Development of a Tool to Evaluate the Psychosocial Drivers of Consumption of Fast Foods Among Makerere University Students.

Abstract

Background: Non-communicable diseases (NCDs) represent an escalating public health crisis in Uganda, accounting for over 33% of national mortalities. Unhealthy dietary behaviours, specifically the frequent consumption of fast foods, are key structural drivers of metabolic risks like obesity among young adults. At Makerere University, 93.7% of students habitually consume fast foods like fries, samosas, Rolex and pizzas among others, despite widespread awareness of the associated health hazards. Traditional dietary assessment methods look primarily at consumption volume and caloric frequency. This leaves a significant methodological gap in evaluating the latent psychological and environmental triggers dietary choices among students. Objective: This study aimed to develop and psychometrically validate a specialized assessment tool to evaluate the multi-dimensional psychosocial drivers of fast-food consumption among university students. Methodology: Grounded in the Theory of Planned Behaviour and the Socio-Ecological Model, an initial questionnaire was constructed across four core behavioural domains: attitudes, subjective norms, perceived behavioural control, and behavioural intentions. A panel of senior academic experts from Makerere University evaluated the item pool to content validity. Students evaluated their understanding on the contents of the questionnaire. The refined tool was field-tested on the College of Agriculture and Environmental Sciences to determine internal consistency and test-retest reliability. Results: Expert panel consensus yielded a high mean Content Validity Ratio (CVR) of 0.83 and an overall Scale-Level Content Validity Index (S-CVI) of 0.92, verifying exceptional conceptual relevance. Subscale evaluation showed strong individual relevance indexes, specifically 0.90 for attitude, 1.00 for subjective norms, 0.97 for perceived behavioural control, and 0.85 for intention. The instrument achieved high internal consistency, with baseline and retest Cronbach‘s alpha coefficients reaching 0.80 and 0.82, respectively. Test-retest reliability over a two-week interval was confirmed by strong linear correlation (r = 0.81) and high absolute agreement via the Intraclass Correlation Coefficient (ICC = 0.80). Conclusion: The developed 15-item tool is a valid, reliable, and culturally adapted instrument for capturing the complex cognitive and situational drivers of fast-food consumption. This diagnostic scale can bypass superficial tracking to provide public health stakeholders, university administrators, and policymakers with the precise data needed to design targeted behavioural interventions, reinforce campus wellness frameworks, and reduce long-term NCD burdens among Ugandan young adults. Keywords: Fast food, Psychometrics, Validation, Theory of Planned Behaviour, University students, Uganda.