Santos Thanise Sabrina Souza, Guimarães Larissa Morelli Ferraz, Freitas Patrícia Pinheiro de, Campos Suellen Fabiane, Cardoso Clareci Silva, Toral Natacha, Lopes Aline Cristine Souza
Universidade de São Paulo, Núcleo de Pesquisas Epidemiológicas em Nutrição e Saúde, São Paulo, SP, Brazil.
Universidade Federal de Minas Gerais, Departamento de Nutrição, Belo Horizonte, MG, Brazil.
Epidemiol Serv Saude. 2025 Apr 14;34:e20240365. doi: 10.1590/S2237-96222025v34e20240365.en. eCollection 2025.
To assess the methodological pathway for developing and validating Instructive for the Obesity Management in the Unified Health System (Sistema Único de Saúde - SUS), focusing on food and nutrition actions, based on the adaptation of the Dietary Guidelines for the Brazilian Population.
The development of the Instructive of Collective Approach for the Obesity Management in the SUS included an evaluation of the proposal summary during an in-person expert workshop, and the analysis of the first draft in an in-person validation workshop. In 2018 and 2019, a dynamic carousel was employed during the workshops to record the perceptions of experts from management, academy, and SUS health services. The materials produced during the workshops underwent exploratory content analysis by two authors independently, using theoretical frameworks and theories as predefined categories. Observed divergences were discussed until consensus was reached.
The first workshop, attended by 21 experts, was essential for the decision to develop a material specifically for collective approaches and for defining the theoretical frameworks and theories to be included in the Instructive. The second workshop, with 17 experts, contributed to resolving conceptual issues, addressing discussions and uncertainties, and consolidating of the care flow. The published version of the Instructive incorporated a problem-posing methodology transversally and the transtheoretical model as the core theoretical framework to enhance treatment effectiveness and adherence.
The development and validation of the Instructive followed a scientific research trajectory, contributing to the creation of instructional materials derived from the Dietary Guidelines.
基于巴西人群膳食指南的改编，评估在统一卫生系统（Sistema Único de Saúde - SUS）中制定和验证肥胖管理指南的方法路径，重点关注食品和营养行动。
SUS中肥胖管理集体方法指南的制定包括在一次面对面的专家研讨会上对提案摘要进行评估，以及在一次面对面的验证研讨会上对初稿进行分析。在2018年和2019年，研讨会上采用了动态轮值方式来记录来自管理层、学术界和SUS卫生服务部门的专家的看法。研讨会期间产生的材料由两位作者独立进行探索性内容分析，使用理论框架和理论作为预先确定的类别。对观察到的分歧进行讨论，直至达成共识。
第一次研讨会有21位专家参加，对于决定专门为集体方法编写一份材料以及确定指南中要纳入的理论框架和理论至关重要。第二次研讨会有17位专家参加，有助于解决概念问题、处理讨论和不确定性，并巩固护理流程。指南的发布版本横向纳入了问题提出方法，并将跨理论模型作为核心理论框架，以提高治疗效果和依从性。
指南的制定和验证遵循了科学研究轨迹，有助于创建源自膳食指南的指导材料。
