Scale for evaluating food and nutrition education practices in Primary Health Care

Abstract

Objective To develop, validate and analyse intra- and inter-raters’ agreement and reliability of a scale for the evaluation of food and nutrition education practices in primary health care. Methods Three theoretical references were used for the development of items with answers on a 4-point scale (not observed, partially/satisfactorily/fully observed): the Brazilian Dietary Guidelines, the Interprofessional Collaborative Practice and the Family Health Strategy as models for organizing primary health care. The scale was submitted for content and face panel validation and it was further reevaluated online. Thirty specialists used the scale for the rating of 4 videos produced for the study showing food and nutrition education practices in primary health care settings. Intra- and inter-raters agreement and reliability were analyzed by test at one time point and retest 30 days later. Results The scale initially included 72 items but was reduced to 17 items after content and face validation, together with a fill-out manual that was reviewed by experts. In the re-evaluation, all 17 items were maintained, and content adjustments were made in the manual. Thirty raters applied the scale to the videos in the test, and 28 in the retest. All videos obtained combined kappa values of >0.4. In the test-retest, 19 raters showed >80% agreement; in the inter-rater evaluation, 14 raters generated kappa values >0.75. Conclusion The scale underwent content and face validation and showed to be useful to diagnose the absence and the full addressing of the Brazilian Dietary Guidelines content with good intra- and inter-rater agreement and reliability in different settings of Primary Health Care.

Dietary guidelines training may improve health promotion practice: Results of a controlled trial in Brazil

“…The work routine of the health teams was observed using a validated scale for evaluating food and nutrition education practices in primary health care (Reis and Jaime, 2020a). Three researchers who were familiar with the content of the Guidelines and not involved with the application of the educational intervention followed the activities performed by the four NASF teams in the municipality as nonparticipant observers.…”

“…All activities that occurred during the workday were monitored; a questionnaire was completed to characterize the activities, and annotations were made in a field diary. Coverage of the Guidelines was recorded using the previously validated scale that contained 17 items covering all chapters of the Guidelines, which are divided into three dimensions: principles (chapter 1), recommendations (chapters 2, 3 and 4) and obstacles (chapter 5) (Reis and Jaime, 2020a). Scoring consisted of observation (yes ¼ 1 or no ¼ 0) of each relative to the Guidelines correctly oriented for each activity, converted into a score of observed practices ranging from 0 to 17 points.…”