Journal of Cancer Education

, Volume 25, Issue 4, pp 512–517 | Cite as

Development and Validation of a Nutritional Education Pamphlet for Low Literacy Pediatric Oncology Caregivers in Central America

  • Melissa Garcia
  • Elisabeth A. Chismark
  • Terezie Mosby
  • Sara W. Day


A culturally appropriate nutrition education pamphlet was developed and validated for low-literacy caregivers in Honduras, El Salvador, and Guatemala. The pamphlet was developed after a preliminary survey of pediatric oncology nurses in the 3 countries to assess the need for education materials, caregiver literacy levels, and local eating habits. Experts in nutrition and low-literacy patient education and pediatric oncology nurses validated the pamphlet’s content and design. The pamphlet was validated positively and has been circulated to pediatric oncology caregivers in Central America.


Central America Pediatric oncology Nutritional education pamphlet 


  1. 1.
    O'Leary M, Krailo M, Anderson JR et al (2008) Progress in childhood cancers: 50 years of research collaboration a report from the childhood oncology group. Semin Oncol 35(5):484–493CrossRefPubMedGoogle Scholar
  2. 2.
    Sala A, Pencharz P, Barr RD (2004) Children, cancer, and nutrition—a dynamic triangle in review. Cancer 100(4):677–687CrossRefPubMedGoogle Scholar
  3. 3.
    Todd J, Schmidt M, Christain J et al (1999) The low-bacteria diet for immunocompromised patients: reasonable prudence or clinical superstition? Cancer Practice 7(4):205–207CrossRefPubMedGoogle Scholar
  4. 4.
    Nursing Meeting: Nutrition in Pediatric Oncology. Central American Association of Pediatric Hematology-Oncology (AHOPCA), Dominican Republic, February 17, 2007.Google Scholar
  5. 5.
    Houts PS, Bachrach R, Witmer JT et al (1998) Using pictographs to enhance recall of spoken medical instructions. Patient Educ Counsel 35(2):83–88CrossRefGoogle Scholar
  6. 6.
    Developing health and family planning print materials for low-literate audiences: a guide. Revised ed. Seattle: Program for Appropriate Technology in Health (PATH), 1996.Google Scholar
  7. 7.
    French KS, Larrabee JH (1999) Relationships among educational material readability, client literacy, perceived beneficence, and perceived quality. J Nurs Care Qual 13(6):68–82PubMedGoogle Scholar
  8. 8.
    Houts PS, Doak CC, Doak LG et al (2006) The role of pictures in improving health communication: a review of research on attention, comprehension, recall, and adherence. Patient Educ Counsel 61(2):173–190CrossRefGoogle Scholar
  9. 9.
    Juarez G, Ferrell B, Borneman T (1999) Cultural considerations in education for cancer pain management. J Cancer Educ 14(3):168–173PubMedGoogle Scholar
  10. 10.
    Sutherland G, Dpsych LH, White V et al (2008) How does cancer education impact on people with cancer and their family and friends? J Cancer Educ 23(2):126–132CrossRefPubMedGoogle Scholar
  11. 11.
    Leininger M (2002) Culture care theory: a major contribution to advance transcultural nursing knowledge and practices. J Transcult Nurs 13(3):189–192CrossRefPubMedGoogle Scholar
  12. 12.
    Lynn MR (1986) Determination and quantification of content validity. Nurs Res 35(6):382–385CrossRefPubMedGoogle Scholar
  13. 13.
    Standards for educational and psychological testing. Washington, DC: American Educational Research Association, American Psychological Association, National Council on Measurement in Education, 1985.Google Scholar
  14. 14.
    Grant JS, Davis LL (1997) Selection and use of content experts for instrument development. Res Nurs Health 20:269–274CrossRefPubMedGoogle Scholar
  15. 15.
    Grant J, Kinney M, Guzzetta C (1990) A methodology for validating nursing diagnoses. Adv Nurs Sci 12(3):65–74Google Scholar
  16. 16.
    McCain, N.L. A test of Cohen's developmental model for professional socialization with baccalaureate nursing students. University of Alabama in Birmingham, 1984.Google Scholar
  17. 17.
    Davis L (1992) Instrument review: getting the most from your panel of experts. Appl Nurs Res 5:104–107Google Scholar
  18. 18.
    Aldridge MD (2004) Writing and designing readable patient education materials. Nephrol Nurs J 31(4):218–224Google Scholar
  19. 19.
    Cutilli CC (2006) Do your patients understand? Providing culturally congruent patient education. Orthop Nurs 25(3):218–224CrossRefPubMedGoogle Scholar
  20. 20.
    Doak LG, Doak DC, Meade CD (1996) Strategies to improve cancer education materials. Oncol Nurs Forum 23(8):1305–1312PubMedGoogle Scholar
  21. 21.
    Hubley J (2006) Patient education in the developing world—a discipline comes of age. Patient Educ Counsel 61(1):161–164CrossRefGoogle Scholar
  22. 22.
    Ngoh LN, Shepherd MD (1997) Design, development, and evaluation of visual aids for communicating prescription drug instructions to nonliterate patients in rural Cameroon. Patient Educ Counsel 31(3):245–261CrossRefGoogle Scholar
  23. 23.
    Massett HA (1996) Appropriateness of Hispanic print materials: a content analysis. Health Educ Res 11(2):231–242CrossRefPubMedGoogle Scholar

Copyright information

© Springer 2010

Authors and Affiliations

  • Melissa Garcia
    • 1
  • Elisabeth A. Chismark
    • 2
  • Terezie Mosby
    • 1
  • Sara W. Day
    • 1
  1. 1.International Outreach Program, St. Jude Children’s Research HospitalMemphisUSA
  2. 2.School of Nursing, Clemson UniversityClemsonUSA

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