Starting the conversation performance of a brief dietary assessment and intervention tool for health professionals

Am J Prev Med. 2011 Jan;40(1):67-71. doi: 10.1016/j.amepre.2010.10.009.


Introduction: For chronic disease prevention and management, brief but valid dietary assessment tools are needed to determine risk, guide counseling, and monitor progress in a variety of settings. Starting The Conversation (STC) is an eight-item simplified food frequency instrument designed for use in primary care and health-promotion settings.

Purpose: This report investigates the feasibility, validity, and sensitivity to change of the STC tool, a simplified screener instrument for assessment and counseling.

Methods: Data from an ongoing practical efficacy study of type 2 diabetes patients in a diverse population (N=463) were used to document STC validity, robustness, stability, and sensitivity to change from baseline to 4 months. Data were collected from 2008 to 2010, and they were analyzed for this report in 2010.

Results: The eight STC items and summary score performed well. STC items and the summary score were moderately intercorrelated (r =0.39-0.59, p<0.05). The STC summary score was significantly correlated with the NCI fat screener at baseline (r =0.39, p<0.05), and change in the STC summary score correlated with reduction in percentage of calories from fat (r =0.22, p<0.05) from baseline to 4 months. The STC was sensitive to the intervention, with intervention participants improving significantly more than controls on the summary score (M=1.16 vs 0.46, p<0.05).

Conclusions: The brief STC is a relatively simple, valid, and efficient tool for dietary assessment and intervention in the clinical setting. It is available in English and Spanish and is in the public domain. Researchers and practitioners are encouraged to assess its utility in other settings and with other dietary interventions.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Validation Study

MeSH terms

  • Aged
  • Counseling / methods
  • Diet Records*
  • Diet*
  • Dietary Fats
  • Feasibility Studies
  • Female
  • Health Promotion / methods*
  • Humans
  • Male
  • Middle Aged
  • Primary Health Care / methods*
  • Surveys and Questionnaires


  • Dietary Fats