ABSTRACT
Background and Objectives
Brief tools are needed for nutrition risk screening in clinical practice and community settings. A previously developed short tool, SCREEN-8, although widely used in practice and research, may not be specific enough, resulting in overidentifying risk. This study aimed to identify the best-minimum set of items from SCREEN-14 (Seniors in the Community Risk Evaluation for Eating and Nutrition) to determine nutrition risk in older adults.
Research Design and Methods
Data from participants who had completed an online version of SCREEN-14 (n = 20,093) were available for analysis. Item Response Theory (IRT), using the Graded Response Model, was applied to identify a subset of eight items for all participants, as well as those over the age of 75 years, with the resulting item sets compared. The eight items identified for the 75+ year subsample were selected for consideration in the abbreviated version; scoring remained consistent with SCREEN-8 for comparison.
Results
The proportion at risk based on SCREEN-8 was 42.1% whereas the proportion at risk with SCREEN-IRT was 27.7%. Items in SCREEN-IRT demonstrated a good model fit (RMSEA = 0.075; CFI = 0.905). SCREEN-8 also demonstrated a good/acceptable model fit (RMSEA = 0.064; CFI = 0.913).
Discussion and Implications
A new 8-item version of SCREEN was created with IRT. This tool has different items than SCREEN-8 and resulted in a lower proportion of adults as potentially at nutrition risk. Further research on criterion validity of SCREEN-IRT is needed.
Journal of Human Nutrition and Dietetics, Volume 39, Issue 3, June 2026. Read More