Universidade de São Paulo. Faculdade de Saúde Pública. Programa de Pós-Graduação em Nutrição em Saúde Pública. São Paulo, SP, Brasil.
Universidade de São Paulo. Faculdade de Saúde Pública. Núcleo de Pesquisas Epidemiológicas em Nutrição e Saúde. São Paulo, SP, Brasil.
Rev Saude Publica. 2021 Nov 22;55:55. doi: 10.11606/s1518-8787.2021055003218. eCollection 2021.
To develop and validate a self-applicable instrument for measuring primary health care (PHC) workers' knowledge on healthy eating.
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.
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.
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.
开发和验证一种用于测量初级卫生保健（PHC）工作者健康饮食知识的自我适用工具。
采用六步方法论研究开发和验证测量工具：基于巴西饮食指南章节的项目开发；专家小组进行内容验证；潜在仪器使用者进行面部验证；内容和面部验证小组的在线仪器重新评估；PHC 工作者在线应用仪器；结构验证的验证性因素分析。
一个包含 25 个项目的初始版本在内容和面部验证小组中进行了内容和语义更改，重新组织成包含 22 个项目的第二版本。在重新评估中，参与者认为 21 个问题清晰且代表巴西饮食指南，其中一个被排除。该仪器的第三个版本在 209 名来自巴西所有宏观区域的 PHC 工作者在线应用后进行了验证性因素分析。在这项分析中，我们排除了五个项目：四个是由于双变量空单元格，一个是由于低鉴别能力。最终模型，有 16 个项目加载到一个维度上，得出了良好的拟合指数[χ2(104) = 119.047，p = 0.1486；RMSEA = 0.026（90%CI = 0.000 至 0.046），Cfit = 0.979；CFI = 0.924；TLI = 0.913]；其信息峰值低于平均值。
该工具被证明对评估巴西初级卫生保健机构中健康饮食知识水平较低的工作者是有效和准确的。它可以通过确定培训卫生专业人员的需求，为改善巴西初级卫生保健机构中促进健康饮食的行动做出贡献。
