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 Health Promotion International, Vol. 30 No. 3
doi:10.1093/heapro/dat072
Advance Access published 22 October, 2013
Reliability and validity of television food advertising
questionnaire in Malaysia
ABDUL RAZAK ZALMA1,2*, MD. YUSOF SAFIAH1, DANIS AJAU1
and MD. ISA KHAIRIL ANUAR1
1
Faculty of Health Sciences, Universiti Teknologi MARA, Puncak Alam Campus, 42300 Puncak Alam,
Selangor, Malaysia and 2Nutrition Division, Ministry of Health Malaysia, Level 1, Block E3, Parcel E,
Precint 1, Federal Government Administrative Center, 62590 Putrajaya, Malaysia
*Corresponding author. E-mail: zairazak_04@yahoo.com.my
SUMMARY
Interventions to counter the influence of television food ad-
vertising amongst children are important. Thus, reliable
and valid instrument to assess its effect is needed. The ob-
jective of this study was to determine the reliability and val-
idity of such a questionnaire. The questionnaire was
administered twice on 32 primary schoolchildren aged 10–
11 years in Selangor, Malaysia. The interval between the
first and second administration was 2 weeks. Test– retest
method was used to examine the reliability of the question-
naire. Intra-rater reliability was determined by kappa coef-
ficient and internal consistency by Cronbach’s alpha
coefficient. Construct validity was evaluated using factor
analysis. The test– retest correlation showed moderate-to-
high reliability for all scores (r ¼ 0.40*, p ¼ 0.02 to r ¼
0.95**, p ¼ 0.00), with one exception, consumption of fast
Key words: reliability; validity; food advertising; schoolchildren
INTRODUCTION
Childhood obesity is a global problem and it is a
public health concern in Malaysia. The National
Health and Morbidity Survey (NHMS) III
reported that 5.4% of children aged ,18 years
were overweight (weight-for-age . þ2SD) (MOH,
2008), whereas the reanalysed data of the NHMS
III showed that 11.4% children aged 6–12 years
were obese (BMI-for-age . þ2SD) (MOH, un-
published data). Whilst many factors contribute to
obesity, food advertisements targeted at children
has been recognized as one of the main factors, and
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foods (r ¼ 0.24, p ¼ 0.20). Kappa coefficient showed ac-
ceptable-to-strong intra-rater reliability (K ¼ 0.40– 0.92),
except for two items under knowledge on television food
advertising (K ¼ 0.26 and K ¼ 0.21) and one item under
preference for healthier foods (K ¼ 0.33). Cronbach’s
alpha coefficient indicated acceptable internal consistency
for all scores (0.45–0.60). After deleting two items under
Consumption of Commonly Advertised Food, the items
showed moderate-to-high loading (0.52, 0.84, 0.42 and
0.42) with the Scree plot showing that there was only one
factor. The Kaiser –Meyer –Olkin was 0.60, showing that
the sample was adequate for factor analysis. The question-
naire on television food advertising is reliable and valid to
assess the effect of media literacy education on television
food advertising on schoolchildren.
it is considered as an important arena of action in
the prevention of obesity (WHO, 2006).
Food industries are using various strategies to
get to the children, and the most dominant
medium used is television (Cairns et al., 2009).
This is because television is the most effective
way of marketing foods worldwide (Hawkes,
2004). Studies done by 13 independent research
groups in 11 countries found that 18% of the
television advertisements were for food, and
overall, food was the second most frequently
advertised product, after channel promotions
(23%). Majority of food advertisements were for
523
 524 A. R. Zalma et al.
non-core (unhealthy) food (67%), such as
fast-food restaurant meals (12% of food adver-
tisements), chocolate and confectionery (12%)
and high-fat, high-sugar or high-salt spreads and
sauces (8%) (Kelly et al., 2010).
In a study conducted in Malaysia, it was found
that 54162 advertisements were broadcasted by
free-to-air TV stations during children’s prime
time, and 27.9% composed of food products
advertisements (Karupaiah et al., 2008). Snack
foods which are considered as unhealthy food
was found to be the most advertised food groups
(34.5%), followed by dairy products (20.3%),
confectionary (13.4%), biscuits (11.2%), fast
food (6.7%), breakfast cereals (6.4%) and bev-
erages (4.1%). Children need to be protected
from heavy marketing of unhealthy food through
television food advertising because marketing
generates positive beliefs about advertised foods
and influences children’s food preferences, pur-
chase requests and consumption (Livingston and
Helpers, 2004; Cairns et al., 2009; Nazari et al.,
2011). The influence of food marketing is beyond
their understanding of its persuasive intent
(WHO, 2012).
Harris and Bargh (Harris and Bargh, 2009)
had proposed media literacy education as one of
the three broad categories of solutions to protect
children against the unhealthy influence of tele-
vision and food advertising. Media literacy
means the ability to gain access, analyse, evalu-
ate, create and participate with media in all its
forms (Jolls, 2011), thus media literacy education
means teaching the skills associated with media
literacy. Critical viewing skills acquired through
media literacy education has been found to be
related to higher taste ratings for healthy foods
and lower taste ratings for unhealthy, highly
advertised foods (Harris and Bargh, 2009). Thus,
teaching children to defend against advertising
influence through media literacy education is
recommended to increase their critical viewing
skills and scepticism about the media and adver-
tising. Media literacy education on television
food advertising is relatively new in Malaysia and
to our knowledge there is no standard instrument
developed for our population to determine the
effectiveness of media literacy education. Other
studies (Stansfeld et al., 2003; Gwozdz and
Reisch, 2011; Jolls, 2011) regarding food advertis-
ing and food consumption have used instruments
suitable for European and American population.
The objective of this study was to examine the reli-
ability and validity of a questionnaire on television
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food advertising, which will be used to assess the
effect of media literacy education on television
food advertising among schoolchildren. Since
food advertising influences children’s nutritional
knowledge, food preferences and food consump-
tions (WHO, 2006), the questionnaire was devel-
oped to cover these three main dimensions which
were knowledge on healthier food, preference
for healthier food and consumption of commonly
advertised foods on television. Knowledge on
television food advertising was also included to
gather some basic data on the children’s media
literacy.
METHODS
This was a pilot study of a questionnaire intended
to be used in a study to evaluate the effect of
media literacy education on television food ad-
vertising on schoolchildren. The study protocol
was approved by the Ethical Committee of
Universiti Teknologi MARA Malaysia.
Sample
For this study a primary school in Selangor (one
of the states in Malaysia) was selected and the
participants were all the pupils from one class
that had been selected at random. At the first ad-
ministration of the questionnaire, 32 participants
aged 10–11 years took part, and at the second
administration 31 took part.
Television food advertising questionnaire
The questionnaire was developed to cover the
three areas that can be influenced by food pro-
motion to children (WHO, 2006). These are chil-
dren’s nutritional knowledge, food preferences
and food consumption. The other areas, which
were purchasing and purchase-related behaviour
and diet and health status, were not covered in
this questionnaire. Items for knowledge on tele-
vision food advertising (section E) were adapted
from Jolls (Jolls, 2011), whereas items for knowl-
edge on healthier food (section F) and prefer-
ence for healthier food (section G) were adapted
from Gwozdz and Reisch (Gwozdz and Reisch,
2011). Items for Consumption of Commonly
Advertised Foods (section H) were adapted
from Stansfeld et al. (Stansfeld et al., 2003).
Sections A –D gather basic information of the
children and their parents which are the parents’

occupation, level of education and household
income (Section A); the children’s date of birth,
gender and race (Section B); the children’s
weight, height and body mass index (Section C)
and the time the children spent watching televi-
sion (Section D). They were not included in the
analysis to assess reliability and validity of the
questionnaire.
There were eight items in Section E. Each
item had two, three or four answer options
(Table 1). Each correct response was allocated
one score and each incorrect response was allo-
cated zero score. The maximum score for this
section was eight.
Sections F and G both consisted of the same
10 matched pairs of food types, one being health-
ier and the other less healthy. In Section F, for
each food pair, the children were required to
record which food type that they preferred and
for Section G, the children were required to
record which food type that they believed to be
healthier. Even though the items were adapted
Gwozdz and Reisch (Gwozdz and Reisch, 2011),
some of the foods were modified or added to suit
the local situation as recommended by the local
experts. The 10 matched food pairs (in order of se-
quence) were sugar-free breakfast cereals versus
sugared breakfast cereals, white rice versus fried
rice (local food added), snack foods versus biscuits
(local food added), carbonated drinks (modified
from ‘Coke’) versus plain water, noodles pre-
pared at home (modified from ‘pasta’) versus
instant noodles (modified form ‘pot noodles’),
fried chicken (modified from ‘beef burger’)
versus chicken soup (modified from ‘roast beef’),
fruit yoghurt (modified from ‘strawberry
yoghurt’) versus fruit cake (modified from ‘straw-
berry cake’), wholemeal bread and white bread,
fried potatoes (French fries) versus boiled pota-
toes (modified from potato) and fruits (modified
from ‘orange’) versus fruit-flavoured ice-cream
or ice confection (modified from ‘orange ice’.
The following food pairs were not included in
our questionnaire—cereal bar versus chocolate
bar and orange juice versus orange squash.
Food pairs were arranged side by side on a
page. Photographs taken from local foods were
placed beside the food item to help the partici-
pants to recognize the products. They were asked
to put a smile on a face image next to the picture
for the food they preferred (Section F) or believed
to be healthier (Section G). Food preferences
were assessed by summing up the total number of
healthier (correct) food types preferred out of the
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Reliability and validity of television 525
10 food pairs to form a maximum healthier prefer-
ence score of 10. Similarly, knowledge of healthier
foods was assessed by summing up the total cor-
rectly identified healthier food types out of the 10
food pairs to form a maximum knowledge score
of 10.
Section H consisted of six food types which
were snack foods, sweets and chocolates, biscuits,
fast food, breakfast cereals and carbonated
drinks. These foods were considered as common-
ly advertised food in the free-to-air Malaysian
TV channels (Karupaiah et al., 2008). All the
food groups were similar to those listed by
Stansfeld et al. (Stansfeld et al., 2003), except for
‘fried food, chips, samosas or bhajis, or fried
English breakfast’ which has been replaced with
fast foods. Breakfast cereal was added to the
questionnaire as the sixth food group.
For each food type, the participants were
asked to record the frequency that they eat the
food, whether more than once a day, once a day,
at least once a week, once or twice a month or
never. Scores were given to the frequencies.
More than once a day was given one score; once
a day, two scores; at least once a week, three
scores; once or twice a month, four scores and
never, five scores.
Translation procedure
The questionnaire was first drafted in English
and later being translated to the national lan-
guage, Bahasa Malaysia. The translation was
checked and verified by the National Institute of
Translation Malaysia.
Data collection
The study was conducted in April 2012 with per-
mission obtained from the Ministry of Education
Malaysia and the Selangor State Education
Department. The questionnaire was adminis-
tered twice to the same participants with 2-weeks
interval to enable test –retest analysis. It was con-
ducted in the classroom, whereby a briefing
session was done by the researcher to all partici-
pants to ensure they understood what was
required to be done. The participants had to
answer the questions by themselves. However,
they could always ask the researcher who was
present all the time to clarify any item that they
were not sure about. Quality check was done
after all the questionnaires were collected while
the participants were still present.
 526 A. R. Zalma et al.
Table 1: Intra-rater reliability test for knowledge on television food advertising, knowledge on healthier food
and preference for healthier food
Dimensions Items Measurement of
agreement (kappa
value)

Knowledge on (1) The main goal of an advertisement or commercial is to. . . 0.558

television food (a) Entertain (incorrect)
advertising (b) Sell (correct)
(Section E) (c) Teach (incorrect)
(d) Make you laugh (incorrect)
(2) Photograph always shows people and things just the way they are in real life: 0.595
(a) True (incorrect)
(b) False (correct)
(3) Food advertisements look fun, with bright colours and music, because. . . 0.553
(a) The food is fun to eat (incorrect)
(b) Parents like the ads (incorrect)
(c) Fun ads get my attention (correct)
(d) Watching food ads will make you a fun person (incorrect)
(4) It is important to ask questions about what advertising tells us because. . . 0.403
(a) Advertising makes us do things (incorrect)
(b) Advertising is bad (incorrect)
(c) Asking questions helps us make better choice (correct)
(d) The teacher told me (incorrect)
(5) Which is the best question to ask after seeing a commercial message that 0.793
advertise candy or snack food?
(a) Where can I buy this candy as soon as possible? (incorrect)
(b) When will I be able to eat this candy? (incorrect)
(c) Why was this message sent? (correct)
(6) Everyone of my age likes the same advertisements on sweets that I like: True 0.262
or false.
(a) True (incorrect)
(b) False (correct)
(7) Television programmes might seem to be free but who ultimately pays for 0.737
them?
(a) Consumers (correct)
(b) TV networks (incorrect)
(c) Advertisers (incorrect)
(8) It is important to consider who created the advertising message in order to. . . 0.209
(a) Know who to blame (incorrect)
(b) Find the bias that always exists (correct)
(c) Find out who created the music on the commercial (incorrect)
Knowledge on 1. Sugar-free breakfast cereals versus sugared breakfast cereals 0.599
healthier food 2. White rice versus fried rice 0.783
(Section F) 3. Snack foods versus biscuits 0.611
4. Carbonated drinks versus plain water 0.413
5. Noodles prepared at home versus instant noodles 0.793
6. Fried chicken versus chicken soup 0.843
7. Fruit yoghurt versus fruit cake 0.757
8. Wholemeal bread and white bread 0.512
9. Fried potatoes (French fries) versus boiled potatoes 0.923
10. Fruits versus fruit-flavoured ice-cream or ice confection 0.712
Preference on 1. Sugar-free breakfast cereals versus sugared breakfast cereals 0.475
healthier food 2. White rice versus fried rice 0.533
(Section G) 3. Snack foods versus biscuits 0.625
4. Carbonated drinks versus plain water 0.64
5. Noodles prepared at home versus instant noodles 0.68
6. Fried chicken versus chicken soup 0.784
7. Fruit yoghurt versus fruit cake 0.713
8. Wholemeal bread and white bread 0.331
9. Fried potatoes (French fries) versus boiled potatoes 0.587
10. Fruits versus fruit-flavoured ice-cream or ice confection 0.585

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 Reliability and validity of television 527
Statistical analysis fast foods which had no significant correlation
The mean scores for each of the sections (E, F, G between test and retest scores.
and H) were calculated to analyse test– retest Kappa coefficient indicated acceptable-to-
correlation to assess reliability. Kappa coefficient strong intra-rater reliability (K . 0.40), except
to assess intra-rater reliability was obtained using for two items under knowledge on television
scores for each item under Sections E, F and G. food advertising and one item under preference
Internal consistency and construct validity was for healthier food (Table 1).
assessed using Cronbach’s alpha coefficient and Internal consistency as showed by Cronbach’s
factor analysis, respectively, for six items from alpha coefficient was low (0.573) when all the
Section H. Significant level was set at 0.05 items under consumption of commonly adver-
(2-tailed). All data were analysed using PASW tised foods were analysed. The value became ac-
Statistics 18 (SPSS, Inc., 2012). ceptable (0.610) after an item ‘consumption of
breakfast cereal’ was deleted. However, the value
of ‘Cronbach’s alpha if item deleted’ for ‘consump-
tion of biscuits’ was higher (0.612) than this corre-
RESULTS
sponding Cronbach’s alpha coefficient. Therefore,
‘consumption of biscuits’ was also deleted. After
All the 32 participants were Malays, 34.4% were
deleting these two items, Cronbach’s alpha coeffi-
male and 65.5% were female. The mean age was
cient showed acceptable internal consistency for
129.5 + 3.7 months (10.8 years). The average time
the scores (Table 2). Even though the values were
they spent watching television was 2 h per day.
,0.7, according to Di Iorio (Di Iorio, 2005), 0.7
Thirty-one participants took part in the retest.
should not be the only standard used to assess reli-
ability, whereby the shorter scale, with the lower
alpha value, actually demonstrates higher inter-
Knowledge on television food advertising,
relatedness among items. Furthermore, the total
knowledge on healthier food and preference for
corrected correlation of each item was .0.2, and
healthier food
the value of ‘Cronbach’s alpha if item deleted’
The results showed that the participants had the for each item was less than the corresponding
highest score for knowledge on healthier food, Cronbach’s alpha coefficient of the dimension,
followed by preference for healthier food and showing that there should be no item to be elimi-
knowledge on television food advertising for both nated or revised.
test and retest. The mean score for test and retest
for knowledge on healthier food was 7.69 +2.28
Validity of the questionnaire
and 6.95 + 2.48, preference for healthier food was
5.13 + 2.03 and 4.93 + 1.91, and, knowledge on Factor analysis was used to assess the validity of
television food advertising was 3.63 + 1.58 and the questionnaire. However, the analysis was only
3.65 + 1.66, respectively.
Table 2: Internal consistency for consumption of
commonly advertised foods
Reliability of the questionnaire
Items Corrected Cronbach’s Cronbach’s
The test–retest correlation coefficient, Spearman’s item-total alpha if item alpha
rho for knowledge on television food advertising correlation deleted
was 0.690 ( p , 0.01), knowledge on healthier
Consumption 0.337 0.588 0.612
food was 0.850 ( p , 0.01) and preference for of snack
healthier food was 0.950 ( p , 0.01). These indi- foods
cated moderate-to-high reliability for all scores. Consumption 0.548 0.451
For consumption of commonly advertised foods, of sweets
the test–retest correlation coefficient, Spearman’s and
chocolates
rho was 0.595 (p , 0.01) for snack foods, 0.533 Consumption 0.407 0.530
(p , 0.01) for sweets and chocolates, 0.648 (p , of fast foods
0.01) for biscuits, 0.238 (p . 0.05) for fast foods, Consumption 0.318 0.598
0.410 (p , 0.05) for breakfast cereals and 0.405 of
carbonated
(p , 0.05) for carbonated drinks. These indicated drinks
moderate reliability, except for consumption of

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 528 A. R. Zalma et al.
done for Part H which had items with more than
three response options. One basic requirement
for factor analysis is that the scale includes items
that are measured on a rating scale that consists of
at least three response options (Di Iorio, 2005).
After deleting two items under consumption
of commonly advertised food, the items showed
moderate-to-high loading (Table 3), with the
Scree plot showing that there was only one
factor. The KMO (Kaiser –Meyer –Olkin) was
0.60, showing that the sample was adequate for
factor analysis (Field, 2005).
DISCUSSION
This study focused on developing an instrument
to assess the effect of media literacy education
on television food advertising on schoolchildren.
The effect was assessed in four dimensions,
which were knowledge on television food adver-
tising, knowledge on healthier food, preference
for healthier food and consumption of commonly
advertised food.
The average time the children spent watching
television was 2 h per day. This shows that this
group of children was appropriate sample for this
study, whereby children who watched TV two or
more hours a day was more likely to be consu-
mers of all the commonly advertised foods
(Utter et al., 2006).
The children had the highest score for knowl-
edge on healthier food. This may be due to fact
that nutrition is one of the health component
taught in schools through various subjects such
as Science, Physical Education and Health,
Living Skills, Bahasa Malaysia and English.
However, scores for preference for healthier
food was not as high as knowledge on healthier
foods, showing that the children do not necessar-
ily choose or eat healthier food even though they
know that the food is healthier. This finding
shows that lack of nutrition knowledge may not
Table 3: Factor analysis for consumption of
commonly advertised foods
Items Factor loading
(n ¼ 32)
Consumption of snack foods 0.523
Consumption of sweets and 0.835
chocolates
Consumption of fast foods 0.423
Consumption of carbonated drinks 0.417
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be the reason for poor eating habits among
schoolchildren in Malaysia. It is consistent with
previous findings among UK children (Kopelman
et al., 2007; Gwozdz and Reisch, 2011). The scores
for knowledge on healthier food and preference
for healthier food was lower at the retest. The par-
ticipants might had been bored and less motivated
since they had to answer the questions twice. This
fatigue effect leads to inaccurate responses by the
children. The same trend was reported in another
study by Vereecken et al. (Vereecken et al., 2012).
However, this seems not to give significant effect
to the stability of the questionnaire as the test–
retest correlation indicates moderate-to-high reli-
ability for all scores. Strong intra-reliability of the
questionnaire showed that it is stable and reprodu-
cible. However, low Kappa value for two items
under knowledge on television food advertising
showed that the items need to be reviewed to
make it better understood by the children. The
same goes to the item under preference for
healthier foods (wholemeal bread and white
bread). The children may not be exposed to or
consume different types of bread; therefore, they
were not being able to choose constantly the
bread that they prefer. This result suggests that ex-
planation on the types of bread need to be thor-
ough and in-depth discussion on the food types
that the children are consuming is crucial before
listing the food types that they prefer.
Two items under consumptions of commonly
advertised foods which were consumptions of
biscuits and consumptions of breakfast cereals
were deleted to have the good internal consist-
ency among the items in this dimension. The
foods listed under this dimension were consid-
ered as less healthy because most food products
advertised on television are high in sugar, fat and
salt (WHO, 2006). However, for these children,
they believe that biscuits and breakfast cereals
are healthy due to repeated messages on televi-
sion portraying all biscuit and breakfast cereals
are healthy. The fact is that most television food
advertisements were for sugary biscuits and
breakfast cereals. Biscuit was one of the food
groups that have the highest energy density and
the highest fat content in the advertised foods
(Karupaiah et al., 2008). This result suggests the
need to include examples of these foods (less
healthy versions that are commonly advertised
on television) in the questionnaire.
Factor analysis showed that the questions
under consumptions of commonly advertised
foods were valid. It was loaded with one factor

which was shown by the Scree plot, the plot that
is being used to determine the number of factors
that are appropriate with the instrument (Brown,
2001). It proved that all the items were asking the
same factor, which is less healthy food which was
commonly advertised on television. Even though
the sample is small, the value of KMO was 0.6,
showing that it is adequate for factor analysis, as
the value of KMO should be .0.5 (Field, 2005).
Furthermore, the sample of 32 for four items is
not really far below the recommendation by Pett
et al. (Pett et al., 2003) who suggest 10–15 partici-
pants per item.
The limitation of the study is that it was con-
ducted in the urban area and the participants
were all Malays. For participants in rural areas, a
simpler questionnaire might be needed since
their level of understanding of the questions
might be lower. Children from rural areas gener-
ally have lower school achievement (Hassan and
Rasiah, 2011). For children from other races es-
pecially who are attending national-type schools
which use Mandarin or Tamil as the medium,
they might not well understood the questions set
in Bahasa Malaysia. A questionnaire set in
Mandarin and Tamil might be needed for these
children. Therefore, other studies need to be
conducted to determine reliability and validity of
this questionnaire amongst rural children and
also children from different ethnic groups. Since
this study has a small sample size and only con-
struct validity was assessed, other studies with
bigger sample size and aimed at assessing other
forms of validity (i.e. discriminative and predict-
ive validity) need to be conducted too.
Overall, the questionnaire on television food
advertising is reliable and valid to assess the
effect of media literacy education on television
food advertising on schoolchildren.
ACKNOWLEDGEMENTS
The authors acknowledge contributions from the
Ministry of Education Malaysia, the Selangor State
Education Department, teachers and students who
enthusiastically participated in this study.
FUNDING
This work was supported by a grant from Uni-
versiti Teknologi MARA (UiTM) (600-RMI/
DANA 5/3/RIF(331/2012).
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Reliability and validity of television 529
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