnaire [ 8 ]. The validity and reliability of the SNKQ for Turkish athletes were verified by administering it to participants (n = 24 athletes, n = 18 students) after a 2-week interval in 2021 [ 9 ]. The analysis of questionnaire reliability revealed a high internal consistency value (Kuder Richardson-20 = 0.927) and a robust test-retest reliability intraclass correlation coefficient (ICC = 0.974). The findings indicated a statistically significant difference in SNKQ total scores between athletes (36.0 ± 8.1) and Nutrition and Dietetics students (59.1 ± 5.98) (p < 0.001). Similarly, Trakman and colleagues [ 6 ] validated their Nutrition for Sport Knowledge Questionnaire (NSKQ) using a comprehensive methodology that integrated relevant techniques from classical test theory (CTT) and Item Response Theory (IRT), specifically Rasch analysis. The overall internal reliability of the questionnaire was found to be high (KR = 0.88), with most sub-sections achieving acceptable internal reliability. Test-retest reliability was confirmed with a strong correlation (r = 0.92, p < 0.001) between individuals' scores on two test attempts conducted 10 days to 2 weeks apart. The conclusion drawn was that the final version of the questionnaire represents a notable improvement over previous tools, as its validity and reliability have now been firmly established. Recognizing the demand for a psychometrically validated tool to measure nutrition knowledge that can be used as a benchmark to assess the general and sports nutrition knowledge of the sports population, this research aims to validate a previously developed SNKQ tailored for Sri Lankan track and field athletes. Methods Ethics approval and consent Ethical approval for the study was obtained from the Ethics Review Committee, Faculty of Medicine, University of Peradeniya, Sri Lanka (Ref No. 2023/EC/48), and all methods were performed in accordance with the Declaration of Helsinki. Informed written consent was obtained from each participant after giving them adequate time to ask questions and clarify doubts about the research. Five-step validation process of the tool After development, five steps were employed to establish validity and reliability based on an extensive review of the literature [ 4 ] and used in the present questionnaire. The steps included: I) Assessment of Content Validity, II) Assessment of Face Validity, III) Assessment of Construct Validity, IV) Assessment of Reproducibility and Internal Consistency, and V) Assessment of Questionnaire Duration (Fig. 1 ). I. Content Validity Upon the formulation of questionnaire items and determination of suitable response formats, invitations were sent to ten potential panelists consisting of experts in the field of nutrition. These experts possessed specialized training in human nutrition and experience working with athletes. All experts had a minimum of postgraduate qualifications in human nutrition and a few had sports nutrition qualifications. Those who agreed to participate underwent individualized telephonic conversation during which relevant materials had been shared via email. Accompanying the validation materials was an information sheet providing comprehensive instructions to guide the experts, including the most recent version of the questionnaire, with the correct response marked. Each expert was tasked with evaluating the questions within each subsection of the questionnaire and their assessment encompassed considerations of relevance, appropriateness, accuracy, and clarity. The evaluation employed a 4-point Likert scale, ranging from 1 ('Not relevant, Not appropriate, Not accurate, Not clear') to 4 ('Highly relevant, Very appropriate, Very accurate, Very clear'), with accompanying written comments for each sub-section [ 4 ]. The Content Validity Index (CVI) for each sub-section was calculated by dividing the cumulative score assigned to that sub-section by all raters, and then dividing by the total number of raters. Index scores exceeding 3.2/4.0 (≥ 0.8) were considered adequate for ratings related to relevance, accuracy, clarity, and appropriateness [ 10 ]. Sub-sections with a mean score below 3.2 were precisely reviewed, and the individual comments provided by experts were incorporated to modify each question qualitatively. Following these revisions, experts who had initially assigned lower scores (1 or 2 out of 4) were contacted and asked to review and provide new ratings on the revised questions. This iterative Delphi process was repeated multiple times until the mean scores for each sub-section reached ≥ 3.2 for the categories of relevance, appropriateness, accuracy, and clarity. II. Face Validity To evaluate face validity, feedback was solicited from a cohort of 15 elite or semi-elite athletes, who were recruited using the purposive sampling technique. A retrospective think-out-loud protocol was used. The athletes were provided with the questionnaire ahead of time, but its precise nature was not disclosed. Subsequently, they convened with the research team through an in-depth telephone interview. This interactive session aimed to address inquiries such as the purpose behind specific sections, the appropriateness of questions for evaluating the SNK of Sri Lankan athletes, and the relevance of sub-sections. Participants were also asked about their satisfaction with the clarity and formulation of the questions. In cases where dissatisfaction arose, alternate approaches to phrasing were explored. Additionally, participants were questioned about the comprehensibility of terms, the clarity of images, and whether any terms appeared unfamiliar. Further, the discussion addressed the potential confusion or misleading nature of any question. These sessions were audio recorded, allowing for the subsequent analysis of responses. Findings from this analysis facilitated the refinement of the questionnaire's terminology and wording, thereby enhancing the clarity of each question from the participant's perspective. III. Construct Validity To assess construct validity, a comparative analysis was undertaken by administering the questionnaire to three distinct groups. Doctors in the NTG (Nutrition-trained group), (n = 18), possessed at least a post-graduate qualification in human nutrition along with prior training in sports nutrition. In contrast, the NNTG (No nutrition-trained group), (n = 18), comprised banking professionals without prior sports nutrition knowledge, and the athletic group (AG) consisted of elite or semi-elite level track and field athletes of both genders (n = 18). IV. Reproducibility and internal consistency The questionnaire was administered online and repeated twice in a test-retest manner, with a three-week interval separating the administrations. This duration was carefully chosen, ensuring sufficient time for answers to fade from memory while minimizing the potential for substantial changes in nutrition knowledge [ 11 ]. The data from the initial collection phase served a dual purpose: assessing internal consistency and confirming construct validity. Both data sets, collected during different phases, were employed to evaluate the questionnaire's reliability over time. An identical set of the questionnaire was administered to an equivalent number (n = 18) of elite track and field athletes in each round. This methodology was employed to evaluate the effectiveness of the questionnaire in measuring the intended construct, specifically sports nutrition knowledge. To ensure precision, each of the five sub-sections underwent individual assessment for internal consistency, given that each sub-section pertained to a distinct area of knowledge. V. Questionnaire duration The revised version of the A-SNKQ was administered to a new cohort of participants. These participants conscientiously completed the questionnaire, noting the time taken for its completion, and providing insights into the duration of the questionnaire. Recruitment For content validity, a panel of experts (n = 10) was assembled through purposive sampling, possessing qualifications and expertise in human nutrition, dietetics, and sports nutrition (Step I). Face validity was established by recruiting elite or semi-elite track and field athletes through purposive sampling (n = 15) (Step II). To assess construct validity, participants voluntarily engaged with the research team through WhatsApp messages from Meta Platforms, Inc., forming three distinct groups, each with 18 members: NTG, NNTG, and AG (Step III). The A-SNKQ was then administered online to NTG, NNTG, and AG (the same population from Step III), twice with a three-week interval (Step IV). The AG in Step III assessed the questionnaire duration (Step V): Fig. 1 . Sample size calculation Content validity was assessed based on feedback from a panel of experts related to sports nutrition recruited via purposive sampling. Calculating a CVI requires the involvement of three to ten experts [ 10 ]. In the context of telephonic in-depth interviews to assess the face validity, the ideal number of participants falls within the range of six to ten individuals [ 12 ]. Based on the research team's experience, Sri Lankan athletes tend to express their opinions with restraint. To account for this, the recruitment strategy was adjusted by doubling the number, resulting in the inclusion of 15 elite or semi-elite athletes. To determine the appropriate sample size for assessing construct validity, a power analysis for an independent sample t-test was conducted using G-POWER [ 13 ]. This analysis considered an alpha level of 0.05, a power of 0.80, a substantial effect size (d = 0.8), and adopted a two-tailed approach. Based on the above-mentioned criteria, the recommended sample size for each group; NTG, NNTG and AG, was determined to be eighteen [ 14 ]. Statistical analysis A comparative analysis was conducted on three groups (NTG, NNTG, and AG) across five sub-sections (Macronutrients, Micronutrients, Energy balance, Hydration, and Pre-training meals). Each participant's performance was assessed based on the percentage of marks received in each sub-section. Non-parametric tests (Mann–Whitney U test; Kruskal-Wallis) were considered more suitable for comparing multiple independent groups [ 6 ] and were employed to evaluate overall differences among the groups due to the violation of normality assumptions. Post-hoc analyses were conducted using Mann-Whitney U tests with Bonferroni correction to identify specific group differences in the case of a significant overall effect. A Pearson's correlation was also conducted to examine the correlation across the results of 54 participants (NTG, NNTG) who undertook the questionnaire at two distinct time points. A significance level of p < 0.05 was adopted to interpret the outcomes. When assessing internal consistency or reliability, Cronbach’s alpha of each of the five sub-sections was evaluated separately, as each sub-section addressed a different area of knowledge. A minimum Cronbach alpha requirement of α > 0.7 was accepted to demonstrate sound internal consistency [ 3 ]. NVIVO v10.0 (QSR International, Southport, UK) was employed to conduct a directed content analysis on the qualitative data collected. Results The final questionnaire content, structure and scoring The previously developed A-SNKQ comprised 32 questions within 12 sub-sections, including 123 individual items [15]. The included questions had three options - 'agree,' 'disagree,' and 'unsure,' while others had five responses carrying the most accurate answer. A plus mark (+1) was awarded for correct answers, each item without any weightage, and a negative mark (-1) for wrong answers; zero marks (0) were given for an unsure response, based on author consensus [16]. This covered a general nutrition knowledge section containing 15 questions with sub-sections covering macronutrients (n = 4), micronutrients (n = 3), energy balance (n = 4), hydration (n = 3), and weight management (n = 1), and a sports nutrition knowledge section with 17 questions, under 17 sub-sections (Carbohydrate loading, Pre-training meals, Training meals, each contains 1 question, Post-training meals: n=2, Sports supplements: n=6, Supplement label reading, alcohol, isotonic drinks, and doping: n=4, Energy intake and food habits: n=2) [15]. This is an online version developed using Google Forms (platform: Google Forms, Google LLC, California, USA) [17] and made available in all three official languages of Sri Lanka: English, Sinhala, and Tamil, ensuring inclusivity for participants across different language backgrounds [15]. A comprehensive overview of the newly validated A-SNKQ is represented in Table 4. Findings of the five-step validation process of the tool I. Content validity Nine experts (5 males and 4 females, with a mean age of 43.7 years) participated in the content validity assessment, and their years of experience ranged from 3 to 20 years. The response rate was 90%. In the initial attempt, the experts affirmed that the sub-sections of the questionnaire were relevant and appropriate for assessing the SNK, thus confirming content validity. Table 1 provides the calculated CVI values, based on the experts' ratings for the relevance, appropriateness, accuracy, and clarity of each sub-section. Items that received low ratings for accuracy and clarity and did not meet the CVI values were subsequently modified in accordance with the comments and suggestions provided by the experts. Out of the total comments (n=70) received for each sub-section, 49 were fully integrated, 4 were partially addressed, and 17 were not incorporated into the questionnaire because they were considered irrelevant/not commensurate to be included in the questionnaire. The CVI values for each sub-section were recalculated based on their ratings from the second attempt. The values for accuracy, appropriateness, clarity, and relevance were 3.6, 3.8, 3.3, and 3.4, respectively (Table 2). Details of the comments provided for each sub-section and how expert feedback was integrated are included in supplementary Table 1. II. Face validity Sixteen elite and nine semi-elite athletes (11 males, and 5 females, with a mean age of 27.5 years) participated to assess face validity. All athletes successfully identified the underlying purpose of each questionnaire section. The majority (13 out of 16) concurred that the questions and sub-sections in the questionnaire were appropriate for evaluating the sports nutrition knowledge of Sri Lankan track and field athletes and that the questions and instructions were clear. Where concerns regarding question wording arose, their comments and suggestions were duly considered, thereby confirming face validity. Particularly, three athletes requested the inclusion of commonly used English terms alongside the local language to enhance comprehension and clarity (e.g., \"recovery,\" \"pre-workout\") (Supplementary Table 2). Furthermore, one athlete proposed dividing the questionnaire into several steps (e.g., 3-4 steps) to prevent the Google Form from becoming excessively lengthy. These comments were seamlessly integrated into the questionnaire. Out of the total comments (n=40) received for each sub-section, 33 comments were fully integrated. Further, seven comments were not incorporated into the questionnaire, as the experts found them inappropriate enough to be included in the questionnaire. Examples of changes made based on athletes' feedback and how they were integrated are included in supplementary table 2. III. Construct validity Tables 2 and 3 present construct validity and reliability statistics for the final set of questions. In the 1 st phase, all 36 participants from both the NT and NNT groups (100%) responded. For the re-test phase, the response rate was 100% for the NT group and 88% (16/18) for the NNT group. The Kruskal-Wallis test revealed significant differences in the performance of NT, NNT, and AG across all sub-sections (p < 0.05). In the Macronutrients sub-section, significant differences were found between NT and NNT (p = 0.027), NT and AG (p = 0.005), and NNT and AG (p = 0.012). Similar significant differences were observed in the Micronutrients (p < 0.05), Energy balance (p < 0.05), Hydration (p < 0.05), and Pre-training meals (p < 0.05) sub-sections. Total scores also exhibited significant differences among all pairs of groups (p < 0.001). On average, athletes scored higher than the NNTG and lower than the NTG across all sub-sections. The total correct response percentages were NTG: 92.5%, AG: 47.0%, and NNTG: 44.7% (Table 3). IV. Reliability A strong test-retest reliability was observed, as indicated in Table 3, with a correlation of 0.98 (p < 0.001) for the total score and correlation coefficients of 0.89 (p < 0.05) to 0.98 (p < 0.001) for individual sub-sections (Table 3). Participants provided identical responses to the same question 90.7% of the time. The NTG showed an identical response rate of 92.3%, while the NNTG exhibited a rate of 89.2%. The micronutrient sub-section had the highest number of identical responses in the NTG at 93.7%, whereas the energy balance sub-section achieved the highest identical response rate for the NNTG at 93.4%. The pre-training meals sub-section had the lowest number of identical responses, with rates of 90.4% and 86.2% for the nutrition and non-nutrition groups, respectively (Table 3). V. Questionnaire duration The average completion time of the final sports nutrition questionnaire for the athletes was 16.5 ± 4.4 min. Discussion The questionnaire The present study aimed to validate a previously developed SNKQ, which can serve as a practical tool for assessing nutrition knowledge among Sri Lankan track and field athletes. The newly validated tool, the Athletic-Sports Nutrition Knowledge Questionnaire (A-SNKQ), includes 97 individual items, consisting of 32 questions (some with multiple parts) across 12 distinct sub-sections. Completing the questionnaire takes about 16 minutes, a duration comparable to the Nutrition for Sport Knowledge Questionnaire (NSKQ) by Trakman et al. [ 6 ], which has 89 items, the Nutrition Knowledge Questionnaire for Athletes (NKQA) with 85 questions by Furber et al. [ 18 ], and the SNKQ developed by Zinn et al. [ 19 ], containing 88 items. To the best of our knowledge, this is one of the few SNKQs validated exclusively within the athletic population [ 20 ] in the global context. More importantly, this is the first SNKQ developed and validated in Sri Lanka. Validity and reliability The key finding of this study is the establishment of the psychometric properties of the A-SNKQ tool via comprehensive and structured validation and reliability assessments. This robust methodology confirmed the content, face, and construct validity, as well as the reliability and internal consistency of the tool. Therefore, health professionals and coaches can confidently use the A-SNKQ to assess athletes' nutrition knowledge. Recruiting sports nutrition experts plays a major role in obtaining essential feedback on the content validity section [ 21 ]. In developed countries, sports dietitians have been identified as discrete and well-developed professionals for the content validity assessment of SNKQs [ 4 , 19 ]. However, in Sri Lanka, sports nutrition advice is mainly provided by doctors who have training in the field of nutrition and experience with the sports population. In the current study, we recruited well-known clinicians, academics, and researchers related to nutrition and working with athletes. Hence, we believe that our expert panel is the best possible cohort to provide feedback on the content of the questionnaire in the Sri Lankan context. In some studies [ 22 ], sports nutrition experts working in the industries have also been recruited for the content validity assessment. However, in Sri Lanka, sports nutrition industries are not that developed, and most supplements and food products are imported. Therefore, it has to be acknowledged that the expert panel recruited for the content validity assessment of the current questionnaire did not include sports nutrition experts related to nutrition field industries, in contrast to previous tools. Furthermore, in most previously developed sports nutrition knowledge questionnaires [ 18 , 19 ], content validity has been assessed qualitatively by incorporating experts' comments and suggestions into the questionnaire. But, being consistent with the methodology followed by Trakman et al. [ 4 ] Tam et al. [ 23 ], Karla et al. [ 24 ], and Scrivin et al. [ 25 ] in the content validity assessment, in the current study, content validity was assessed quantitatively using a CVI. This robust revision of the content of the questionnaire by adhering to the individual comments of each expert should have improved the clarity and accuracy of the questionnaire. When evaluating face validity, it is important to note that the majority of studies in this area have involved college-level athletes. Even though the studies aimed to have a diverse sample, including both genders and individuals at elite and semi-elite levels, only 13 out of 16 participants provided substantial feedback to improve the questionnaire items. This contrasts with similar studies conducted by Trakman et al., [ 4 ], Furber et al., [ 18 ], Tam et al., [ 23 ], Karla et al., [ 24 ], and Scrivin et al., [ 25 ] where athletes played a significant role in making the questionnaire clearer, more applicable, and easier to read. This discrepancy could be linked to the educational background of Sri Lankan athletes. They may have received lower levels of education and have affiliations with the Sri Lankan forces, distinguishing them from athletes in more developed nations. Additionally, the athletic population in a developing country may not be as inclined to offer diverse opinions due to a less supportive educational environment. This is reflected in the observation that only four out of the 16 participants in our face validity assessment, who had a relatively stronger educational background, provided meaningful comments to improve the clarity of the questionnaire. In contrast, Trakman et al., [ 4 ] engaged student-athletes who were college graduates in their study in assessing face validity, and this demographic played a crucial role in refining their developed and validated questionnaire. In evaluating construct validity and reliability, most studies have enlisted a cohort comprising individuals with and without nutritional qualifications. These investigations typically employ two divergent groups to scrutinize this facet of the assessment tool. Conversely, some studies have opted for a more homogeneous subject population. Following recruitment, a nutrition education intervention is exclusively administered to one group, allowing for the longitudinal evaluation of construct validity and test-retest reliability. In our approach, we adhered to the former method, selecting a sample of doctors possessing a minimum post-graduate qualification in human nutrition and some prior sports nutrition training for the NT group. In contrast, a disparate set of professionals from the banking sector constituted the NNT group. Upon analysis of the results of construct validity and test-retest reliability, it is noteworthy that both the NTG and NNTG scored highly in GNK sub-sections such as Macro-nutrients and Hydration. However, in the case of SNK sub-sections, specifically pre-training meals, the NTG exhibited a significantly higher percentage of correct responses compared to the NNTG. This disparity was more pronounced than in the GNK sub-sections. This outcome underscores the robust construct validity and reliability of the current assessment tool, indicating its effectiveness for discerning individuals with substantial human nutrition qualifications and experience in sports nutrition training with athletes. Additionally, a subsequent step was taken wherein the A-SNKQ tool was administered to a sample of track and field athletes. Their scores, expressed as percentages, were then compared with those of the NTG and NNTG. The findings from this phase revealed that, on average, athletes scored higher than the NNTG and lower than the NTG across all sub-sections. This serves to further confirm the construct validity of the tool, proving its efficacy in distinguishing between individuals with varying levels of nutrition knowledge, particularly within the context of athletic nutrition. A key strength of the present study lies in the comprehensive and structured validation procedure employed for validating the newly developed A-SNKQ, utilizing the modified Delphi process. Additionally, this tool has confirmed content, face, and construct validities, along with demonstrating adequate reliability and strong reproducibility. Moreover, the administration of this questionnaire is facilitated by its online format, enhancing accessibility for athletes through their smart devices. This approach aligns with the integration of novel technology, making the questionnaire more user-friendly and feasible for widespread use. However, this method of validation has a few limitations. We did not consider all the items in the questionnaire due to the complexity and difficulty of comparing between the three cohorts: NT, NNT, and AG. Therefore, future studies should be planned in a way that the validation procedure covers all sub-sections of the SNKQ. Additionally, interventions should be designed and administered to the athletic population based on the SNK assessed by properly developed and well-validated tools like this one. This approach may provide insights into improving SNK and, consequently, enhancing sports performance and overall well-being. Conclusions Following the development of the A-SNKQ, five steps were employed to establish validity and reliability. Content validity was confirmed by integrating comments and suggestions from a panel of sports nutrition experts received for each sub-section. Face validity was established by feedback from elite or semi-elite athletes. Construct validity was confirmed by administering the tool to two distinct groups: NTG, NNTG, and AG using a comparative analysis. Internal reliability was established by administering the tool to the NTG and NNTG twice in a test-retest manner, with a three-week interval separating the administrations. The A-SNKQ meets all psychometric measures, providing a new, valid, and reliable tool to assess general and sports nutrition knowledge among Sri Lankan track and field athletes. Widespread utilization of the tool in the long term will allow for a more accurate evaluation of SNK, and sports nutrition interventions for sports personals enhancing their overall sporting performance outcomes. Abbreviations A-SNKQ: Athletic Sports Nutrition Knowledge Questionnaire; GNK: General Nutrition Knowledge; MCQs: Multiple Choice Questions; SNK: Sports Nutrition Knowledge; SNKQ: Sports Nutrition Knowledge Questionnaire. Declarations Acknowledgments We express our gratitude to all the authors who granted permission to adopt the questions from their previous questionnaire tools, as well as to all the other contributors who contributed to the improvement of the study. Funding No funding was received for conducting this study. Conflicts of interest The authors declare no competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. Consent for publication Not applicable Availability of data and materials The datasets used in the current study are available in supplementary Table 1 and Table 2. Ethical approval and consent to participate The qualitative study used in the multi-modal approach during the development of the questionnaire was conducted in accordance with the standards set by the Declaration of Helsinki. Ethical approval was obtained from the Ethics Review Committee of the Faculty of Medicine, University of Peradeniya, Sri Lanka, prior to conducting the study (Ref No. 2022/EC/66). All participants provided written informed consent to participate in the study. Authors' contribution RJ conceived and designed the study. RJ, GT, and KW participated in the finalization of the questionnaire. RJ, KW, and GT contributed to drafting the manuscript. NSK, TM, and APH, as supervisory team members participated in the revision of the paper. All authors provided valuable feedback on the manuscript. Additionally, all authors carefully reviewed and approved the final version of the manuscript. References Jayawardena R, Weerasinghe K, Trakman G, Madhujith T, Hills A, Kalupahana N. Development of a sports nutrition knowledge questionnaire for Sri Lankan athletes2023. Tsang S, Royse CF, Terkawi AS. Guidelines for developing, translating, and validating a questionnaire in perioperative and pain medicine. Saudi J Anaesth. 2017;11(Suppl 1):S80-s9. Aithal A, Aithal P. Development and validation of survey questionnaire & experimental data–a systematical review-based statistical approach. International Journal of Management, Technology, and Social Sciences (IJMTS). 2020;5(2):233-51. Trakman GL, Forsyth A, Hoye R, Belski R. Developing and validating a nutrition knowledge questionnaire: key methods and considerations. Public Health Nutr. 2017;20(15):2670-9. Boateng GO, Neilands TB, Frongillo EA, Melgar-Quiñonez HR, Young SL. Best Practices for Developing and Validating Scales for Health, Social, and Behavioral Research: A Primer. Front Public Health. 2018;6:149. Trakman GL, Forsyth A, Hoye R, Belski R. The nutrition for sport knowledge questionnaire (NSKQ): development and validation using classical test theory and Rasch analysis. J Int Soc Sports Nutr. 2017;14:26. Clark LA, Watson D. Constructing validity: New developments in creating objective measuring instruments. Psychol Assess. 2019;31(12):1412-27. Busschaert C, De Bourdeaudhuij I, Van Holle V, Chastin SFM, Cardon G, De Cocker K. Reliability and validity of three questionnaires measuring context-specific sedentary behaviour and associated correlates in adolescents, adults and older adults. International Journal of Behavioral Nutrition and Physical Activity. 2015;12(1):117. OZENER B, KARABULUT E, Kocahan T, BILGIC P. Validity and reliability of the Sports Nutrition Knowledge Questionnaire for the Turkish athletes. Marmara Medical Journal. 2021;34(1):45-50. Polit DF, Beck CT, Owen SV. Is the CVI an acceptable indicator of content validity? Appraisal and recommendations. Res Nurs Health. 2007;30(4):459-67. Cappelleri JC, Jason Lundy J, Hays RD. Overview of classical test theory and item response theory for the quantitative assessment of items in developing patient-reported outcomes measures. Clin Ther. 2014;36(5):648-62. Poliandri D, Perazzolo M, Pillera GC, Giampietro L. Dematerialized participation challenges: Methods and practices for online focus groups. Front Sociol. 2023;8:1145264. Kang H. Sample size determination and power analysis using the G*Power software. J Educ Eval Health Prof. 2021;18:17. Faul F, Erdfelder E, Lang AG, Buchner A. G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007;39(2):175-91. Hasson F, Keeney S, McKenna H. Research guidelines for the Delphi survey technique. J Adv Nurs. 2000;32(4):1008-15. Pallant J. Scale development, Rasch analysis and item response theory. Melbourne Australian Consortium for Social & Political Research Inc. 2016. LLC G. Google Forms California, USA[cited 2024 Jan 16] [Available from: Available from: https://policies.google.com/terms?hl=en-US. Furber MJW, Roberts JD, Roberts MG. A valid and reliable nutrition knowledge questionnaire for track and field athletes. BMC Nutr. 2017;3:36. Zinn C, Schofield G, Wall C. Development of a psychometrically valid and reliable sports nutrition knowledge questionnaire. J Sci Med Sport. 2005;8(3):346-51. Edmonds C, Tam R, Madigan S, Gubb L, Beck KL, Gifford JA, et al. Validation of a sports nutrition knowledge questionnaire for athletes in the United Kingdom and Ireland. J Nutr Sci. 2023;12:e2. MacKenzie SB, Podsakoff PM, Podsakoff NP. Construct measurement and validation procedures in MIS and behavioral research: Integrating new and existing techniques. MIS quarterly. 2011:293-334. Capling L, Gifford JA, Beck KL, Flood VM, Slater GJ, Denyer GS, et al. Development of an Athlete Diet Index for Rapid Dietary Assessment of Athletes. Int J Sport Nutr Exerc Metab. 2019;29(6):643-50. Tam R, Beck K, Scanlan JN, Hamilton T, Prvan T, Flood V, et al. The Platform to Evaluate Athlete Knowledge of Sports Nutrition Questionnaire: a reliable and valid electronic sports nutrition knowledge questionnaire for athletes. Br J Nutr. 2021;126(4):561-71. Vázquez-Espino K, Fernández-Tena C, Lizarraga-Dallo MA, Farran-Codina A. Development and Validation of a Short Sport Nutrition Knowledge Questionnaire for Athletes. Nutrients. 2020;12(11). Scrivin R, Costa RJ, Pelly F, Lis D, Slater G. Development and validation of a questionnaire investigating endurance athletes practices to manage gastrointestinal symptoms around exercise. Nutr Diet. 2021;78(3):286-95. Tables Table 1: CVI values Sub-section (number of questions) 1 st attempt 2 nd attempt Accuracy V 1 Appropriateness V 1 Clarity V 1 Relevance V 1 Accuracy V 2 Clarity V 2 Macronutrients (n=27) 3.4 3.6 3.3 3.7 3.4 3.3 Micronutrients (n=7) 3.2 3.7 3.4 3.8 3.2 3.4 Energy balance (n=9) 3.4 3.6 3.3 3.7 3.4 3.3 Hydration (n=11) 3.2 3.7 3.6 3.8 3.2 3.6 Weight management (n=1) 3.2 3.2 2.7 3.6 3.2 3.2 Carbohydrate loading (n=1) 3.2 3.8 3.6 3.8 3.2 3.6 Pre-training meals (n=4) 3.6 3.8 3.9 4.0 3.6 3.9 Training meals (n=4) 2.2 3.4 3.3 4.0 3.3 3.3 Post-training meals (n=15) 2.6 3.6 3.3 3.5 3.4 3.3 Sports supplements (n=6) 2.7 3.2 3.2 3.8 3.6 3.2 Supplement label reading, alcohol, isotonic drink, and doping (n=10) 3.2 3.8 3.4 4.0 3.2 3.4 Energy intake and food habits (n=2) 3.3 3.6 3.4 3.8 3.3 3.4 Total (n=97) 3.0 3.6 3.3 3.8 3.3 3.4 CVI: Content validity index, V 1 : Version 1, V 2 : Version 2 Table 2 Total scores achieved as a percentage on the A-SNKQ by the NT, NNT and AG Sub-section (n) Marks of NTG (%) Marks of NNTG (%) Marks of AG (%) NTG vs. NNTG p value NNTG vs. AG p value NTG vs. AG p value 1. Macronutrients (n=20) 92.5 56.3 60.5 p =0.027 p =0.005 p =0.012 2. Micronutrients (n=5) 91.1 38.2 45.8 p =0.016 p =0.005 p =0.003 3. Energy balance (n=6) 90.7 16.6 25.0 p =0.016 p =0.007 p =0.002 4. Hydration (n=5) 92.2 61.1 73.4 p =0.004 p =0.023 p =0.031 5. Pre-training meals (n=4) 97.2 20.8 30.6 p =0.012 p =0.005 p =0.020 Total (n=40) 462.5 (92.5%) 223.5 (44.7%) 235 (47.0%) p < 0.001 p < 0.001 p < 0.001 NTG: Nutrition-trained group, NNTG: No nutrition-trained group, AG: Athletic Group. Table 3: Internal reliability, test-retest reliability, and identical response rates of the A-SNKQ across two data collection periods separated by a 3-week interval Sub-section (n) Internal reliability a (α) Test-retest correlation b (r) Identical responses from both tests (all participants) (%) Identical responses from both tests (NTG) (%) Identical responses from both tests (NNTG) (%) 1.Macronutrients (n=20) 0.85 0.89 90.6 92.1 89.2 2.Micronutrients (n=5) 0.85 0.98 91.8 93.7 90.0 3.Energy balance (n=6) 0.78 0.98 93.3 93.3 93.4 4.Hydration (n=5) 0.84 0.90 89.7 92.2 87.2 5.Pre-training meals (n=4) 0.77 0.97 88.3 90.4 86.2 Total (n=40) NA 0.98 90.7 92.3 89.2 A-SNKQ: Athletic-Sports Nutrition Knowledge Questionnaire, NTG: Nutrition-trained group, NNTG: No nutrition-trained group, NA: Not applicable a Chronbach’s alpha ( α ) b Pearson’s correlation is significant (r) at p < 0.05 Table 4 Summary of the newly validated A-SNKQ Section Sub-sections Questions (n) Items (n) Question format GNK Macronutrients 04 27 SBRQs Micronutrients 03 08 SBRQs Energy balance 04 09 SBRQs Hydration 03 11 SBRQs Weight management 01 01 SBRQs SNK Carbohydrate loading 01 01 SBRQs Pre-training meals 01 04 SBRQs Training meals 01 06 MCQs Post-training meals 02 11 MCQs, SBRQs Sports supplements 06 25 SBRQs Supplement label reading, alcohol, isotonic drink, and doping 04 18 SBRQs Energy intake and food habits 02 02 SBRQs Total 12 32 123 NA GNK= General nutrition knowledge, MCQs= Multiple-choice questions, SBRQs= Single-best response questions, SNK= Sports nutrition knowledge. 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1\",\"display\":\"\",\"copyAsset\":false,\"role\":\"figure\",\"size\":111161,\"visible\":true,\"origin\":\"\",\"legend\":\"\\u003cp\\u003e\\u003cstrong\\u003eFlow chart of 5-step validation and assessment of the reliability of the A-SNKQ\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eAG: Athletic Group, A-SNKQ: Athletic-Sports Nutrition Knowledge Questionnaire, CVI: Content Validity Index, NNTG: No Nutrition-Trained Group, NTG: Nutrition-Trained Group.\\u003c/p\\u003e\",\"description\":\"\",\"filename\":\"1.jpg\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-3891666/v1/66820b5f11edd73e550fc017.jpg\"},{\"id\":52672806,\"identity\":\"b237d40e-2a22-4e89-ade5-a2806b63df10\",\"added_by\":\"auto\",\"created_at\":\"2024-03-14 10:32:37\",\"extension\":\"pdf\",\"order_by\":0,\"title\":\"\",\"display\":\"\",\"copyAsset\":false,\"role\":\"manuscript-pdf\",\"size\":546187,\"visible\":true,\"origin\":\"\",\"legend\":\"\",\"description\":\"\",\"filename\":\"manuscript.pdf\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-3891666/v1/2572726c-725f-4cf7-b121-2090a298a539.pdf\"},{\"id\":50183709,\"identity\":\"a02a3911-83e0-4c45-ba7d-f58e6359f403\",\"added_by\":\"auto\",\"created_at\":\"2024-01-25 19:31:48\",\"extension\":\"docx\",\"order_by\":1,\"title\":\"\",\"display\":\"\",\"copyAsset\":false,\"role\":\"supplement\",\"size\":50802,\"visible\":true,\"origin\":\"\",\"legend\":\"\",\"description\":\"\",\"filename\":\"SupplymentrayTabledocx.docx\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-3891666/v1/50dfdf8651538498ecda4465.docx\"}],\"financialInterests\":\"No competing interests reported.\",\"formattedTitle\":\"Validation of a sports nutrition knowledge questionnaire for track and field athletes\",\"fulltext\":[{\"header\":\"Introduction\",\"content\":\"\\u003cp\\u003eIn the specific context of Sri Lanka, the assessment of Sports Nutrition Knowledge (SNK) among track and field athletes has led to the development of an evidence-based and culturally acceptable tool, A-SNKQ (Athletic-Sports Nutrition Knowledge Questionnaire), as described elsewhere [\\u003cspan citationid=\\\"CR1\\\" class=\\\"CitationRef\\\"\\u003e1\\u003c/span\\u003e]. Appropriate validation of this tool is critical if it is to be used by health staff and coaches to assess the SNK of athletes, which may ultimately influence athlete eating behaviour and subsequent sports performance.\\u003c/p\\u003e \\u003cp\\u003eThe validation of a newly developed questionnaire is of key importance, serving as a crucial step in ensuring its efficacy and applicability for the intended target population [\\u003cspan citationid=\\\"CR2\\\" class=\\\"CitationRef\\\"\\u003e2\\u003c/span\\u003e]. During the validation stage, the questionnaire can be further refined to a degree that minimizes potential statistical errors in the final outcome [\\u003cspan citationid=\\\"CR3\\\" class=\\\"CitationRef\\\"\\u003e3\\u003c/span\\u003e].\\u003c/p\\u003e \\u003cp\\u003eContent validity assesses a questionnaire's ability to comprehensively cover all relevant aspects of the concept being measured [\\u003cspan citationid=\\\"CR4\\\" class=\\\"CitationRef\\\"\\u003e4\\u003c/span\\u003e]. Face validity assesses how well the items in a questionnaire reflect the construct being measured at first glance [\\u003cspan citationid=\\\"CR4\\\" class=\\\"CitationRef\\\"\\u003e4\\u003c/span\\u003e]. Construct validity assesses whether the questionnaire scores align with predefined hypotheses (such as differences between relevant groups) when we assume the questionnaire accurately measures the intended construct [\\u003cspan citationid=\\\"CR4\\\" class=\\\"CitationRef\\\"\\u003e4\\u003c/span\\u003e].\\u003c/p\\u003e \\u003cp\\u003eThe validation process of any questionnaire should take into account not only the accuracy of its content but also its relevance to the target population [\\u003cspan citationid=\\\"CR5\\\" class=\\\"CitationRef\\\"\\u003e5\\u003c/span\\u003e]. Concerning a sports nutrition knowledge questionnaire (SNKQ), content validity should specifically focus on evaluating evidence-based sports nutrition guidelines and cultural dietary practices. Conversely, the face validity of the SNKQ relies on two key factors: firstly, aspects linked to the questionnaire itself, such as clarity and readability, and secondly, the level of literacy and nutrition knowledge within the athletic population [\\u003cspan citationid=\\\"CR6\\\" class=\\\"CitationRef\\\"\\u003e6\\u003c/span\\u003e]. Construct validity reflects both the theoretical framework and the practical understanding of the subject matter by the target population [\\u003cspan citationid=\\\"CR7\\\" class=\\\"CitationRef\\\"\\u003e7\\u003c/span\\u003e].\\u003c/p\\u003e \\u003cp\\u003eIn addition to validity, repeated measurements are essential to assess the reliability of any newly developed questionnaire [\\u003cspan citationid=\\\"CR8\\\" class=\\\"CitationRef\\\"\\u003e8\\u003c/span\\u003e]. The validity and reliability of the SNKQ for Turkish athletes were verified by administering it to participants (n\\u0026thinsp;=\\u0026thinsp;24 athletes, n\\u0026thinsp;=\\u0026thinsp;18 students) after a 2-week interval in 2021 [\\u003cspan citationid=\\\"CR9\\\" class=\\\"CitationRef\\\"\\u003e9\\u003c/span\\u003e]. The analysis of questionnaire reliability revealed a high internal consistency value (Kuder Richardson-20\\u0026thinsp;=\\u0026thinsp;0.927) and a robust test-retest reliability intraclass correlation coefficient (ICC\\u0026thinsp;=\\u0026thinsp;0.974). The findings indicated a statistically significant difference in SNKQ total scores between athletes (36.0\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;8.1) and Nutrition and Dietetics students (59.1\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;5.98) (p\\u0026thinsp;\\u0026lt;\\u0026thinsp;0.001). Similarly, Trakman and colleagues [\\u003cspan citationid=\\\"CR6\\\" class=\\\"CitationRef\\\"\\u003e6\\u003c/span\\u003e] validated their Nutrition for Sport Knowledge Questionnaire (NSKQ) using a comprehensive methodology that integrated relevant techniques from classical test theory (CTT) and Item Response Theory (IRT), specifically Rasch analysis. The overall internal reliability of the questionnaire was found to be high (KR\\u0026thinsp;=\\u0026thinsp;0.88), with most sub-sections achieving acceptable internal reliability. Test-retest reliability was confirmed with a strong correlation (r\\u0026thinsp;=\\u0026thinsp;0.92, p\\u0026thinsp;\\u0026lt;\\u0026thinsp;0.001) between individuals' scores on two test attempts conducted 10 days to 2 weeks apart. The conclusion drawn was that the final version of the questionnaire represents a notable improvement over previous tools, as its validity and reliability have now been firmly established.\\u003c/p\\u003e \\u003cp\\u003eRecognizing the demand for a psychometrically validated tool to measure nutrition knowledge that can be used as a benchmark to assess the general and sports nutrition knowledge of the sports population, this research aims to validate a previously developed SNKQ tailored for Sri Lankan track and field athletes.\\u003c/p\\u003e\"},{\"header\":\"Methods\",\"content\":\"\\u003cdiv id=\\\"Sec3\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003eEthics approval and consent\\u003c/h2\\u003e \\u003cp\\u003e \\u003cstrong\\u003eEthical approval\\u003c/strong\\u003e \\u003cp\\u003e for the study was obtained from the Ethics Review Committee, Faculty of Medicine, University of Peradeniya, Sri Lanka (Ref No. 2023/EC/48), and all methods were performed in accordance with the Declaration of Helsinki. Informed written consent was obtained from each participant after giving them adequate time to ask questions and clarify doubts about the research.\\u003c/p\\u003e \\u003c/p\\u003e \\u003c/div\\u003e \\u003cdiv id=\\\"Sec4\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003eFive-step validation process of the tool\\u003c/h2\\u003e \\u003cp\\u003eAfter development, five steps were employed to establish validity and reliability based on an extensive review of the literature [\\u003cspan citationid=\\\"CR4\\\" class=\\\"CitationRef\\\"\\u003e4\\u003c/span\\u003e] and used in the present questionnaire. The steps included: I) Assessment of Content Validity, II) Assessment of Face Validity, III) Assessment of Construct Validity, IV) Assessment of Reproducibility and Internal Consistency, and V) Assessment of Questionnaire Duration (Fig.\\u0026nbsp;\\u003cspan refid=\\\"Fig1\\\" class=\\\"InternalRef\\\"\\u003e1\\u003c/span\\u003e).\\u003c/p\\u003e \\u003cp\\u003e \\u003c/p\\u003e \\u003c/div\\u003e \\u003cdiv id=\\\"Sec5\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003eI. Content Validity\\u003c/h2\\u003e \\u003cp\\u003eUpon the formulation of questionnaire items and determination of suitable response formats, invitations were sent to ten potential panelists consisting of experts in the field of nutrition. These experts possessed specialized training in human nutrition and experience working with athletes. All experts had a minimum of postgraduate qualifications in human nutrition and a few had sports nutrition qualifications. Those who agreed to participate underwent individualized telephonic conversation during which relevant materials had been shared via email.\\u003c/p\\u003e \\u003cp\\u003eAccompanying the validation materials was an information sheet providing comprehensive instructions to guide the experts, including the most recent version of the questionnaire, with the correct response marked. Each expert was tasked with evaluating the questions within each subsection of the questionnaire and their assessment encompassed considerations of relevance, appropriateness, accuracy, and clarity. The evaluation employed a 4-point Likert scale, ranging from 1 ('Not relevant, Not appropriate, Not accurate, Not clear') to 4 ('Highly relevant, Very appropriate, Very accurate, Very clear'), with accompanying written comments for each sub-section [\\u003cspan citationid=\\\"CR4\\\" class=\\\"CitationRef\\\"\\u003e4\\u003c/span\\u003e].\\u003c/p\\u003e \\u003cp\\u003eThe Content Validity Index (CVI) for each sub-section was calculated by dividing the cumulative score assigned to that sub-section by all raters, and then dividing by the total number of raters. Index scores exceeding 3.2/4.0 (\\u0026ge;\\u0026thinsp;0.8) were considered adequate for ratings related to relevance, accuracy, clarity, and appropriateness [\\u003cspan citationid=\\\"CR10\\\" class=\\\"CitationRef\\\"\\u003e10\\u003c/span\\u003e]. Sub-sections with a mean score below 3.2 were precisely reviewed, and the individual comments provided by experts were incorporated to modify each question qualitatively. Following these revisions, experts who had initially assigned lower scores (1 or 2 out of 4) were contacted and asked to review and provide new ratings on the revised questions. This iterative Delphi process was repeated multiple times until the mean scores for each sub-section reached\\u0026thinsp;\\u0026ge;\\u0026thinsp;3.2 for the categories of relevance, appropriateness, accuracy, and clarity.\\u003c/p\\u003e \\u003c/div\\u003e \\u003cdiv id=\\\"Sec6\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003eII. Face Validity\\u003c/h2\\u003e \\u003cp\\u003eTo evaluate face validity, feedback was solicited from a cohort of 15 elite or semi-elite athletes, who were recruited using the purposive sampling technique. A retrospective think-out-loud protocol was used. The athletes were provided with the questionnaire ahead of time, but its precise nature was not disclosed. Subsequently, they convened with the research team through an in-depth telephone interview. This interactive session aimed to address inquiries such as the purpose behind specific sections, the appropriateness of questions for evaluating the SNK of Sri Lankan athletes, and the relevance of sub-sections. Participants were also asked about their satisfaction with the clarity and formulation of the questions. In cases where dissatisfaction arose, alternate approaches to phrasing were explored. Additionally, participants were questioned about the comprehensibility of terms, the clarity of images, and whether any terms appeared unfamiliar. Further, the discussion addressed the potential confusion or misleading nature of any question.\\u003c/p\\u003e \\u003cp\\u003eThese sessions were audio recorded, allowing for the subsequent analysis of responses. Findings from this analysis facilitated the refinement of the questionnaire's terminology and wording, thereby enhancing the clarity of each question from the participant's perspective.\\u003c/p\\u003e \\u003c/div\\u003e \\u003cdiv id=\\\"Sec7\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003eIII. Construct Validity\\u003c/h2\\u003e \\u003cp\\u003eTo assess construct validity, a comparative analysis was undertaken by administering the questionnaire to three distinct groups. Doctors in the NTG (Nutrition-trained group), (n\\u0026thinsp;=\\u0026thinsp;18), possessed at least a post-graduate qualification in human nutrition along with prior training in sports nutrition. In contrast, the NNTG (No nutrition-trained group), (n\\u0026thinsp;=\\u0026thinsp;18), comprised banking professionals without prior sports nutrition knowledge, and the athletic group (AG) consisted of elite or semi-elite level track and field athletes of both genders (n\\u0026thinsp;=\\u0026thinsp;18).\\u003c/p\\u003e \\u003c/div\\u003e \\u003cdiv id=\\\"Sec8\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003eIV. Reproducibility and internal consistency\\u003c/h2\\u003e \\u003cp\\u003eThe questionnaire was administered online and repeated twice in a test-retest manner, with a three-week interval separating the administrations. This duration was carefully chosen, ensuring sufficient time for answers to fade from memory while minimizing the potential for substantial changes in nutrition knowledge [\\u003cspan citationid=\\\"CR11\\\" class=\\\"CitationRef\\\"\\u003e11\\u003c/span\\u003e].\\u003c/p\\u003e \\u003cp\\u003eThe data from the initial collection phase served a dual purpose: assessing internal consistency and confirming construct validity. Both data sets, collected during different phases, were employed to evaluate the questionnaire's reliability over time.\\u003c/p\\u003e \\u003cp\\u003eAn identical set of the questionnaire was administered to an equivalent number (n\\u0026thinsp;=\\u0026thinsp;18) of elite track and field athletes in each round. This methodology was employed to evaluate the effectiveness of the questionnaire in measuring the intended construct, specifically sports nutrition knowledge.\\u003c/p\\u003e \\u003cp\\u003eTo ensure precision, each of the five sub-sections underwent individual assessment for internal consistency, given that each sub-section pertained to a distinct area of knowledge.\\u003c/p\\u003e \\u003c/div\\u003e \\u003cdiv id=\\\"Sec9\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003eV. Questionnaire duration\\u003c/h2\\u003e \\u003cp\\u003eThe revised version of the A-SNKQ was administered to a new cohort of participants. These participants conscientiously completed the questionnaire, noting the time taken for its completion, and providing insights into the duration of the questionnaire.\\u003c/p\\u003e \\u003c/div\\u003e \\u003cdiv id=\\\"Sec10\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003eRecruitment\\u003c/h2\\u003e \\u003cp\\u003eFor content validity, a panel of experts (n\\u0026thinsp;=\\u0026thinsp;10) was assembled through purposive sampling, possessing qualifications and expertise in human nutrition, dietetics, and sports nutrition (Step I). Face validity was established by recruiting elite or semi-elite track and field athletes through purposive sampling (n\\u0026thinsp;=\\u0026thinsp;15) (Step II). To assess construct validity, participants voluntarily engaged with the research team through WhatsApp messages from Meta Platforms, Inc., forming three distinct groups, each with 18 members: NTG, NNTG, and AG (Step III). The A-SNKQ was then administered online to NTG, NNTG, and AG (the same population from Step III), twice with a three-week interval (Step IV). The AG in Step III assessed the questionnaire duration (Step V): Fig.\\u0026nbsp;\\u003cspan refid=\\\"Fig1\\\" class=\\\"InternalRef\\\"\\u003e1\\u003c/span\\u003e.\\u003c/p\\u003e \\u003c/div\\u003e \\u003cdiv id=\\\"Sec11\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003eSample size calculation\\u003c/h2\\u003e \\u003cp\\u003eContent validity was assessed based on feedback from a panel of experts related to sports nutrition recruited via purposive sampling. Calculating a CVI requires the involvement of three to ten experts [\\u003cspan citationid=\\\"CR10\\\" class=\\\"CitationRef\\\"\\u003e10\\u003c/span\\u003e]. In the context of telephonic in-depth interviews to assess the face validity, the ideal number of participants falls within the range of six to ten individuals [\\u003cspan citationid=\\\"CR12\\\" class=\\\"CitationRef\\\"\\u003e12\\u003c/span\\u003e]. Based on the research team's experience, Sri Lankan athletes tend to express their opinions with restraint. To account for this, the recruitment strategy was adjusted by doubling the number, resulting in the inclusion of 15 elite or semi-elite athletes. To determine the appropriate sample size for assessing construct validity, a power analysis for an independent sample t-test was conducted using G-POWER [\\u003cspan citationid=\\\"CR13\\\" class=\\\"CitationRef\\\"\\u003e13\\u003c/span\\u003e]. This analysis considered an alpha level of 0.05, a power of 0.80, a substantial effect size (d\\u0026thinsp;=\\u0026thinsp;0.8), and adopted a two-tailed approach. Based on the above-mentioned criteria, the recommended sample size for each group; NTG, NNTG and AG, was determined to be eighteen [\\u003cspan citationid=\\\"CR14\\\" class=\\\"CitationRef\\\"\\u003e14\\u003c/span\\u003e].\\u003c/p\\u003e \\u003c/div\\u003e \\u003cdiv id=\\\"Sec12\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003eStatistical analysis\\u003c/h2\\u003e \\u003cp\\u003eA comparative analysis was conducted on three groups (NTG, NNTG, and AG) across five sub-sections (Macronutrients, Micronutrients, Energy balance, Hydration, and Pre-training meals). Each participant's performance was assessed based on the percentage of marks received in each sub-section. Non-parametric tests (Mann\\u0026ndash;Whitney U test; Kruskal-Wallis) were considered more suitable for comparing multiple independent groups [\\u003cspan citationid=\\\"CR6\\\" class=\\\"CitationRef\\\"\\u003e6\\u003c/span\\u003e] and were employed to evaluate overall differences among the groups due to the violation of normality assumptions. Post-hoc analyses were conducted using Mann-Whitney U tests with Bonferroni correction to identify specific group differences in the case of a significant overall effect.\\u003c/p\\u003e \\u003cp\\u003eA Pearson's correlation was also conducted to examine the correlation across the results of 54 participants (NTG, NNTG) who undertook the questionnaire at two distinct time points. A significance level of p\\u0026thinsp;\\u0026lt;\\u0026thinsp;0.05 was adopted to interpret the outcomes. When assessing internal consistency or reliability, Cronbach\\u0026rsquo;s alpha of each of the five sub-sections was evaluated separately, as each sub-section addressed a different area of knowledge. A minimum Cronbach alpha requirement of α\\u0026thinsp;\\u0026gt;\\u0026thinsp;0.7 was accepted to demonstrate sound internal consistency [\\u003cspan citationid=\\\"CR3\\\" class=\\\"CitationRef\\\"\\u003e3\\u003c/span\\u003e]. NVIVO v10.0 (QSR International, Southport, UK) was employed to conduct a directed content analysis on the qualitative data collected.\\u003c/p\\u003e \\u003c/div\\u003e\"},{\"header\":\"Results\",\"content\":\"\\u003cp\\u003e\\u003cstrong\\u003eThe final questionnaire content, structure and scoring\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eThe previously developed A-SNKQ comprised 32 questions within 12 sub-sections, including 123 individual items\\u0026nbsp;[15]. The included questions had three options - \\u0026apos;agree,\\u0026apos; \\u0026apos;disagree,\\u0026apos; and \\u0026apos;unsure,\\u0026apos; while others had five responses carrying the most accurate answer. A plus mark (+1) was awarded for correct answers, each item without any weightage, and a negative mark (-1) for wrong answers; zero marks (0) were given for an unsure response, based on author consensus\\u0026nbsp;[16]. This covered a general nutrition knowledge section containing 15 questions with sub-sections covering macronutrients (n = 4), micronutrients (n = 3), energy balance (n = 4), hydration (n = 3), and weight management (n = 1), and a sports nutrition knowledge section with 17 questions, under 17 sub-sections (Carbohydrate loading, Pre-training meals, Training meals, each contains 1 question, Post-training meals: n=2, Sports supplements: n=6, Supplement label reading, alcohol, isotonic drinks, and doping: n=4, Energy intake and food habits: n=2)\\u0026nbsp;[15]. This is an online version developed using Google Forms (platform: Google Forms, Google LLC, California, USA)\\u0026nbsp;[17]\\u0026nbsp;and made available in all three official languages of Sri Lanka: English, Sinhala, and Tamil, ensuring inclusivity for participants across different language backgrounds\\u0026nbsp;[15].\\u0026nbsp;A comprehensive overview of the newly validated A-SNKQ is represented in Table 4.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eFindings of the five-step validation process of the tool\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eI. Content validity\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eNine experts (5 males and 4 females, with a mean age of 43.7 years) participated in the content validity assessment, and their years of experience ranged from 3 to 20 years. The response rate was 90%. In the initial attempt, the experts affirmed that the sub-sections of the questionnaire were relevant and appropriate for assessing the SNK, thus confirming content validity. Table 1 provides the calculated CVI values, based on the experts\\u0026apos; ratings for the relevance, appropriateness, accuracy, and clarity of each sub-section. Items that received low ratings for accuracy and clarity and did not meet the CVI values were subsequently modified in accordance with the comments and suggestions provided by the experts. Out of the total comments (n=70) received for each sub-section, 49 were fully integrated, 4 were partially addressed, and 17 were not incorporated into the questionnaire because they were considered irrelevant/not commensurate to be included in the questionnaire.\\u003c/p\\u003e\\n\\u003cp\\u003eThe CVI values for each sub-section were recalculated based on their ratings from the second attempt. The values for accuracy, appropriateness, clarity, and relevance were 3.6, 3.8, 3.3, and 3.4, respectively (Table 2). Details of the comments provided for each sub-section and how expert feedback was integrated are included in supplementary Table 1.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eII. Face validity\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eSixteen elite and nine semi-elite athletes (11 males, and 5 females, with a mean age of 27.5 years) participated to assess face validity. All athletes successfully identified the underlying purpose of each questionnaire section. The majority (13 out of 16) concurred that the questions and sub-sections in the questionnaire were appropriate for evaluating the sports nutrition knowledge of Sri Lankan track and field athletes and that the questions and instructions were clear. Where concerns regarding question wording arose, their comments and suggestions were duly considered, thereby confirming face validity. Particularly, three athletes requested the inclusion of commonly used English terms alongside the local language to enhance comprehension and clarity (e.g., \\u0026quot;recovery,\\u0026quot; \\u0026quot;pre-workout\\u0026quot;) (Supplementary Table 2).\\u003c/p\\u003e\\n\\u003cp\\u003eFurthermore, one athlete proposed dividing the questionnaire into several steps (e.g., 3-4 steps) to prevent the Google Form from becoming excessively lengthy. These comments were seamlessly integrated into the questionnaire.\\u0026nbsp;\\u003c/p\\u003e\\n\\u003cp\\u003eOut of the total comments (n=40) received for each sub-section, 33 comments were fully integrated. Further, seven comments were not incorporated into the questionnaire, as the experts found them inappropriate enough to be included in the questionnaire. Examples of changes made based on athletes\\u0026apos; feedback and how they were integrated are included in supplementary table 2.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eIII. Construct validity\\u0026nbsp;\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eTables 2 and 3 present construct validity and reliability statistics for the final set of questions. In the 1\\u003csup\\u003est\\u003c/sup\\u003e phase, all 36 participants from both the NT and NNT groups (100%) responded. For the re-test phase, the response rate was 100% for the NT group and 88% (16/18) for the NNT\\u0026nbsp;group.\\u003c/p\\u003e\\n\\u003cp\\u003eThe Kruskal-Wallis test revealed significant differences in the performance of NT, NNT, and AG across all sub-sections (p \\u0026lt; 0.05). In the Macronutrients sub-section, significant differences were found between NT and NNT (p = 0.027), NT and AG (p = 0.005), and NNT and AG (p = 0.012). Similar significant differences were observed in the Micronutrients (p \\u0026lt; 0.05), Energy balance (p \\u0026lt; 0.05), Hydration (p \\u0026lt; 0.05), and Pre-training meals (p \\u0026lt; 0.05) sub-sections. Total scores also exhibited significant differences among all pairs of groups (p \\u0026lt; 0.001).\\u0026nbsp;\\u003c/p\\u003e\\n\\u003cp\\u003eOn average, athletes scored higher than the NNTG and lower than the NTG across all sub-sections. The total correct response percentages were NTG: 92.5%, AG: 47.0%, and NNTG: 44.7% (Table 3).\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eIV. Reliability\\u0026nbsp;\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eA strong test-retest reliability was observed, as indicated in Table 3, with a correlation of 0.98 (p \\u0026lt; 0.001) for the total score and correlation coefficients of 0.89 (p \\u0026lt; 0.05) to 0.98 (p \\u0026lt; 0.001) for individual sub-sections (Table 3). Participants provided identical responses to the same question 90.7% of the time. The NTG showed an identical response rate of 92.3%, while the NNTG exhibited a rate of 89.2%. The micronutrient sub-section had the highest number of identical responses in the NTG at 93.7%, whereas the energy balance sub-section achieved the highest identical response rate for the NNTG at 93.4%. The pre-training meals sub-section had the lowest number of identical responses, with rates of 90.4% and 86.2% for the nutrition and non-nutrition groups, respectively (Table 3).\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eV. Questionnaire duration\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eThe average completion time of the final sports nutrition questionnaire for the athletes was 16.5 \\u0026plusmn; 4.4 min.\\u003c/p\\u003e\"},{\"header\":\"Discussion\",\"content\":\"\\u003cdiv id=\\\"Sec21\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003eThe questionnaire\\u003c/h2\\u003e \\u003cp\\u003eThe present study aimed to validate a previously developed SNKQ, which can serve as a practical tool for assessing nutrition knowledge among Sri Lankan track and field athletes. The newly validated tool, the Athletic-Sports Nutrition Knowledge Questionnaire (A-SNKQ), includes 97 individual items, consisting of 32 questions (some with multiple parts) across 12 distinct sub-sections. Completing the questionnaire takes about 16 minutes, a duration comparable to the Nutrition for Sport Knowledge Questionnaire (NSKQ) by Trakman et al. [\\u003cspan citationid=\\\"CR6\\\" class=\\\"CitationRef\\\"\\u003e6\\u003c/span\\u003e], which has 89 items, the Nutrition Knowledge Questionnaire for Athletes (NKQA) with 85 questions by Furber et al. [\\u003cspan citationid=\\\"CR18\\\" class=\\\"CitationRef\\\"\\u003e18\\u003c/span\\u003e], and the SNKQ developed by Zinn et al. [\\u003cspan citationid=\\\"CR19\\\" class=\\\"CitationRef\\\"\\u003e19\\u003c/span\\u003e], containing 88 items. To the best of our knowledge, this is one of the few SNKQs validated exclusively within the athletic population [\\u003cspan citationid=\\\"CR20\\\" class=\\\"CitationRef\\\"\\u003e20\\u003c/span\\u003e] in the global context. More importantly, this is the first SNKQ developed and validated in Sri Lanka.\\u003c/p\\u003e \\u003c/div\\u003e \\u003cdiv id=\\\"Sec22\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003eValidity and reliability\\u003c/h2\\u003e \\u003cp\\u003eThe key finding of this study is the establishment of the psychometric properties of the A-SNKQ tool via comprehensive and structured validation and reliability assessments. This robust methodology confirmed the content, face, and construct validity, as well as the reliability and internal consistency of the tool. Therefore, health professionals and coaches can confidently use the A-SNKQ to assess athletes' nutrition knowledge.\\u003c/p\\u003e \\u003cp\\u003eRecruiting sports nutrition experts plays a major role in obtaining essential feedback on the \\u003cspan refid=\\\"Sec5\\\" class=\\\"InternalRef\\\"\\u003econtent validity\\u003c/span\\u003e section [\\u003cspan citationid=\\\"CR21\\\" class=\\\"CitationRef\\\"\\u003e21\\u003c/span\\u003e]. In developed countries, sports dietitians have been identified as discrete and well-developed professionals for the content validity assessment of SNKQs [\\u003cspan citationid=\\\"CR4\\\" class=\\\"CitationRef\\\"\\u003e4\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR19\\\" class=\\\"CitationRef\\\"\\u003e19\\u003c/span\\u003e]. However, in Sri Lanka, sports nutrition advice is mainly provided by doctors who have training in the field of nutrition and experience with the sports population. In the current study, we recruited well-known clinicians, academics, and researchers related to nutrition and working with athletes. Hence, we believe that our expert panel is the best possible cohort to provide feedback on the content of the questionnaire in the Sri Lankan context.\\u003c/p\\u003e \\u003cp\\u003eIn some studies [\\u003cspan citationid=\\\"CR22\\\" class=\\\"CitationRef\\\"\\u003e22\\u003c/span\\u003e], sports nutrition experts working in the industries have also been recruited for the content validity assessment. However, in Sri Lanka, sports nutrition industries are not that developed, and most supplements and food products are imported. Therefore, it has to be acknowledged that the expert panel recruited for the content validity assessment of the current questionnaire did not include sports nutrition experts related to nutrition field industries, in contrast to previous tools.\\u003c/p\\u003e \\u003cp\\u003eFurthermore, in most previously developed sports nutrition knowledge questionnaires [\\u003cspan citationid=\\\"CR18\\\" class=\\\"CitationRef\\\"\\u003e18\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR19\\\" class=\\\"CitationRef\\\"\\u003e19\\u003c/span\\u003e], content validity has been assessed qualitatively by incorporating experts' comments and suggestions into the questionnaire. But, being consistent with the methodology followed by Trakman et al. [\\u003cspan citationid=\\\"CR4\\\" class=\\\"CitationRef\\\"\\u003e4\\u003c/span\\u003e] Tam et al. [\\u003cspan citationid=\\\"CR23\\\" class=\\\"CitationRef\\\"\\u003e23\\u003c/span\\u003e], Karla et al. [\\u003cspan citationid=\\\"CR24\\\" class=\\\"CitationRef\\\"\\u003e24\\u003c/span\\u003e], and Scrivin et al. [\\u003cspan citationid=\\\"CR25\\\" class=\\\"CitationRef\\\"\\u003e25\\u003c/span\\u003e] in the content validity assessment, in the current study, content validity was assessed quantitatively using a CVI. This robust revision of the content of the questionnaire by adhering to the individual comments of each expert should have improved the clarity and accuracy of the questionnaire.\\u003c/p\\u003e \\u003cp\\u003eWhen evaluating face validity, it is important to note that the majority of studies in this area have involved college-level athletes. Even though the studies aimed to have a diverse sample, including both genders and individuals at elite and semi-elite levels, only 13 out of 16 participants provided substantial feedback to improve the questionnaire items. This contrasts with similar studies conducted by Trakman et al., [\\u003cspan citationid=\\\"CR4\\\" class=\\\"CitationRef\\\"\\u003e4\\u003c/span\\u003e], Furber et al., [\\u003cspan citationid=\\\"CR18\\\" class=\\\"CitationRef\\\"\\u003e18\\u003c/span\\u003e], Tam et al., [\\u003cspan citationid=\\\"CR23\\\" class=\\\"CitationRef\\\"\\u003e23\\u003c/span\\u003e], Karla et al., [\\u003cspan citationid=\\\"CR24\\\" class=\\\"CitationRef\\\"\\u003e24\\u003c/span\\u003e], and Scrivin et al., [\\u003cspan citationid=\\\"CR25\\\" class=\\\"CitationRef\\\"\\u003e25\\u003c/span\\u003e] where athletes played a significant role in making the questionnaire clearer, more applicable, and easier to read. This discrepancy could be linked to the educational background of Sri Lankan athletes. They may have received lower levels of education and have affiliations with the Sri Lankan forces, distinguishing them from athletes in more developed nations. Additionally, the athletic population in a developing country may not be as inclined to offer diverse opinions due to a less supportive educational environment. This is reflected in the observation that only four out of the 16 participants in our face validity assessment, who had a relatively stronger educational background, provided meaningful comments to improve the clarity of the questionnaire.\\u003c/p\\u003e \\u003cp\\u003eIn contrast, Trakman et al., [\\u003cspan citationid=\\\"CR4\\\" class=\\\"CitationRef\\\"\\u003e4\\u003c/span\\u003e] engaged student-athletes who were college graduates in their study in assessing face validity, and this demographic played a crucial role in refining their developed and validated questionnaire. In evaluating construct validity and reliability, most studies have enlisted a cohort comprising individuals with and without nutritional qualifications. These investigations typically employ two divergent groups to scrutinize this facet of the assessment tool. Conversely, some studies have opted for a more homogeneous subject population. Following recruitment, a nutrition education intervention is exclusively administered to one group, allowing for the longitudinal evaluation of construct validity and test-retest reliability. In our approach, we adhered to the former method, selecting a sample of doctors possessing a minimum post-graduate qualification in human nutrition and some prior sports nutrition training for the NT group. In contrast, a disparate set of professionals from the banking sector constituted the NNT group.\\u003c/p\\u003e \\u003cp\\u003eUpon analysis of the results of construct validity and test-retest reliability, it is noteworthy that both the NTG and NNTG scored highly in GNK sub-sections such as Macro-nutrients and Hydration. However, in the case of SNK sub-sections, specifically pre-training meals, the NTG exhibited a significantly higher percentage of correct responses compared to the NNTG. This disparity was more pronounced than in the GNK sub-sections. This outcome underscores the robust construct validity and reliability of the current assessment tool, indicating its effectiveness for discerning individuals with substantial human nutrition qualifications and experience in sports nutrition training with athletes.\\u003c/p\\u003e \\u003cp\\u003eAdditionally, a subsequent step was taken wherein the A-SNKQ tool was administered to a sample of track and field athletes. Their scores, expressed as percentages, were then compared with those of the NTG and NNTG. The findings from this phase revealed that, on average, athletes scored higher than the NNTG and lower than the NTG across all sub-sections. This serves to further confirm the construct validity of the tool, proving its efficacy in distinguishing between individuals with varying levels of nutrition knowledge, particularly within the context of athletic nutrition.\\u003c/p\\u003e \\u003cp\\u003eA key strength of the present study lies in the comprehensive and structured validation procedure employed for validating the newly developed A-SNKQ, utilizing the modified Delphi process. Additionally, this tool has confirmed content, face, and construct validities, along with demonstrating adequate reliability and strong reproducibility. Moreover, the administration of this questionnaire is facilitated by its online format, enhancing accessibility for athletes through their smart devices. This approach aligns with the integration of novel technology, making the questionnaire more user-friendly and feasible for widespread use.\\u003c/p\\u003e \\u003cp\\u003eHowever, this method of validation has a few limitations. We did not consider all the items in the questionnaire due to the complexity and difficulty of comparing between the three cohorts: NT, NNT, and AG. Therefore, future studies should be planned in a way that the validation procedure covers all sub-sections of the SNKQ. Additionally, interventions should be designed and administered to the athletic population based on the SNK assessed by properly developed and well-validated tools like this one. This approach may provide insights into improving SNK and, consequently, enhancing sports performance and overall well-being.\\u003c/p\\u003e \\u003c/div\\u003e\"},{\"header\":\"Conclusions\",\"content\":\"\\u003cp\\u003eFollowing the development of the A-SNKQ, five steps were employed to establish validity and reliability. Content validity was confirmed by integrating comments and suggestions from a panel of sports nutrition experts received for each sub-section. Face validity was established by feedback from elite or semi-elite athletes. Construct validity was confirmed by administering the tool to two distinct groups: NTG, NNTG, and AG using a comparative analysis. Internal reliability was established by administering the tool to the NTG and NNTG twice in a test-retest manner, with a three-week interval separating the administrations. The A-SNKQ meets all psychometric measures, providing a new, valid, and reliable tool to assess general and sports nutrition knowledge among Sri Lankan track and field athletes. Widespread utilization of the tool in the long term will allow for a more accurate evaluation of SNK, and sports nutrition interventions for sports personals enhancing their overall sporting performance outcomes.\\u003c/p\\u003e\"},{\"header\":\"Abbreviations\",\"content\":\"\\u003cp\\u003eA-SNKQ: Athletic Sports Nutrition Knowledge Questionnaire; GNK: General Nutrition Knowledge; MCQs: Multiple Choice Questions; SNK: Sports Nutrition Knowledge; SNKQ: Sports Nutrition Knowledge Questionnaire.\\u003c/p\\u003e\"},{\"header\":\"Declarations\",\"content\":\"\\u003cp\\u003e\\u003cstrong\\u003eAcknowledgments\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eWe express our gratitude to all the authors who granted permission to adopt the questions from their previous questionnaire tools, as well as to all the other contributors who contributed to the improvement of the study.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eFunding\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eNo funding was received for conducting this study.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eConflicts of interest\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eThe authors declare no competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eConsent for publication\\u0026nbsp;\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eNot applicable\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eAvailability of data and materials\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eThe datasets used in the current study are available in supplementary Table 1 and Table 2.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eEthical approval\\u003c/strong\\u003e \\u003cstrong\\u003eand consent to participate\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eThe qualitative study used in the multi-modal approach during the development of the questionnaire was conducted in accordance with the standards set by the Declaration of Helsinki. Ethical approval was obtained from the Ethics Review Committee of the Faculty of Medicine, University of Peradeniya, Sri Lanka, prior to conducting the study (Ref No. 2022/EC/66). All participants provided written informed consent to participate in the study.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eAuthors\\u0026apos; contribution\\u0026nbsp;\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eRJ conceived and designed the study. RJ, GT, and KW participated in the finalization of the questionnaire. RJ, KW, and GT contributed to drafting the manuscript. NSK, TM, and APH, as supervisory team members participated in the revision of the paper. All authors provided valuable feedback on the manuscript. Additionally, all authors carefully reviewed and approved the final version of the manuscript.\\u003c/p\\u003e\"},{\"header\":\"References\",\"content\":\"\\u003col\\u003e\\n\\u003cli\\u003eJayawardena R, Weerasinghe K, Trakman G, Madhujith T, Hills A, Kalupahana N. Development of a sports nutrition knowledge questionnaire for Sri Lankan athletes2023.\\u003c/li\\u003e\\n\\u003cli\\u003eTsang S, Royse CF, Terkawi AS. Guidelines for developing, translating, and validating a questionnaire in perioperative and pain medicine. Saudi J Anaesth. 2017;11(Suppl 1):S80-s9.\\u003c/li\\u003e\\n\\u003cli\\u003eAithal A, Aithal P. Development and validation of survey questionnaire \\u0026amp; experimental data\\u0026ndash;a systematical review-based statistical approach. International Journal of Management, Technology, and Social Sciences (IJMTS). 2020;5(2):233-51.\\u003c/li\\u003e\\n\\u003cli\\u003eTrakman GL, Forsyth A, Hoye R, Belski R. Developing and validating a nutrition knowledge questionnaire: key methods and considerations. Public Health Nutr. 2017;20(15):2670-9.\\u003c/li\\u003e\\n\\u003cli\\u003eBoateng GO, Neilands TB, Frongillo EA, Melgar-Qui\\u0026ntilde;onez HR, Young SL. Best Practices for Developing and Validating Scales for Health, Social, and Behavioral Research: A Primer. Front Public Health. 2018;6:149.\\u003c/li\\u003e\\n\\u003cli\\u003eTrakman GL, Forsyth A, Hoye R, Belski R. The nutrition for sport knowledge questionnaire (NSKQ): development and validation using classical test theory and Rasch analysis. J Int Soc Sports Nutr. 2017;14:26.\\u003c/li\\u003e\\n\\u003cli\\u003eClark LA, Watson D. Constructing validity: New developments in creating objective measuring instruments. Psychol Assess. 2019;31(12):1412-27.\\u003c/li\\u003e\\n\\u003cli\\u003eBusschaert C, De Bourdeaudhuij I, Van Holle V, Chastin SFM, Cardon G, De Cocker K. Reliability and validity of three questionnaires measuring context-specific sedentary behaviour and associated correlates in adolescents, adults and older adults. International Journal of Behavioral Nutrition and Physical Activity. 2015;12(1):117.\\u003c/li\\u003e\\n\\u003cli\\u003eOZENER B, KARABULUT E, Kocahan T, BILGIC P. Validity and reliability of the Sports Nutrition Knowledge Questionnaire for the Turkish athletes. Marmara Medical Journal. 2021;34(1):45-50.\\u003c/li\\u003e\\n\\u003cli\\u003ePolit DF, Beck CT, Owen SV. Is the CVI an acceptable indicator of content validity? Appraisal and recommendations. Res Nurs Health. 2007;30(4):459-67.\\u003c/li\\u003e\\n\\u003cli\\u003eCappelleri JC, Jason Lundy J, Hays RD. Overview of classical test theory and item response theory for the quantitative assessment of items in developing patient-reported outcomes measures. Clin Ther. 2014;36(5):648-62.\\u003c/li\\u003e\\n\\u003cli\\u003ePoliandri D, Perazzolo M, Pillera GC, Giampietro L. Dematerialized participation challenges: Methods and practices for online focus groups. Front Sociol. 2023;8:1145264.\\u003c/li\\u003e\\n\\u003cli\\u003eKang H. Sample size determination and power analysis using the G*Power software. J Educ Eval Health Prof. 2021;18:17.\\u003c/li\\u003e\\n\\u003cli\\u003eFaul F, Erdfelder E, Lang AG, Buchner A. G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007;39(2):175-91.\\u003c/li\\u003e\\n\\u003cli\\u003eHasson F, Keeney S, McKenna H. Research guidelines for the Delphi survey technique. J Adv Nurs. 2000;32(4):1008-15.\\u003c/li\\u003e\\n\\u003cli\\u003ePallant J. Scale development, Rasch analysis and item response theory. Melbourne Australian Consortium for Social \\u0026amp; Political Research Inc. 2016.\\u003c/li\\u003e\\n\\u003cli\\u003eLLC G. Google Forms California, USA[cited 2024 Jan 16] [Available from: Available from: https://policies.google.com/terms?hl=en-US.\\u003c/li\\u003e\\n\\u003cli\\u003eFurber MJW, Roberts JD, Roberts MG. A valid and reliable nutrition knowledge questionnaire for track and field athletes. BMC Nutr. 2017;3:36.\\u003c/li\\u003e\\n\\u003cli\\u003eZinn C, Schofield G, Wall C. Development of a psychometrically valid and reliable sports nutrition knowledge questionnaire. J Sci Med Sport. 2005;8(3):346-51.\\u003c/li\\u003e\\n\\u003cli\\u003eEdmonds C, Tam R, Madigan S, Gubb L, Beck KL, Gifford JA, et al. Validation of a sports nutrition knowledge questionnaire for athletes in the United Kingdom and Ireland. J Nutr Sci. 2023;12:e2.\\u003c/li\\u003e\\n\\u003cli\\u003eMacKenzie SB, Podsakoff PM, Podsakoff NP. Construct measurement and validation procedures in MIS and behavioral research: Integrating new and existing techniques. MIS quarterly. 2011:293-334.\\u003c/li\\u003e\\n\\u003cli\\u003eCapling L, Gifford JA, Beck KL, Flood VM, Slater GJ, Denyer GS, et al. Development of an Athlete Diet Index for Rapid Dietary Assessment of Athletes. Int J Sport Nutr Exerc Metab. 2019;29(6):643-50.\\u003c/li\\u003e\\n\\u003cli\\u003eTam R, Beck K, Scanlan JN, Hamilton T, Prvan T, Flood V, et al. The Platform to Evaluate Athlete Knowledge of Sports Nutrition Questionnaire: a reliable and valid electronic sports nutrition knowledge questionnaire for athletes. Br J Nutr. 2021;126(4):561-71.\\u003c/li\\u003e\\n\\u003cli\\u003eV\\u0026aacute;zquez-Espino K, Fern\\u0026aacute;ndez-Tena C, Lizarraga-Dallo MA, Farran-Codina A. Development and Validation of a Short Sport Nutrition Knowledge Questionnaire for Athletes. Nutrients. 2020;12(11).\\u003c/li\\u003e\\n\\u003cli\\u003eScrivin R, Costa RJ, Pelly F, Lis D, Slater G. Development and validation of a questionnaire investigating endurance athletes practices to manage gastrointestinal symptoms around exercise. Nutr Diet. 2021;78(3):286-95.\\u003c/li\\u003e\\n\\u003c/ol\\u003e\"},{\"header\":\"Tables\",\"content\":\"\\u003cp\\u003e\\u003cstrong\\u003e\\u003cu\\u003eTable 1: CVI values\\u0026nbsp;\\u003c/u\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003ctable border=\\\"1\\\" cellspacing=\\\"0\\\" cellpadding=\\\"0\\\" width=\\\"972\\\"\\u003e\\n \\u003ctbody\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd width=\\\"27.160493827160494%\\\" rowspan=\\\"2\\\" valign=\\\"top\\\"\\u003e\\u003cstrong\\u003e\\u0026nbsp;\\u003c/strong\\u003e\\u003cbr\\u003eSub-section (number of questions)\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"48.45679012345679%\\\" colspan=\\\"4\\\" valign=\\\"top\\\"\\u003e1\\u003csup\\u003est\\u003c/sup\\u003e attempt\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"24.382716049382715%\\\" colspan=\\\"2\\\" valign=\\\"top\\\"\\u003e2\\u003csup\\u003end\\u003c/sup\\u003e attempt\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd width=\\\"14.589235127478753%\\\" valign=\\\"top\\\"\\u003e\\u0026nbsp;\\u003cbr\\u003eAccuracy V\\u003csub\\u003e1\\u003c/sub\\u003e\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"18.555240793201133%\\\" valign=\\\"top\\\"\\u003e\\u0026nbsp;\\u003cbr\\u003eAppropriateness V\\u003csub\\u003e1\\u003c/sub\\u003e\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"16.71388101983003%\\\" valign=\\\"top\\\"\\u003e\\u0026nbsp;\\u003cbr\\u003eClarity V\\u003csub\\u003e1\\u003c/sub\\u003e\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"16.71388101983003%\\\" valign=\\\"top\\\"\\u003e\\u0026nbsp;\\u003cbr\\u003eRelevance V\\u003csub\\u003e1\\u003c/sub\\u003e\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"16.71388101983003%\\\" valign=\\\"top\\\"\\u003e\\u0026nbsp;\\u003cbr\\u003eAccuracy V\\u003csub\\u003e2\\u003c/sub\\u003e\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"16.71388101983003%\\\" valign=\\\"top\\\"\\u003e\\u0026nbsp;\\u003cbr\\u003eClarity V\\u003csub\\u003e2\\u003c/sub\\u003e\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd width=\\\"27.216494845360824%\\\" valign=\\\"top\\\"\\u003e\\n \\u003col\\u003e\\n \\u003cli\\u003eMacronutrients \\u003cem\\u003e(n=27)\\u003c/em\\u003e\\u003c/li\\u003e\\n \\u003c/ol\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd width=\\\"10.618556701030927%\\\" valign=\\\"top\\\"\\u003e3.4\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"13.505154639175258%\\\" valign=\\\"top\\\"\\u003e3.6\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"12.164948453608247%\\\" valign=\\\"top\\\"\\u003e3.3\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"12.164948453608247%\\\" valign=\\\"top\\\"\\u003e3.7\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"12.164948453608247%\\\" valign=\\\"top\\\"\\u003e3.4\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"12.164948453608247%\\\" valign=\\\"top\\\"\\u003e3.3\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd width=\\\"27.216494845360824%\\\" valign=\\\"top\\\"\\u003e\\n \\u003col\\u003e\\n \\u003cli\\u003eMicronutrients \\u003cem\\u003e(n=7)\\u003c/em\\u003e\\u003c/li\\u003e\\n \\u003c/ol\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd width=\\\"10.618556701030927%\\\" valign=\\\"top\\\"\\u003e3.2\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"13.505154639175258%\\\" valign=\\\"top\\\"\\u003e3.7\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"12.164948453608247%\\\" valign=\\\"top\\\"\\u003e3.4\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"12.164948453608247%\\\" valign=\\\"top\\\"\\u003e3.8\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"12.164948453608247%\\\" valign=\\\"top\\\"\\u003e3.2\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"12.164948453608247%\\\" valign=\\\"top\\\"\\u003e3.4\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd width=\\\"27.216494845360824%\\\" valign=\\\"top\\\"\\u003e\\n \\u003col\\u003e\\n \\u003cli\\u003eEnergy balance \\u003cem\\u003e(n=9)\\u003c/em\\u003e\\u003c/li\\u003e\\n \\u003c/ol\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd width=\\\"10.618556701030927%\\\" valign=\\\"top\\\"\\u003e3.4\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"13.505154639175258%\\\" valign=\\\"top\\\"\\u003e3.6\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"12.164948453608247%\\\" valign=\\\"top\\\"\\u003e3.3\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"12.164948453608247%\\\" valign=\\\"top\\\"\\u003e3.7\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"12.164948453608247%\\\" valign=\\\"top\\\"\\u003e3.4\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"12.164948453608247%\\\" valign=\\\"top\\\"\\u003e3.3\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd width=\\\"27.216494845360824%\\\" valign=\\\"top\\\"\\u003e\\n \\u003col\\u003e\\n \\u003cli\\u003eHydration \\u003cem\\u003e(n=11)\\u003c/em\\u003e\\u003c/li\\u003e\\n \\u003c/ol\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd width=\\\"10.618556701030927%\\\" valign=\\\"top\\\"\\u003e3.2\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"13.505154639175258%\\\" valign=\\\"top\\\"\\u003e3.7\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"12.164948453608247%\\\" valign=\\\"top\\\"\\u003e3.6\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"12.164948453608247%\\\" valign=\\\"top\\\"\\u003e3.8\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"12.164948453608247%\\\" valign=\\\"top\\\"\\u003e3.2\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"12.164948453608247%\\\" valign=\\\"top\\\"\\u003e3.6\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd width=\\\"27.216494845360824%\\\" valign=\\\"top\\\"\\u003e\\n \\u003col\\u003e\\n \\u003cli\\u003eWeight management \\u003cem\\u003e(n=1)\\u003c/em\\u003e\\u003c/li\\u003e\\n \\u003c/ol\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd width=\\\"10.618556701030927%\\\" valign=\\\"top\\\"\\u003e3.2\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"13.505154639175258%\\\" valign=\\\"top\\\"\\u003e3.2\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"12.164948453608247%\\\" valign=\\\"top\\\"\\u003e\\u003cstrong\\u003e2.7\\u003c/strong\\u003e\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"12.164948453608247%\\\" valign=\\\"top\\\"\\u003e3.6\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"12.164948453608247%\\\" valign=\\\"top\\\"\\u003e3.2\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"12.164948453608247%\\\" valign=\\\"top\\\"\\u003e\\u003cstrong\\u003e3.2\\u003c/strong\\u003e\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd width=\\\"27.216494845360824%\\\" valign=\\\"top\\\"\\u003e\\n \\u003col\\u003e\\n \\u003cli\\u003eCarbohydrate loading \\u003cem\\u003e(n=1)\\u003c/em\\u003e\\u003c/li\\u003e\\n \\u003c/ol\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd width=\\\"10.618556701030927%\\\" valign=\\\"top\\\"\\u003e3.2\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"13.505154639175258%\\\" valign=\\\"top\\\"\\u003e3.8\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"12.164948453608247%\\\" valign=\\\"top\\\"\\u003e3.6\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"12.164948453608247%\\\" valign=\\\"top\\\"\\u003e3.8\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"12.164948453608247%\\\" valign=\\\"top\\\"\\u003e3.2\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"12.164948453608247%\\\" valign=\\\"top\\\"\\u003e3.6\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd width=\\\"27.216494845360824%\\\" valign=\\\"top\\\"\\u003e\\n \\u003col\\u003e\\n \\u003cli\\u003ePre-training meals \\u003cem\\u003e(n=4)\\u003c/em\\u003e\\u003c/li\\u003e\\n \\u003c/ol\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd width=\\\"10.618556701030927%\\\" valign=\\\"top\\\"\\u003e3.6\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"13.505154639175258%\\\" valign=\\\"top\\\"\\u003e3.8\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"12.164948453608247%\\\" valign=\\\"top\\\"\\u003e3.9\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"12.164948453608247%\\\" valign=\\\"top\\\"\\u003e4.0\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"12.164948453608247%\\\" valign=\\\"top\\\"\\u003e3.6\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"12.164948453608247%\\\" valign=\\\"top\\\"\\u003e3.9\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd width=\\\"27.216494845360824%\\\" valign=\\\"top\\\"\\u003e\\n \\u003col\\u003e\\n \\u003cli\\u003eTraining meals \\u003cem\\u003e(n=4)\\u003c/em\\u003e\\u003c/li\\u003e\\n \\u003c/ol\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd width=\\\"10.618556701030927%\\\" valign=\\\"top\\\"\\u003e\\u003cstrong\\u003e2.2\\u003c/strong\\u003e\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"13.505154639175258%\\\" valign=\\\"top\\\"\\u003e3.4\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"12.164948453608247%\\\" valign=\\\"top\\\"\\u003e3.3\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"12.164948453608247%\\\" valign=\\\"top\\\"\\u003e4.0\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"12.164948453608247%\\\" valign=\\\"top\\\"\\u003e\\u003cstrong\\u003e3.3\\u003c/strong\\u003e\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"12.164948453608247%\\\" valign=\\\"top\\\"\\u003e3.3\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd width=\\\"27.216494845360824%\\\" valign=\\\"top\\\"\\u003e\\n \\u003col\\u003e\\n \\u003cli\\u003ePost-training meals \\u003cem\\u003e(n=15)\\u003c/em\\u003e\\u003c/li\\u003e\\n \\u003c/ol\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd width=\\\"10.618556701030927%\\\" valign=\\\"top\\\"\\u003e\\u003cstrong\\u003e2.6\\u003c/strong\\u003e\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"13.505154639175258%\\\" valign=\\\"top\\\"\\u003e3.6\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"12.164948453608247%\\\" valign=\\\"top\\\"\\u003e3.3\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"12.164948453608247%\\\" valign=\\\"top\\\"\\u003e3.5\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"12.164948453608247%\\\" valign=\\\"top\\\"\\u003e\\u003cstrong\\u003e3.4\\u003c/strong\\u003e\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"12.164948453608247%\\\" valign=\\\"top\\\"\\u003e3.3\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd width=\\\"27.216494845360824%\\\" valign=\\\"top\\\"\\u003e\\n \\u003col\\u003e\\n \\u003cli\\u003eSports supplements \\u003cem\\u003e(n=6)\\u003c/em\\u003e\\u003c/li\\u003e\\n \\u003c/ol\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd width=\\\"10.618556701030927%\\\" valign=\\\"top\\\"\\u003e\\u003cstrong\\u003e2.7\\u003c/strong\\u003e\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"13.505154639175258%\\\" valign=\\\"top\\\"\\u003e3.2\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"12.164948453608247%\\\" valign=\\\"top\\\"\\u003e3.2\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"12.164948453608247%\\\" valign=\\\"top\\\"\\u003e3.8\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"12.164948453608247%\\\" valign=\\\"top\\\"\\u003e\\u003cstrong\\u003e3.6\\u003c/strong\\u003e\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"12.164948453608247%\\\" valign=\\\"top\\\"\\u003e3.2\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd width=\\\"27.216494845360824%\\\" valign=\\\"top\\\"\\u003e\\n \\u003col\\u003e\\n \\u003cli\\u003eSupplement label reading, alcohol, isotonic drink, and doping \\u003cem\\u003e(n=10)\\u003c/em\\u003e\\u003c/li\\u003e\\n \\u003c/ol\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd width=\\\"10.618556701030927%\\\" valign=\\\"top\\\"\\u003e3.2\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"13.505154639175258%\\\" valign=\\\"top\\\"\\u003e3.8\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"12.164948453608247%\\\" valign=\\\"top\\\"\\u003e3.4\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"12.164948453608247%\\\" valign=\\\"top\\\"\\u003e4.0\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"12.164948453608247%\\\" valign=\\\"top\\\"\\u003e3.2\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"12.164948453608247%\\\" valign=\\\"top\\\"\\u003e3.4\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd width=\\\"27.216494845360824%\\\" valign=\\\"top\\\"\\u003e\\n \\u003col\\u003e\\n \\u003cli\\u003eEnergy intake and food habits \\u003cem\\u003e(n=2)\\u003c/em\\u003e\\u003c/li\\u003e\\n \\u003c/ol\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd width=\\\"10.618556701030927%\\\" valign=\\\"top\\\"\\u003e3.3\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"13.505154639175258%\\\" valign=\\\"top\\\"\\u003e3.6\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"12.164948453608247%\\\" valign=\\\"top\\\"\\u003e3.4\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"12.164948453608247%\\\" valign=\\\"top\\\"\\u003e3.8\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"12.164948453608247%\\\" valign=\\\"top\\\"\\u003e3.3\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"12.164948453608247%\\\" valign=\\\"top\\\"\\u003e3.4\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd width=\\\"27.216494845360824%\\\" valign=\\\"top\\\"\\u003eTotal \\u003cem\\u003e(n=97)\\u003c/em\\u003e\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"10.618556701030927%\\\" valign=\\\"top\\\"\\u003e3.0\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"13.505154639175258%\\\" valign=\\\"top\\\"\\u003e3.6\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"12.164948453608247%\\\" valign=\\\"top\\\"\\u003e3.3\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"12.164948453608247%\\\" valign=\\\"top\\\"\\u003e3.8\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"12.164948453608247%\\\" valign=\\\"top\\\"\\u003e3.3\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"12.164948453608247%\\\" valign=\\\"top\\\"\\u003e3.4\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003c/tbody\\u003e\\n\\u003c/table\\u003e\\n\\u003cp\\u003eCVI: Content validity index, V\\u003csub\\u003e1\\u003c/sub\\u003e: Version 1, V\\u003csub\\u003e2\\u003c/sub\\u003e: Version 2\\u003cstrong\\u003e\\u003cbr\\u003e\\u0026nbsp;\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eTable 2 Total scores achieved as a percentage on the A-SNKQ by the NT, NNT and AG\\u0026nbsp;\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003ctable border=\\\"1\\\" cellspacing=\\\"0\\\" cellpadding=\\\"0\\\" width=\\\"730\\\"\\u003e\\n \\u003ctbody\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd width=\\\"18.194254445964432%\\\" valign=\\\"top\\\"\\u003eSub-section\\u0026nbsp;\\u003cbr\\u003e(n)\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"22.571819425444595%\\\" valign=\\\"top\\\"\\u003eMarks of NTG\\u0026nbsp;\\u003cbr\\u003e(%)\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"15.595075239398085%\\\" valign=\\\"top\\\"\\u003eMarks of NNTG\\u003cbr\\u003e(%)\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"13.269493844049247%\\\" valign=\\\"top\\\"\\u003eMarks of AG (%)\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"10.12311901504788%\\\" valign=\\\"top\\\"\\u003eNTG vs. NNTG\\u0026nbsp;\\u003cbr\\u003e\\u003cem\\u003ep\\u003c/em\\u003e value\\u0026nbsp;\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"10.12311901504788%\\\" valign=\\\"top\\\"\\u003eNNTG vs. AG\\u003cbr\\u003e\\u003cem\\u003ep\\u003c/em\\u003e value\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"10.12311901504788%\\\" valign=\\\"top\\\"\\u003eNTG vs. AG\\u003cbr\\u003e\\u003cem\\u003ep\\u0026nbsp;\\u003c/em\\u003evalue\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd width=\\\"18.194254445964432%\\\" valign=\\\"top\\\"\\u003e1. Macronutrients \\u003cem\\u003e(n=20)\\u003c/em\\u003e\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"22.571819425444595%\\\" valign=\\\"top\\\"\\u003e92.5\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"15.595075239398085%\\\" valign=\\\"top\\\"\\u003e56.3\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"13.269493844049247%\\\" valign=\\\"top\\\"\\u003e60.5\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"10.12311901504788%\\\" valign=\\\"top\\\"\\u003e\\u003cem\\u003ep\\u003c/em\\u003e =0.027\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"10.12311901504788%\\\" valign=\\\"top\\\"\\u003e\\u003cem\\u003ep\\u003c/em\\u003e =0.005\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"10.12311901504788%\\\" valign=\\\"top\\\"\\u003e\\u003cem\\u003ep\\u003c/em\\u003e =0.012\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd width=\\\"18.194254445964432%\\\" valign=\\\"top\\\"\\u003e2. Micronutrients \\u003cem\\u003e(n=5)\\u003c/em\\u003e\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"22.571819425444595%\\\" valign=\\\"top\\\"\\u003e91.1\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"15.595075239398085%\\\" valign=\\\"top\\\"\\u003e38.2\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"13.269493844049247%\\\" valign=\\\"top\\\"\\u003e45.8\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"10.12311901504788%\\\" valign=\\\"top\\\"\\u003e\\u003cem\\u003ep\\u003c/em\\u003e =0.016\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"10.12311901504788%\\\" valign=\\\"top\\\"\\u003e\\u003cem\\u003ep\\u003c/em\\u003e =0.005\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"10.12311901504788%\\\" valign=\\\"top\\\"\\u003e\\u003cem\\u003ep\\u003c/em\\u003e =0.003\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd width=\\\"18.194254445964432%\\\" valign=\\\"top\\\"\\u003e3. Energy balance \\u003cem\\u003e(n=6)\\u003c/em\\u003e\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"22.571819425444595%\\\" valign=\\\"top\\\"\\u003e90.7\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"15.595075239398085%\\\" valign=\\\"top\\\"\\u003e16.6\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"13.269493844049247%\\\" valign=\\\"top\\\"\\u003e25.0\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"10.12311901504788%\\\" valign=\\\"top\\\"\\u003e\\u003cem\\u003ep\\u003c/em\\u003e =0.016\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"10.12311901504788%\\\" valign=\\\"top\\\"\\u003e\\u003cem\\u003ep\\u003c/em\\u003e =0.007\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"10.12311901504788%\\\" valign=\\\"top\\\"\\u003e\\u003cem\\u003ep\\u003c/em\\u003e =0.002\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd width=\\\"18.194254445964432%\\\" valign=\\\"top\\\"\\u003e4. Hydration \\u0026nbsp; \\u0026nbsp; \\u0026nbsp; \\u0026nbsp;\\u0026nbsp;\\u003cem\\u003e(n=5)\\u003c/em\\u003e\\u0026nbsp; \\u0026nbsp; \\u0026nbsp;\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"22.571819425444595%\\\" valign=\\\"top\\\"\\u003e92.2\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"15.595075239398085%\\\" valign=\\\"top\\\"\\u003e61.1\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"13.269493844049247%\\\" valign=\\\"top\\\"\\u003e73.4\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"10.12311901504788%\\\" valign=\\\"top\\\"\\u003e\\u003cem\\u003ep\\u003c/em\\u003e =0.004\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"10.12311901504788%\\\" valign=\\\"top\\\"\\u003e\\u003cem\\u003ep\\u003c/em\\u003e =0.023\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"10.12311901504788%\\\" valign=\\\"top\\\"\\u003e\\u003cem\\u003ep\\u003c/em\\u003e =0.031\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd width=\\\"18.194254445964432%\\\" valign=\\\"top\\\"\\u003e5. Pre-training meals\\u0026nbsp;\\u003cem\\u003e(n=4)\\u003c/em\\u003e\\u0026nbsp; \\u0026nbsp; \\u0026nbsp; \\u0026nbsp; \\u0026nbsp; \\u0026nbsp; \\u0026nbsp; \\u0026nbsp; \\u0026nbsp;\\u0026nbsp;\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"22.571819425444595%\\\" valign=\\\"top\\\"\\u003e97.2\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"15.595075239398085%\\\" valign=\\\"top\\\"\\u003e20.8\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"13.269493844049247%\\\" valign=\\\"top\\\"\\u003e30.6\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"10.12311901504788%\\\" valign=\\\"top\\\"\\u003e\\u003cem\\u003ep\\u003c/em\\u003e =0.012\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"10.12311901504788%\\\" valign=\\\"top\\\"\\u003e\\u003cem\\u003ep\\u003c/em\\u003e =0.005\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"10.12311901504788%\\\" valign=\\\"top\\\"\\u003e\\u003cem\\u003ep\\u003c/em\\u003e =0.020\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd width=\\\"18.194254445964432%\\\" valign=\\\"top\\\"\\u003eTotal \\u0026nbsp; \\u0026nbsp; \\u0026nbsp; \\u0026nbsp; \\u0026nbsp; \\u0026nbsp; \\u0026nbsp; \\u0026nbsp; \\u0026nbsp;\\u003cem\\u003e(n=40)\\u003c/em\\u003e\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"22.571819425444595%\\\" valign=\\\"top\\\"\\u003e462.5 (92.5%)\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"15.595075239398085%\\\" valign=\\\"top\\\"\\u003e223.5 (44.7%)\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"13.269493844049247%\\\" valign=\\\"top\\\"\\u003e235 (47.0%)\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"10.12311901504788%\\\" valign=\\\"top\\\"\\u003e\\u003cem\\u003ep\\u003c/em\\u003e \\u0026lt; 0.001\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"10.12311901504788%\\\" valign=\\\"top\\\"\\u003e\\u003cem\\u003ep\\u003c/em\\u003e \\u0026lt; 0.001\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"10.12311901504788%\\\" valign=\\\"top\\\"\\u003e\\u003cem\\u003ep\\u003c/em\\u003e \\u0026lt; 0.001\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003c/tbody\\u003e\\n\\u003c/table\\u003e\\n\\u003cp\\u003eNTG: Nutrition-trained group, NNTG: No nutrition-trained group, AG: Athletic Group.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cbr\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003e\\u003cstrong\\u003eTable 3: Internal reliability, test-retest reliability, and identical response rates of the A-SNKQ across two data collection periods separated by a 3-week interval\\u003c/strong\\u003e\\u003cbr\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003ctable border=\\\"1\\\" cellspacing=\\\"0\\\" cellpadding=\\\"0\\\" width=\\\"1008\\\"\\u003e\\n \\u003ctbody\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd width=\\\"14.285714285714286%\\\" valign=\\\"top\\\"\\u003e\\u003cbr\\u003e\\u0026nbsp;Sub-section (n)\\u003cbr\\u003e\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"12.5%\\\" valign=\\\"top\\\"\\u003eInternal reliability\\u003csup\\u003ea\\u003c/sup\\u003e\\u003cbr\\u003e(\\u0026alpha;)\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"23.214285714285715%\\\" valign=\\\"top\\\"\\u003eTest-retest correlation\\u003csup\\u003eb\\u003c/sup\\u003e\\u003cbr\\u003e(r)\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"17.857142857142858%\\\" valign=\\\"top\\\"\\u003eIdentical responses from both tests (all participants)\\u003cbr\\u003e(%)\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"14.880952380952381%\\\" valign=\\\"top\\\"\\u003eIdentical responses from both tests (NTG)\\u003cbr\\u003e(%)\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"17.261904761904763%\\\" valign=\\\"top\\\"\\u003eIdentical responses from both tests (NNTG)\\u003cbr\\u003e(%)\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd width=\\\"14.285714285714286%\\\" valign=\\\"top\\\"\\u003e\\u003cstrong\\u003e\\u0026nbsp;\\u003c/strong\\u003e\\u003cbr\\u003e1.Macronutrients\\u003cbr\\u003e(n=20)\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"12.5%\\\" valign=\\\"top\\\"\\u003e\\u0026nbsp;\\u003cbr\\u003e0.85\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"23.214285714285715%\\\" valign=\\\"top\\\"\\u003e\\u0026nbsp;\\u003cbr\\u003e0.89\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"17.857142857142858%\\\" valign=\\\"top\\\"\\u003e\\u0026nbsp;\\u003cbr\\u003e90.6\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"14.880952380952381%\\\" valign=\\\"top\\\"\\u003e\\u0026nbsp;\\u003cbr\\u003e92.1\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"17.261904761904763%\\\" valign=\\\"top\\\"\\u003e\\u0026nbsp;\\u003cbr\\u003e89.2\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd width=\\\"14.285714285714286%\\\" valign=\\\"top\\\"\\u003e\\u003cstrong\\u003e\\u0026nbsp;\\u003c/strong\\u003e\\u003cbr\\u003e2.Micronutrients\\u003cbr\\u003e(n=5)\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"12.5%\\\" valign=\\\"top\\\"\\u003e\\u0026nbsp;\\u003cbr\\u003e0.85\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"23.214285714285715%\\\" valign=\\\"top\\\"\\u003e\\u0026nbsp;\\u003cbr\\u003e0.98\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"17.857142857142858%\\\" valign=\\\"top\\\"\\u003e\\u0026nbsp;\\u003cbr\\u003e91.8\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"14.880952380952381%\\\" valign=\\\"top\\\"\\u003e\\u0026nbsp;\\u003cbr\\u003e93.7\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"17.261904761904763%\\\" valign=\\\"top\\\"\\u003e\\u0026nbsp;\\u003cbr\\u003e90.0\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd width=\\\"14.285714285714286%\\\" valign=\\\"top\\\"\\u003e\\u003cstrong\\u003e\\u0026nbsp;\\u003c/strong\\u003e\\u003cbr\\u003e3.Energy balance\\u003cbr\\u003e(n=6)\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"12.5%\\\" valign=\\\"top\\\"\\u003e\\u0026nbsp;\\u003cbr\\u003e0.78\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"23.214285714285715%\\\" valign=\\\"top\\\"\\u003e\\u0026nbsp;\\u003cbr\\u003e0.98\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"17.857142857142858%\\\" valign=\\\"top\\\"\\u003e\\u0026nbsp;\\u003cbr\\u003e93.3\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"14.880952380952381%\\\" valign=\\\"top\\\"\\u003e\\u0026nbsp;\\u003cbr\\u003e93.3\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"17.261904761904763%\\\" valign=\\\"top\\\"\\u003e\\u0026nbsp;\\u003cbr\\u003e93.4\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd width=\\\"14.285714285714286%\\\" valign=\\\"top\\\"\\u003e\\u003cstrong\\u003e\\u0026nbsp;\\u003c/strong\\u003e\\u003cbr\\u003e4.Hydration\\u003cbr\\u003e(n=5)\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"12.5%\\\" valign=\\\"top\\\"\\u003e\\u0026nbsp;\\u003cbr\\u003e0.84\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"23.214285714285715%\\\" valign=\\\"top\\\"\\u003e\\u0026nbsp;\\u003cbr\\u003e0.90\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"17.857142857142858%\\\" valign=\\\"top\\\"\\u003e\\u0026nbsp;\\u003cbr\\u003e89.7\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"14.880952380952381%\\\" valign=\\\"top\\\"\\u003e\\u0026nbsp;\\u003cbr\\u003e92.2\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"17.261904761904763%\\\" valign=\\\"top\\\"\\u003e\\u0026nbsp;\\u003cbr\\u003e87.2\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd width=\\\"14.285714285714286%\\\" valign=\\\"top\\\"\\u003e\\u003cstrong\\u003e\\u0026nbsp;\\u003c/strong\\u003e\\u003cbr\\u003e5.Pre-training meals\\u003cbr\\u003e(n=4)\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"12.5%\\\" valign=\\\"top\\\"\\u003e\\u0026nbsp;\\u003cbr\\u003e0.77\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"23.214285714285715%\\\" valign=\\\"top\\\"\\u003e\\u0026nbsp;\\u003cbr\\u003e0.97\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"17.857142857142858%\\\" valign=\\\"top\\\"\\u003e\\u0026nbsp;\\u003cbr\\u003e88.3\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"14.880952380952381%\\\" valign=\\\"top\\\"\\u003e\\u0026nbsp;\\u003cbr\\u003e90.4\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"17.261904761904763%\\\" valign=\\\"top\\\"\\u003e\\u0026nbsp;\\u003cbr\\u003e86.2\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd width=\\\"14.285714285714286%\\\" valign=\\\"top\\\"\\u003e\\u003cstrong\\u003e\\u0026nbsp;\\u003c/strong\\u003e\\u003cbr\\u003eTotal\\u003cbr\\u003e(n=40)\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"12.5%\\\" valign=\\\"top\\\"\\u003e\\u0026nbsp;\\u003cbr\\u003eNA\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"23.214285714285715%\\\" valign=\\\"top\\\"\\u003e\\u0026nbsp;\\u003cbr\\u003e0.98\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"17.857142857142858%\\\" valign=\\\"top\\\"\\u003e\\u0026nbsp;\\u003cbr\\u003e90.7\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"14.880952380952381%\\\" valign=\\\"top\\\"\\u003e\\u0026nbsp;\\u003cbr\\u003e92.3\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"17.261904761904763%\\\" valign=\\\"top\\\"\\u003e\\u0026nbsp;\\u003cbr\\u003e89.2\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003c/tbody\\u003e\\n\\u003c/table\\u003e\\n\\u003cp\\u003eA-SNKQ: Athletic-Sports Nutrition Knowledge Questionnaire, NTG: Nutrition-trained group, NNTG: No nutrition-trained group, NA: Not applicable\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003csup\\u003ea\\u003c/sup\\u003eChronbach\\u0026rsquo;s alpha \\u003cstrong\\u003e(\\u003c/strong\\u003e\\u0026alpha;\\u003cstrong\\u003e)\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003csup\\u003eb\\u003c/sup\\u003ePearson\\u0026rsquo;s correlation is significant (r) at\\u0026nbsp;\\u003cem\\u003ep\\u003c/em\\u003e\\u0026lt; 0.05\\u003cbr\\u003e\\u0026nbsp;\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eTable 4\\u0026nbsp;\\u003c/strong\\u003e\\u003cstrong\\u003eSummary of the newly validated A-SNKQ\\u0026nbsp;\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003ctable border=\\\"0\\\" cellspacing=\\\"0\\\" cellpadding=\\\"0\\\" width=\\\"896\\\"\\u003e\\n \\u003ctbody\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd width=\\\"20.535714285714285%\\\" valign=\\\"top\\\"\\u003eSection\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"27.678571428571427%\\\" valign=\\\"top\\\"\\u003eSub-sections\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"15.401785714285714%\\\" valign=\\\"top\\\"\\u003eQuestions (n)\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"13.504464285714286%\\\" valign=\\\"top\\\"\\u003eItems (n)\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"22.879464285714285%\\\" valign=\\\"top\\\"\\u003eQuestion format\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd width=\\\"20.535714285714285%\\\" rowspan=\\\"6\\\" valign=\\\"top\\\"\\u003e\\n \\u003col\\u003e\\n \\u003cli\\u003eGNK\\u003c/li\\u003e\\n \\u003c/ol\\u003e\\u0026nbsp;\\u003cbr\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd width=\\\"27.678571428571427%\\\" rowspan=\\\"2\\\" valign=\\\"top\\\"\\u003eMacronutrients\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"51.785714285714285%\\\" colspan=\\\"3\\\" valign=\\\"top\\\"\\u003e\\u0026nbsp;\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd width=\\\"29.74137931034483%\\\" valign=\\\"top\\\"\\u003e04\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"26.07758620689655%\\\" valign=\\\"top\\\"\\u003e27\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"44.18103448275862%\\\" valign=\\\"top\\\"\\u003eSBRQs\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd width=\\\"34.831460674157306%\\\" valign=\\\"top\\\"\\u003eMicronutrients\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"19.382022471910112%\\\" valign=\\\"top\\\"\\u003e03\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"16.99438202247191%\\\" valign=\\\"top\\\"\\u003e08\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"28.792134831460675%\\\" valign=\\\"top\\\"\\u003eSBRQs\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd width=\\\"34.831460674157306%\\\" valign=\\\"top\\\"\\u003eEnergy balance\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"19.382022471910112%\\\" valign=\\\"top\\\"\\u003e04\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"16.99438202247191%\\\" valign=\\\"top\\\"\\u003e09\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"28.792134831460675%\\\" valign=\\\"top\\\"\\u003eSBRQs\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd width=\\\"34.831460674157306%\\\" valign=\\\"top\\\"\\u003eHydration\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"19.382022471910112%\\\" valign=\\\"top\\\"\\u003e03\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"16.99438202247191%\\\" valign=\\\"top\\\"\\u003e11\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"28.792134831460675%\\\" valign=\\\"top\\\"\\u003eSBRQs\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd width=\\\"34.831460674157306%\\\" valign=\\\"top\\\"\\u003eWeight management\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"19.382022471910112%\\\" valign=\\\"top\\\"\\u003e01\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"16.99438202247191%\\\" valign=\\\"top\\\"\\u003e01\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"28.792134831460675%\\\" valign=\\\"top\\\"\\u003eSBRQs\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd width=\\\"20.535714285714285%\\\" rowspan=\\\"7\\\" valign=\\\"top\\\"\\u003e\\n \\u003col\\u003e\\n \\u003cli\\u003eSNK\\u003c/li\\u003e\\n \\u003c/ol\\u003e\\u0026nbsp;\\u003cbr\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd width=\\\"27.678571428571427%\\\" valign=\\\"top\\\"\\u003eCarbohydrate loading\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"15.401785714285714%\\\" valign=\\\"top\\\"\\u003e01\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"13.504464285714286%\\\" valign=\\\"top\\\"\\u003e01\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"22.879464285714285%\\\" valign=\\\"top\\\"\\u003eSBRQs\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd width=\\\"34.831460674157306%\\\" valign=\\\"top\\\"\\u003ePre-training meals\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"19.382022471910112%\\\" valign=\\\"top\\\"\\u003e01\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"16.99438202247191%\\\" valign=\\\"top\\\"\\u003e04\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"28.792134831460675%\\\" valign=\\\"top\\\"\\u003eSBRQs\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd width=\\\"34.831460674157306%\\\" valign=\\\"top\\\"\\u003eTraining meals\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"19.382022471910112%\\\" valign=\\\"top\\\"\\u003e01\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"16.99438202247191%\\\" valign=\\\"top\\\"\\u003e06\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"28.792134831460675%\\\" valign=\\\"top\\\"\\u003eMCQs\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd width=\\\"34.831460674157306%\\\" valign=\\\"top\\\"\\u003ePost-training meals\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"19.382022471910112%\\\" valign=\\\"top\\\"\\u003e02\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"16.99438202247191%\\\" valign=\\\"top\\\"\\u003e11\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"28.792134831460675%\\\" valign=\\\"top\\\"\\u003eMCQs, SBRQs\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd width=\\\"34.831460674157306%\\\" valign=\\\"top\\\"\\u003eSports supplements\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"19.382022471910112%\\\" valign=\\\"top\\\"\\u003e06\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"16.99438202247191%\\\" valign=\\\"top\\\"\\u003e25\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"28.792134831460675%\\\" valign=\\\"top\\\"\\u003eSBRQs\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd width=\\\"34.831460674157306%\\\" valign=\\\"top\\\"\\u003eSupplement label reading, alcohol, isotonic drink, and doping\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"19.382022471910112%\\\" valign=\\\"top\\\"\\u003e04\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"16.99438202247191%\\\" valign=\\\"top\\\"\\u003e18\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"28.792134831460675%\\\" valign=\\\"top\\\"\\u003eSBRQs\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd width=\\\"34.831460674157306%\\\" valign=\\\"top\\\"\\u003eEnergy intake and food habits\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"19.382022471910112%\\\" valign=\\\"top\\\"\\u003e02\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"16.99438202247191%\\\" valign=\\\"top\\\"\\u003e02\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"28.792134831460675%\\\" valign=\\\"top\\\"\\u003eSBRQs\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd width=\\\"20.535714285714285%\\\" valign=\\\"top\\\"\\u003eTotal\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"27.678571428571427%\\\" valign=\\\"top\\\"\\u003e12\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"15.401785714285714%\\\" valign=\\\"top\\\"\\u003e32\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"13.504464285714286%\\\" valign=\\\"top\\\"\\u003e123\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"22.879464285714285%\\\" valign=\\\"top\\\"\\u003eNA\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003c/tbody\\u003e\\n\\u003c/table\\u003e\\n\\u003cp\\u003eGNK= General nutrition knowledge, MCQs= Multiple-choice questions, SBRQs= Single-best response questions, SNK= Sports nutrition knowledge.\\u003c/p\\u003e\"}],\"fulltextSource\":\"\",\"fullText\":\"\",\"funders\":[],\"hasAdminPriorityOnWorkflow\":false,\"hasManuscriptDocX\":true,\"hasOptedInToPreprint\":true,\"hasPassedJournalQc\":\"\",\"hasAnyPriority\":false,\"hideJournal\":true,\"highlight\":\"\",\"institution\":\"\",\"isAcceptedByJournal\":false,\"isAuthorSuppliedPdf\":false,\"isDeskRejected\":\"\",\"isHiddenFromSearch\":false,\"isInQc\":false,\"isInWorkflow\":false,\"isPdf\":false,\"isPdfUpToDate\":true,\"isWithdrawnOrRetracted\":false,\"journal\":{\"display\":true,\"email\":\"info@researchsquare.com\",\"identity\":\"researchsquare\",\"isNatureJournal\":false,\"hasQc\":true,\"allowDirectSubmit\":true,\"externalIdentity\":\"\",\"sideBox\":\"\",\"snPcode\":\"\",\"submissionUrl\":\"/submission\",\"title\":\"Research Square\",\"twitterHandle\":\"researchsquare\",\"acdcEnabled\":true,\"dfaEnabled\":false,\"editorialSystem\":\"\",\"reportingPortfolio\":\"\",\"inReviewEnabled\":false,\"inReviewRevisionsEnabled\":true},\"keywords\":\"Sports nutrition knowledge, track and field, athlete, questionnaire, validation, Sri Lanka\",\"lastPublishedDoi\":\"10.21203/rs.3.rs-3891666/v1\",\"lastPublishedDoiUrl\":\"https://doi.org/10.21203/rs.3.rs-3891666/v1\",\"license\":{\"name\":\"CC BY 4.0\",\"url\":\"https://creativecommons.org/licenses/by/4.0/\"},\"manuscriptAbstract\":\"\\u003ch2\\u003eBackground\\u003c/h2\\u003e \\u003cp\\u003eProper validation of a newly developed sports nutrition knowledge questionnaire is crucial to ensure that health professionals and coaches can confidently assess athletes' nutrition knowledge, which is known to impact athletes' food choices. This study aims to validate the Athletic-Sports Nutrition Knowledge Questionnaire (A-SNKQ), specifically tailored for Sri Lankan track and field athletes.\\u003c/p\\u003e\\u003ch2\\u003eMethods\\u003c/h2\\u003e \\u003cp\\u003eContent validity was determined by translating the ratings of items by sports nutrition experts into a content validity index. Face validity was assessed via in-depth telephone interviews with elite track and field athletes, using a retrospective think-out-loud protocol. Three groups\\u0026mdash;doctors with post-graduate qualifications in human nutrition (NTG), banking professionals (NNTG), and elite or semi-elite track and field athletes (AG)\\u0026mdash;were engaged for the execution of construct validity. Cronbach's alpha was calculated to assess internal consistency, and the correlation coefficient between the two test attempts (test-retest reliability) was determined to evaluate reproducibility.\\u003c/p\\u003e\\u003ch2\\u003eResults\\u003c/h2\\u003e \\u003cp\\u003eThe final tool comprised 123 individual items, formulated as 32 questions within 12 sub-sections. Content validity was confirmed by fully integrating 49 out of 70 comments received for each sub-section and partially integrating 4 comments. Face validity was established by fully integrating 33 comments out of the total (n\\u0026thinsp;=\\u0026thinsp;40) received from 16 athletes. Construct validity was confirmed using the Kruskal-Wallis test, indicating significant differences in the total scores achieved as a percentage of the A-SNKQ among the NTG (462.5, 92.5%), NNTG (223.5, 44.7%), and AG (235, 47.0%; p\\u0026thinsp;\\u0026lt;\\u0026thinsp;0.001). Reproducibility was established by strong test-retest reliability between individuals' scores on two test attempts, three weeks apart (r\\u0026thinsp;=\\u0026thinsp;0.98, p\\u0026thinsp;\\u0026lt;\\u0026thinsp;0.05). Internal reliability for each sub-section met psychometric reliability requirements (Cronbach's α\\u0026thinsp;\\u0026gt;\\u0026thinsp;0.7).\\u003c/p\\u003e\\u003ch2\\u003eConclusion\\u003c/h2\\u003e \\u003cp\\u003eThe A-SNKQ meets all psychometric measures, providing a new, valid, and reliable tool to assess general and sports nutrition knowledge among Sri Lankan track and field athletes.\\u003c/p\\u003e\",\"manuscriptTitle\":\"Validation of a sports nutrition knowledge questionnaire for track and field athletes\",\"msid\":\"\",\"msnumber\":\"\",\"nonDraftVersions\":[{\"code\":1,\"date\":\"2024-01-25 19:31:44\",\"doi\":\"10.21203/rs.3.rs-3891666/v1\",\"editorialEvents\":[{\"type\":\"communityComments\",\"content\":0}],\"status\":\"published\",\"journal\":{\"display\":true,\"email\":\"info@researchsquare.com\",\"identity\":\"researchsquare\",\"isNatureJournal\":false,\"hasQc\":true,\"allowDirectSubmit\":true,\"externalIdentity\":\"\",\"sideBox\":\"\",\"snPcode\":\"\",\"submissionUrl\":\"/submission\",\"title\":\"Research Square\",\"twitterHandle\":\"researchsquare\",\"acdcEnabled\":true,\"dfaEnabled\":false,\"editorialSystem\":\"\",\"reportingPortfolio\":\"\",\"inReviewEnabled\":false,\"inReviewRevisionsEnabled\":true}}],\"origin\":\"\",\"ownerIdentity\":\"40f27518-f98f-4ac3-a58e-60cb7343a882\",\"owner\":[],\"postedDate\":\"January 25th, 2024\",\"published\":true,\"recentEditorialEvents\":[],\"rejectedJournal\":[],\"revision\":\"\",\"amendment\":\"\",\"status\":\"posted\",\"subjectAreas\":[],\"tags\":[],\"updatedAt\":\"2024-03-14T10:24:30+00:00\",\"versionOfRecord\":[],\"versionCreatedAt\":\"2024-01-25 19:31:44\",\"video\":\"\",\"vorDoi\":\"\",\"vorDoiUrl\":\"\",\"workflowStages\":[]},\"version\":\"v1\",\"identity\":\"rs-3891666\",\"journalConfig\":\"researchsquare\"},\"__N_SSP\":true},\"page\":\"/article/[identity]/[[...version]]\",\"query\":{\"redirect\":\"/article/rs-3891666\",\"identity\":\"rs-3891666\",\"version\":[\"v1\"]},\"buildId\":\"qtupq5eGEP_6zYnWcrvyt\",\"isFallback\":false,\"isExperimentalCompile\":false,\"dynamicIds\":[84888],\"gssp\":true,\"scriptLoader\":[]}","source_license":"CC-BY-4.0","license_restricted":false}