Pool of items to measure Primary Health Care workers’ knowledge on healthy eating

Autores

  • Lígia Cardoso dos Reis Universidade de São Paulo. Faculdade de Saúde Pública. Programa de Pós-Graduação em Nutrição em Saúde Pública. São Paulo, SP, Brasil https://orcid.org/0000-0001-9708-2230
  • Patricia Constante Jaime Universidade de São Paulo. Faculdade de Saúde Pública. Núcleo de Pesquisas Epidemiológicas em Nutrição e Saúde. São Paulo, SP, Brasil https://orcid.org/0000-0003-2291-8536

DOI:

https://doi.org/10.11606/s1518-8787.2021055003218

Palavras-chave:

Health Personnel, Health Knowledge, Attitudes, Practice, Diet, Healthy, Surveys and Questionnaires, Validation Study

Resumo

OBJECTIVE: To develop and validate a self-applicable instrument for measuring primary health care (PHC) workers’ knowledge on healthy eating. METHODS: A six-step methodological study to develop and validate a measurement instrument: item development based on the Brazilian Dietary Guidelines’ chapters; content validation with a panel of experts; face validation with potential instrument users; online instrument reevaluation by participants of the content and face validation panels; online application of the instrument with PHC workers; confirmatory factor analysis for construct validation. RESULTS: A first version with 25 items underwent content and semantic changes in the content and face validation panels, being reorganized into a second version with 22 items. In the reevaluation, participants considered 21 questions to be clear and representative of the Brazilian Dietary Guidelines, with one being excluded. This third version of the instrument underwent confirmatory factor analysis after being applied online with 209 PHC workers from all Brazilian macroregions. We excluded five items in this analysis: four due to bivariate empty cells and one due to low discrimination capacity. The final model, with 16 items loaded onto one dimension, returned good fit indices [χ²(104) = 119.047, p = 0.1486; RMSEA = 0.026 (90% CI = 0.000 to 0.046), Cfit = 0.979; CFI = 0.924; TLI = 0.913]; its information peak was below average. CONCLUSIONS: The instrument proved to be valid and accurate for assessing PHC workers with below average knowledge of the Brazilian Dietary Guidelines. It might contribute to improving actions to promote healthy eating in Brazilian PHC settings by identifying the need for training health professionals.

Referências

Ministry of Health (BR), Secretariat of Health Care, Primary Health Care Department. Dietary guidelines for the Brazilian population. Brasília, DF: Ministry of Health; 2015 [cited 2020 Oct 2]. Available from: https://bit.ly/3l9pVDu

Ahmed S, Downs S, Fanzo J. Advancing an integrative framework to evaluate sustainability in National Dietary Guidelines. Front Sustain Food Syst. 2019;3:76. https://doi.org/10.3389/fsufs.2019.00076

Monteiro CA, Cannon G, Moubarac JC, Martins APB, Martins CA, Garzillo J, et al. Dietary guidelines to nourish humanity and the planet in the twenty-first century. A blueprint from Brazil. Public Health Nutr. 2015;18(13):2311-22. https://doi.org/10.1017/S1368980015002165

Organización de las Naciones Unidas para la Alimentación y la Agricultura. El estado de las guías alimentarias baseadas en alimentos en América Latina y el Caribe: 21 años después de la Conferencia Internacional sobre Nutrición. Roma: FAO; 2014 [cited 2020 Oct 2]. Available from: https://bit.ly/2GlbNIj

World Health Organization; United Nations Children’s Fund. A vision for Primary Health Care in the 21st century. Towards universal health coverage and the Sustainable Development Goals. Geneva: (CH): WHO; UNICEF; 2018 [cited 2020 Oct 2]. Available from: https://bit.ly/33mPrio

Vanderlee L, McCrory C, Hammond D. Awareness and knowledge of recommendations from Canada’s Food Guide. Can J Diet Pract Res. 2015;76(3):146-9. https://doi.org/10.3148/cjdpr-2015-014

Gabe KT, Jaime PC. Development and testing of a scale to evaluate diet according to the recommendations of the Dietary Guidelines for the Brazilian Population. Public Health Nutr. 2019;22(5):785-96. https://doi.org/10.1017/S1368980018004123

Truman E, Lane D, Elliott C. Defining food literacy: a scoping review. Appetite. 2017;116:365-71. https://doi.org/10.1016/j.appet.2017.05.007

Krause C, Sommerhalder K, Beer-Borst S, Abel T. Just a subtle difference? Findings from a systematic review on definitions of nutrition literacy and food literacy. Health Promot Int. 2018;33(3):378-89. https://doi.org/10.1093/heapro/daw084

Bandura A. Health promotion by social cognitive means. Health Educ Behav. 2004;31(2):143-64. https://doi.org/10.1177/1090198104263660

Hall E, Chai W, Koszewski W, Albrecht J. Development and validation of a social cognitive theory-based survey for elementary nutrition education program. Int J Behav Nutr Phys Act. 2015;12:47. https://doi.org/10.1186/s12966-015-0206-4

Pasquali L. Validade dos testes psicológicos: será possível reencontrar o caminho? Psic Teor Pesq. 2007;23 Nº esp:99-107. https://doi.org/10.1590/S0102-37722007000500019

Nunally JC, Bernstein IH. Psychometric theory. 3. ed. New York: McGraw-Hill; 1994.

Muthén LK, Muthén BO. Mplus: the comprehensive modelling program for applied researchers: user’s guide. Los Angeles, CA: Muthén and Muthén; 2012.

Beauducel A, Herzberg PY. On the performance of maximum likelihood versus means and variance adjusted weighted least squares estimation in CFA. Struct Equ Modeling. 2006;13(2):186-203. https://doi.org/10.1207/s15328007sem1302_2

Little TD. Longitudinal structural equation modeling. New York: Guilford Press; 2013.

Baker FB, Kim SH. Item response theory: parameter estimation techniques. 2. ed. Boca Raton, FL: CRC Press; 2004.

Asparouhov T. Sampling weights in latent variable modeling. Struct Equ Modeling. 2005;12(3):411-34. https://doi.org/10.1207/s15328007sem1203_4

Asparouhov T. General multi-level modeling with sampling weights. Commun Stat Theory Methods. 2006;35(3):439-60. https://doi.org/10.1080/03610920500476598

Pinho L, Moura PHT, Silveira MF, Botelho ACC, Caldeira AP. Development and validity of a questionnaire to test the knowledge of primary care personnel regarding nutrition in obese adolescents. BMC Fam Pract. 2013;14:102. https://doi.org/10.1186/1471-2296-14-102

Food and Agriculture Organization of the United Nations. Developing food-based dietary guidelines: a manual from the English-speaking Caribbean. Rome (IT): FAO; 2007 [cited 2020 Oct 2]. Available from: https://bit.ly/2Sn1wxY

Hawkes C. Promoting healthy diets through nutrition education and changes in the food environment: an international review of actions and their effectiveness. Rome (IT): FAO; 2013 [cited 2020 Oct 2]. Available from: http://www.fao.org/3/i3235e/i3235e.pdf

Kris-Etherton PM, Akabas SR, Douglas P, Kohlmeier M, Laur C, Lenders CM, et al. Nutrition competencies in health professionals’ education and training: a new paradigm. Adv Nutr. 2015;6(1):83-7. https://doi.org/10.3945/an.114.006734

GBD 2017 Diet Collaborators. Health effects of dietary risks in 195 countries, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2019;393(10184):1958-72. https://doi.org/10.1016/S0140-6736(19)30041-8

Florindo AA, Nakamura PM, Farias Júnior JC, Siqueira FV, Reis RS, Cruz DKA, et al. Promotion of physical activity, healthy eating and family health in municipalities with health gym. Rev Bras Educ Fís Esporte. 2016;30(4):925-36. https://doi.org/10.1590/1807-55092016000400913

Rodríguez-Rodríguez E, Aparicio A, Aranceta-Bartrina J, Gil A, González-Gross M, Serra-Majem L, et al. Low adherence to dietary guidelines in Spain, especially in the overweight/obese population: The ANIBES Study. J Am Coll Nutr. 2017;36(4):240-7. https://doi.org/10.1080/07315724.2016.1248246

Canella DS, Louzada MLC, Claro RM, Costa JC, Bandoni DH, Levy RB, et al. Consumption of vegetables and their relation with ultra-processed foods in Brazil. Rev Saude Publica. 2018;52:50. https://doi.org/10.11606/s1518-8787.2018052000111

Schuh DS, Pellanda LC, Guessous I, Marques-Vidal P. Trends and determinants of change in compliance to dietary guidelines in a Swiss community-dwelling sample. Prev Med. 2018; 111:198-203. https://doi.org/10.1016/j.ypmed.2018.03.008

Paim J, Travassos C, Almeida C, Bahia L, Macinko J. The Brazilian health system: history, advances, and challenges. Lancet. 2011;377(9779):1778-97. https://doi.org/10.1016/S0140-6736(11)60054-8

Baur C. New directions in research on public health and health literacy. J Health Commun. 2010;15 Suppl 2:42-50. https://doi.org/10.1080/10810730.2010.499989

Publicado

2021-11-22

Edição

Seção

Artigos Originais

Como Citar

Reis, L. C. dos, & Jaime, P. C. (2021). Pool of items to measure Primary Health Care workers’ knowledge on healthy eating. Revista De Saúde Pública, 55, 55. https://doi.org/10.11606/s1518-8787.2021055003218

Dados de financiamento