Attitudes of Polish adolescents towards energy drinks. Part 1. Development, validation and reliability testing of a scale to identify attitudes towards energy drinks
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Faculty of Physiotherapy and Health Sciences, Gdansk College of Health, Poland
Faculty of Management and Quality Science, Gdynia Maritime University, Poland
Katarzyna Żyłka   

Faculty of Physiotherapy and Health Sciences, Gdansk College of Health, Pelplinska 7, 80-335 Gdansk, Poland
Introduction and objective:
Attitudes towards food are one of the most important but often underestimated factors related to food consumption. In recent years, researchers have pointed to the growing popularity of energy drinks (EDs) among adolescents and emphasized health risks posed by energy drink (ED) consumption. A substantive and research gap has been found in the subject of identifying attitudes towards EDs.

The aim of the study was to develop and validate a scale to identify adolescents’ attitudes towards EDs, and to examine this scale in terms of reliability.

Material and methods:
The scale was validated, including content validation, response process validation and statistical validation. Experts in identifying attitudes towards food participated in the content validation procedure. Response process validation was conducted in a pre-test sample of adolescents aged 13–19 years, while statistical validation was performed based on results obtained in a pilot study. Reliability was tested using Cronbach’s alpha.

At the beginning, the scale consisted of 28 statements. Performing content validation resulted in the elimination of 2 items from the scale. The last step of the procedure, reliability testing, was connected with removing another 5 statements from the scale. A final version of the scale to identify adolescents’ attitudes towards EDs consisted of 21 statements. Cronbach’s alpha of the scale was 0.856, indicating high reliability of this scale.

The constructed scale is valid, reliable and therefore can be used as a research instrument in the identification of adolescents’ attitudes towards EDs, and also in investigating associations between these attitudes and behaviours related to ED consumption.

BMI—body mass index; ED—energy drink; EDs—energy drinks; KMO—Kaiser-Meyer-Olkin; PC—principal component; PCA—principal component analysis; PCs—principal components; PC1—first principal component; PC2—second principal component; PC3—third principal component
Bogacz A. [Who is bothered with energy drinks?]. Przem Ferment Owoc-Warz. 2016;3:32–33 (in Polish).
Reissig CJ, Strain EC, Griffiths RR. Caffeinated energy drinks – a growing problem. Drug Alcohol Depend. 2009;99(1–3):1–10.
Błaszczyk-Bębenek E, Jagielski P, Schlegel-Zawadzka M. Characteristics of energy drink consumption among adolescents from southern Poland. J Hygienic Engin Design. 2018;23:91–98.
Kwiatkowska K, Winiarska-Mieczan A, Kwiecień M, et al. [Consumption of energy drinks by teenagers in Lublin Province]. Probl Hig Epidemiol. 2018;99(2):140–145 (in Polish).
Carsi Kuhangana T, Muta Musambo T, Pyana Kitenge J, et al. Energy Drink Consumption among Adolescents Attending Schools in Lubumbashi, Democratic Republic of Congo. Int J Environ Res Public Health. 2021;18:7617.
Cofini V, Cecilia MR, Di Giacomo D, et al. Energy drinks consumption in Italian adolescents: preliminary data of social, psychological and behavioral features. Minerva Pediatr. 2019;71(6): 488–494.
Kaldenbach S, Strand TA, Solvik BS, Holten-Andersen M. Social determinants and changes in energy drink consumption among adolescents in Norway, 2017–2019: a cross-sectional study. BMJ Open. 2021;11:e049284.
Harris JL, Munsell CR. Energy drinks and adolescents: what’s the harm? Nutr Rev. 2015;73(4): 247–257.
De Sanctis V, Soliman N, Soliman AT, et al. Caffeinated energy drink consumption among adolescents and potential health consequences associated with their use: a significant public health hazard. Acta Biomed. 2017;88(2):222–231. 10.23750/abm.v88i2.6664.
Kurzydem L. Energy drinks as a potential health risk for children and adolescents. J Physical Educ Health. 2019;8(13):25–35.
Ruiz LD, Scherr RE. Risk of Energy Drink Consumption to Adolescent Health. Am J Lifestyle Med. 2018;13(1):22–25.
Schneider MB, Benjamin HJ, Committee on Nutrition and the Council on Sports Medicine and Fitness. Sports Drinks and Energy Drinks for Children and Adolescents: Are They Appropriate? Pediatrics. 2011;127(6):1182–1189.
Zucconi S, Volpato C, Adinolfi F, et al. Gathering consumption data on specific consumer groups of energy drinks. EFSA Supporting Publications. 2013;EN-394.
Euromonitor International. Will Increasing Regulation Slow Growth of Energy Drinks in Mexico? (access: 15.02.2022).
European Parliament. Parliamentary questions. Subject: National policies on energy drink sales to minors. (access: 15.02.2022).
Marmorstein NR. Interactions Between Energy Drink Consumption and Sleep Problems: Associations with Alcohol Use Among Young Adolescents. J Caffeine Res. 2017;7(3):111–116.
Moussa M, Hansz K, Rasmussen M, et al. Cardiovascular Effects of Energy Drinks in the Pediatric Population. Pediatr Emerg Care. 2021;37(11):578–582.
Petrelli F, Grappasonni I, Evangelista D, et al. Mental and physical effects of energy drinks consumption in an Italian young people group: a pilot study. J Prev Med Hyg. 2018;59(1):E80-E87.
Richards G, Smith AP. A Review of Energy Drinks and Mental Health, with a Focus on Stress, Anxiety, and Depression. J Caffeine Res. 2016;6(2):49–63.
Holubcikova J, Kolarcik P, Madarasova Geckova A, et al. Regular energy drink consumption is associated with the risk of health and behavioural problems in adolescents. Eur J Pediatr. 2017; 176(5):599–605.
Matumoto MSS, Terada RSS, Higashi DT, et al. In vitro effect of energy drinks on human enamel surface. Rev Odontol UNESP. 2018;47(1):57–62.
Hardy LL, Bell J, Bauman A, Mihrshahi S. Association between adolescents’ consumption of total different types of sugar-sweetened beverages with oral health impacts and weight status. Aust N Z J Public Health. 2018;42(1):22–26.
Ajzen I. Attitudes and personality traits. In: Manstead T, editor. Attitudes, personality and behavior. 2nd ed. Berkshire: Open University Press; 2005. p. 1–23.
Bohner G, Dickel N. Attitudes and Attitude Change. Annu Rev Psychol. 2011;62:391–417.
Jain V. 3D Model of Attitude. Int J Adv Res Manag Soc Sci. 2014;3(3).
Maio GR, Haddock G. Attitudes: Content, Structure and Functions. In: The Psychology of Attitudes and Attitude Change. 2nd ed. Thousand Oaks: Sage Publications Ltd; 2015. p. 112–133.
Kowalkowska J, Lonnie M, Wadolowska L, et al. Health- and Taste-Related Attitudes Associated with Dietary Patterns in a Representative Sample of Polish Girls and Young Women: A Cross-Sectional Study (GEBaHealth Project). Nutrients. 2018;10(2).
Koo HC, Lee CL, Nur Hidayah AS, Nurain Hazwani AR. Knowledge, attitudes and practices of schoolchildren toward whole grains and nutritional outcomes in Malaysia. Appetite. 2018;123:256–263.
Gawronski B, Brannon SM. Attitudes and the Implicit-Explicit Dualism. In: Albarracin D, Johnson BT, editors. The Handbook of Attitudes. Volume 1: Basic Principles. 2nd ed. New York: Routledge; 2018. p. 158–196.
Krosnick JA, Judd CM, Wittenbrink B. The measurement of attitudes. In: Albarracin D, Johnson BT, Zanna MP, editors. The Handbook of Attitudes. Mahwah: Lawrence Erlbaum Associates Publishers; 2005. p. 21–76.
Maliszewski N, Suszek H, Abdulqadir Z, Wojciechowski Ł. [Implicit political attitudes in crisis situations: the case of 2010 presidential election]. Czasopismo Psychologiczne – Psychol J. 2017;23(1):21–33 (in Polish).
Chybicka A, Kosakowska N, Karasiewicz K. [Behaviour and explicit and implicit attitudes towards gender]. Przegląd Psychologiczny. 2008;51(4):465–490 (in Polish).
Ocieczek A, Bartkowicz J, Żyłka K. [Determinants of Consumers’ Attitudes and Behaviors in the Novel Food Market as Indicators of the Evolutionary Changes in the Food Market]. Roczniki Naukowe Stowarzyszenia Ekonomistów Rolnictwa i Agrobiznesu. 2018;20(6):181–188 (Polish). 10.5604/01.3001.0012.7759.
Casuccio A, Bonanno V, Catalano R, et al. Knowledge, Attitudes, and Practices on Energy Drink Consumption and Side Effects in a Cohort of Medical Students. J Addict Dis. 2015;34(4):274–283.
Ancheta A, Manchikanti N, Neelam S, et al. Nurses: Their Knowledge, Attitudes, and Practices About Energy Shots. New Jersey Nurse & Institute for Nursing Newsletter. 2018;48(2):10–12.
Aljaloud SO. Understanding the Behaviors and Attitudes of Athletes Participating in the 2016 Rio Olympics Regarding Nutritional Supplements, Energy Drinks, and Doping. Int J Sports Exerc Med. 2018;4(4).
Luo R, Fu R, Dong L, et al. Knowledge and prevalence of energy drinks consumption in Shanghai, China: a cross-sectional survey of adolescents. Gen Psychiatr. 2021;34(3):e100389.
Fazio RH. Attitudes as Object-Evaluation Associations of Varying Strength. Soc Cogn. 2007;25(5):603–637.
Dolek BE, Bosi TB. Examination of Attitudes of Sports Science Faculty Students about Energy Drinks, Sports Drinks and Ergogenic Substances. J Educat Learning. 2019;8(5):241–247.
Musaiger AO, Zagzoog N. Knowledge, Attitudes and Practices toward Energy Drinks among Adolescents in Saudi Arabia. Glob J Health Sci. 2014;6(2):42–46.
Turton P, Piché L, Battram DS. Adolescent Attitudes and Beliefs Regarding Caffeine and the Consumption of Caffeinated Beverages. J Nutr Educ Behav. 2016;48(3):181–189.
Grigorieva NG, Druskaya SM. The Attitude of Energy Drinks in Formation of a Healthy Lifestyle. In: Solovev D, editor. Smart Technologies and Innovations in Design for Control of Technological Processes and Objects: Economy and Production. FarEastСon 2018. Smart Innovation, Systems and Technologies. Volume 139. Cham: Springer; 2019. p. 725-731.
Kozirok W. Consumer Attitudes and Behaviour Towards Energy Drinks. Handel Wewnętrzny. 2017;1(366):216–229.
Yusoff MSB. ABC of Response Process Validation and Face Validity Index Calculation. Educ Med J. 2019;11(3):55–61.
Hair JF Jr, Gabriel MLDS, Da Silva D, Braga S Jr. Development and validation of attitudes measurement scales: fundamental and practical aspects. RAUSP Management J. 2019;54(4):490–507.
Urala N, Lähteenmäki L. Attitudes behind consumers’ willingness to use functional foods. Food Qual Prefer. 2004;15(7/8):793–803.
Van Batenburg-Eddes T, Lee NC, Weeda W, et al. The potential adverse effect of energy drinks on executive functions in early adolescence. Front Psychol. 2014;5(457).
Kalkan I, Pehlivan M, Öztürk SA, Ersoy G. Awareness and usage of sports and energy drinks among university students: A pilot study in Turkey. BLDE Univ J Health Sci. 2018;3:18–23.
Visram S, Cheetham M, Riby DM, et al. Consumption of energy drinks by children and young people: a rapid review examining evidence of physical effects and consumer attitudes. BMJ Open. 2016;6(10):e010380.
Hammond D, Reid JL. Exposure and perceptions of marketing for caffeinated energy drinks among young Canadians. Public Health Nutr. 2018;21(3):535–542.
Nassaif MM, Alobed GJJ, Alaam NAA, et al. Energy Drink Consumption Practices of Young People in Bahrain. Cent Asian J Glob Health. 2016;4(2):216.
Martins A, Ferreira C, Sousa D. Consumption Patterns of Energy Drinks in Portugese Adolescents from A City in Northern Portugal. Acta Med Port. 2018;31(4):207–212.
Nowak D, Jasionowski A. Analysis of the Consumption of Caffeinated Energy Drinks among Polish Adolescents. Int J Environ Res Public Health. 2015;12(7):7910–7921.
Richards G, Smith AP. Breakfast and Energy Drink Consumption in Secondary School Children: Breakfast Omission, in Isolation or in Combination with Frequent Energy Drink Use, is Associated with Stress, Anxiety, and Depression Cross-Sectionally, but not at 6-Month Follow-Up. Front Psychol. 2016;7(106).
Degirmenci N, Fossum IN, Strand TA, et al. Consumption of energy drinks among adolescents in Norway: a cross-sectional study. BMC Public Health. 2018;18(1):1391.
Foxx RM, Rubinoff A. Behavioral treatment of caffeinism: reducing excessive coffee drinking. J Appl Behav Anal. 1979;12(3):335–344.
Bradley JR, Petree A. Caffeine consumption, expectancies of caffeine-enhanced performance, and caffeinism symptoms among university students. J Drug Educ. 1990;20(4):319–328.
Jaworski M, Gustek S, Barcz M. [Relationship of cola drink consumption with the use of other stimulants by adolescents and young adults]. Alkoholizm i Narkomania. 2013;26(4):349–364 (in Polish).
Ksouri R. Food components and diet habits: chief factors of cancer development. Food Qual Saf. 2019;3(4):227–231.
Papadimitriou N, Markozannes G, Kanellopoulou A, et al. An umbrella review of the evidence associating diet and cancer risk at 11 anatomical sites. Nat Commun. 2021;12(4579).
Svenningsson J, Höst G, Hultén M, Hallström J. Students’ attitudes toward technology: exploring the relationship among affective, cognitive and behavioral components of the attitude construct. Int J Technol Des Educ. 2021.
Knekta E, Runyon C, Eddy S. One Size Doesn’t Fit All: Using Factor Analysis to Gather Validity Evidence When Using Surveys in Your Research. CBE Life Sci Educ. 2019;18(1).
Haynes SN, Richard DCS, Kubany ES. Content validity in psychological assessment: A functional approach to concepts and methods. Psychol Assess. 1995;7:238–247.
Cook DA, Beckman TJ. Current concepts in validity and reliability for psychometric instruments: theory and application. Am J Med. 2006;119(2):116.e7–16.
De Oliveira Santos R, Mendes Gorgulho B, de Castro MA. Principal Component Analysis and Factor Analysis: differences and similarities in Nutritional Epidemiology application. Rev Bras Epidemiol. 2019;22:E190041.
Raykov T, Marcoulides GA. Thanks Coefficient Alpha, We Still Need You! Educ Psychol Meas. 2019;79(1):200–210.
Taber KS. The Use of Cronbach’s Alpha When Developing and Reporting Research Instruments in Science Education. Res Sci Educ. 2018;48:1273–1296.
Shrestha N. Factor Analysis as a Tool for Survey Analysis. Am J Appl Math Stat. 2021;9(1):4–11.
Watkins MW. Exploratory Factor Analysis: A Guide to Best Practice. J Black Psychol. 2018;44(3):219–246.
Koparan T. Development of an Attitude Scale towards Statistics: A Study on Reliability and Validity. Karaelmas J Educ Sci. 2015;3:76–86.
Boateng GO, Neilands TB, Frongillo EA, et al. Best Practices on Developing and Validating Scales for Health, Social, and Behavioral Research: A Primer. Front Public Health. 2018;6(149).
Tavakol M, Dennick R. Making sense of Cronbach’s alpha. Int J Med Educ. 2011;2:53–55.
Augustine LF, Vazir S, Fernandez Rao S, et al. Psychometric validation of a knowledge questionnaire on micronutrients among adolescents and its relationship to micronutrient status of 15–19-year-old adolescent boys, Hyderabad, India. Public Health Nutr. 2012;15(7):1182–1189.
Byrne ZS, Weston JW, Cave K. Development of a Scale for Measuring Students’ Attitudes Towards Learning Professional (i.e., Soft) Skills. Res Sci Educ. 2020;50:1417–1433.
Akan Y. Development of the “COVID‑19 psychological impact Scale”: A validity and reliability study. Curr Psychol. 2022.
Jaworski M. [Polish version of The Attitudes to Chocolate Questionnaire (ACQ)]. Med Og Nauk Zdr. 2013;19(4):549–555 (in Polish).
Roininen K, Lähteenmäki L, Tuorila H. Quantification of consumer attitudes to health and hedonic characteristics of foods. Appetite.1999;33(1):71–88.