Tecnologias de apoio à implementação do guia alimentar para a população brasileira na atenção básica

Abstract

Introduction: The dissemination of dietary guidelines is globally seen as crucial for the healthy eating promotion policies, especially those targeting the training of facilitators. Objective: To develop and validate technologies to support the implementation of the Brazilian Dietary Guidelines (BDG) in Primary Health Care (PHC). Methodology: Three manuscripts about development and validation of measurement tools were written. Manuscript 1-GAB1 (scale for measuring the knowledge of PHC professionals about the BDG) was developed and validated in six steps: items' development, content validation with panel of experts, face validation with potential users, online reevaluation by health professionals and experts, online application with PHC professionals working all over Brazil's macro-regions, confirmatory factor analysis to investigate construct validity. Manuscript 2-GAB2 (scale for measuring the self-efficacy and collective efficacy of PHC professionals to apply the BDG) were submitted to the same procedures described in manuscript 1. Manuscript 3-GAB3 (scale for evaluating the implementation of the BDG in PHC educational interventions) was developed, validated and tested in five steps: items' development; content validation with panel of experts; face validation with potential users; online reevaluation; test-retest to analyze intra and interobserver agreement and reliability with experts applying GAB3 while watching 4 videos produced for this study. Results: Manuscript 1-GAB1 was initially developed with 25 items and it was reduced to 22 items after content and face validation. GAB1's items were considered clear and representative of the BDG, with exception of 1 item that was excluded when the scale was reevaluated. This version of the scale was applied to 209 PHC professionals through a website. In the confirmatory factor analysis, GAB1's initial model constituted by 21 items had 5 items excluded: 4 returned bivariate empty cells and 1 with lowest discrimination value. All the fit indices returned a well-fitted model constituted by 16 items loaded onto 1 dimension, with peak of information centered below the mean. Manuscript 2-GAB2 was initially developed with 22 items and it reached 24 items equally divided in part A (self-efficacy) and B (collective efficacy) after content and face validation. All GAB2's items were considered clear and representative of the BDG when reevaluated. GAB2 showed to have excellent fit indices, with peak of information centered around the mean. Manuscript 3-GAB3's items were reduced from 72 to 25 after content validation. The scale reached 17 items in the face validation accompanied by a completion manual, reviewed by specialists. All the 17 items were considered clear and representative of the BDG when reevaluated and adjustments in the manual's content were made. Thirty raters applied GAB3 to watch the videos for test and 28 for the retest. All videos obtained combined kappa values>0.4. In the test-retest, only one rater had an agreement <0.4 and for reliability, only two raters ...

Improving knowledge, self-efficacy and collective efficacy regarding the Brazilian dietary guidelines in primary health care professionals: a community controlled trial

“…Traditionally, assessment of this outcomes is based on professionals self-reports [21,32]. The scales used to assess the outcomes in this study were previously validated by a rigorous five-step process: content validation with panel of experts, face validation with potential users, online reevaluation by health professionals and experts, online application with PHC professionals working all over Brazil's macro-regions and confirmatory factor analysis to investigate construct validity [33]. The use of these scales to assess the knowledge of health professionals about the dietary guidelines, as well as their self-efficacy and collective efficacy preceptions to guide healthy eating, guarantees more reliability to the results found.…”

Ações de educação alimentar e nutricional no ambiente escolar: uma revisão de escopo

“…Devido à falta de integração dos diversos setores, tais como educação e saúde, a implantação sistemática e efetiva para atingir a população é um grande desafio (Barbosa et al, 2008). Nesta perspectiva, diversos materiais têm sido produzidos como tecnologias de apoio à implementação do Guia no âmbito da atenção básica de saúde, sendo observado seu potencial como instrumento de suporte teórico e prático (Reis, 2019). Entretanto, as diretrizes alimentares são planejadas para serem usadas não só nas unidades de saúde, mas também na casa das pessoas, nas escolas e em todos os outros locais relacionados à saúde (Monteiro et al, 2015).…”

Ações de educação alimentar e nutricional no ambiente escolar: uma revisão de escopo

“…Assim como observado por Cervato-Mancuso et al (2016), a maioria dos estudos descreve de forma clara e objetiva a metodologia de análise, mas não fornece detalhes suficientes do método educativo utilizado, apresentando uma descrição superficial. Outros autores também evidenciam o baixo número de publicações na área que descrevem o embasamento teórico para o planejamento e execução das atividades ao longo do trabalho (Ramos et al, 2013;Reis;Reinaldo, 2017).…”

“…Freiriana e Modelo Transteórico. Tais achados são semelhantes na literatura, na qual as bases teórico-metodológicas que embasam o componente educativo dos estudos mais comumente apontadas são as concepções problematizadoras de Paulo Freire (Ramos et al, 2013;Cervato-Mancuso et al, 2016;Reis;Reinaldo, 2017), teorias de mudança comportamental como a Teoria Cognitiva Social (Silveira et al, 2011) e a Teoria de Piaget (Ramos et al, 2013).…”

“…Apesar da predominância dos métodos tradicionais, a literatura mostra que a presença de atividades lúdicas (Pereira et al, 2011;Ramos et al, 2013;Reis;Reinaldo, 2017), promove ações que capturam a atenção dos alunos e ainda são prazerosas de se executar (Reis;Reinaldo, 2017). Pode-se destacar o uso de histórias infantis e em quadrinhos, teatro de fantoches e jogos educativos (Ramos et al, 2013).…”