Abstract
Objective
This study aimed to describe the development and analyze the content validity of an educational material with intervention strategies to promote a healthy consumer food environment according to the Dietary Guidelines for the Brazilian Population.
Subject and methods
The recommendations of the Brazilian Dietary Guideline were used to develop the educational material. The content validity was performed by a panel of experts who assessed the aspects of clarity, pertinence, relevance, and representativeness for each of the 31 educational strategies included in the material. The content validity index (CVI > = 0.90) was used for the content validity analysis through item level-CVI and scale-CVI. The reliability was accessed by the percentage of the interrater agreement (IRA > 0.80 was considered great) to clarity and representativeness aspects.
Results
The educational material was named Healthy Food Trade: A guide to action for public managers and retailers to promote a healthy food environment in the community (HFT). Ten experts participated in the content validation process; 20% worked in the public supply sector, 70% had academic experience in food retail environments, and 10% worked on communication strategies. The percentage of IRA was 0.93 to clarity and 0.94 to representativeness to the overall material. The S-CVI was 0.93. After the modifications, the final version presents intervention strategies that can be carried out in food retailers to make them healthier.
Conclusion
The HFT Guide had intervention strategies validated by a panel of experts that could support public managers and food retailers in promoting a healthier consumer food environment.
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References
Albert SL, Langellier BA, Sharif MZ, Chan-Golston AM, Prelip ML, Elena Garcia R et al (2017) A corner store intervention to improve access to fruits and vegetables in two Latino communities. Public Health Nutr 20(12):2249–2259. https://doi.org/10.1007/S1368980017001008
Alexandre NMC, Coluci MZO (2011) Content validity in the development and adaptation processes of measurement instruments. Ciênc Amp Saúde Coletiva 16(7):3061–3068. https://doi.org/10.1590/S1413-81232011000800006
Almanasreh E, Moles R, Chen TF (2019) Evaluation of methods used for estimating content validity. Res Soc Adm Pharm 15(2):214–221. https://doi.org/10.1016/j.sapharm.2018.03.066
Caspi CE, Pelletier JE, Harnack LJ, Erickson DJ, Lenk K, Laska MN (2017) Pricing of staple foods at supermarkets versus small food stores. Int J Environ Res 14(8):915. https://doi.org/10.3390/ijerph14080915
Castro IA, Majmundar A, Williams CB, Baquero B (2018) Customer purchase intentions and choice in food retail environments: a scoping review. Int J Environ Res Public Health 15(11):2493. https://doi.org/10.3390/ijerph15112493
Centers for Disease Control and Prevention (2014). Healthier Food Retail: An Action Guide for Public Health Practitioners. Atlanta: U.S. Department of Health and Human Services. 160p. Available in: https://www.cdc.gov/nccdphp/dnpao/state-local-programs/pdf/Healthier-Food-Retail-guide-full.pdf. Accessed 10 Apr 2020
Chen PJ, Antonelli M (2020) Conceptual models of food choice: influential factors related to foods, individual differences, and society. Foods 9(12):1898. https://doi.org/10.3390/foods9121898
Cooksey-Stowers K, Schwartz MB, Brownell KD (2017) Food swamps predict obesity rates better than food deserts in the United States. Int J Environ Res Public Health 14(11). https://doi.org/10.3390/ijerph14111366
da Louzada MLC, Baraldi LG, Steele EM, Martins APB, Canella DS, Moubarac J-C, et al. (2015) Consumption of ultra-processed foods and obesity in Brazilian adolescents and adults. Prev Med 81:9–15. https://doi.org/10.1016/j.ypmed.2015.07.018
de Tavares PAJ, Hamamoto Filho PT, Ferreira ASSBS, Avila MAG (2018). Construction and Validation of Educational Material for Children with Hydrocephalus and Their Informal Caregivers. World Neurosurg 114:381–390. https://doi.org/10.1016/j.wneu.2018.03.082
Escaron, AL, Meinen AM, Nitzke SA, Martinez-Donate AP (2013). Peer reviewed: supermarket and grocery store–based interventions to promote healthful food choices and eating practices: a systematic review. Prev Chronic Dis 10:120156. https://doi.org/10.5888/pcd10.120156
Filatro A (2011) Instructional design in context: education and technology, 3rd edn. Senac, Sao Paulo
Glanz K, Sallis JF, Saelens BE, Frank LD (2005) Healthy food environments: concepts and measures. Am J Health Promot 19(5):330–333. https://doi.org/10.4278/0890-1171-19.5.330
Grant JS, Davis LL (1997) Selection and use of content experts for instrument development. Res Nurs Health 20(3):269–274. https://doi.org/10.1002/(SICI)1098-240X(199706)20:3<269::AID-NUR9>3.0.CO;2-G
Hawkes C (2008) Dietary implications of supermarket development: a global perspective. Development Policy Review 26(6):657–692. https://doi.org/10.1111/j.1467-7679.2008.00428.x
Health Canada (CA) (2019) Minister of Health. Canada’s Food Guide.https://food-guide.canada.ca/en/. Accessed 19 Sept 2021
Houghtaling B, Serrano EL, Kraak VI, Harden SM, Davis GC, Misyak SA (2019) A systematic review of factors that influence food store owner and manager decision making and ability or willingness to use choice architecture and marketing mix strategies to encourage healthy consumer purchases in the United States, 2005–2017. Int J Behav Nutr Phys Act 16(1):1–14. https://doi.org/10.1186/s12966-019-0767-8
Kanter R, Walls HL, Tak M, Roberts F, Waage J (2015) A conceptual framework for understanding the impacts of agriculture and food system policies on nutrition and health. Food security 7(4):767–777. https://doi.org/10.1007/s12571-015-0473-6
Korhonen J, Axelin A, Grobler G, Lahti M (2019) Content validation of mental health literacy scale (MHLS) for primary health care workers in South Africa and Zambia — a heterogeneous expert panel method. Glob Health Action 12(1). https://doi.org/10.1080/16549716.2019.1668215
Langellier BA, Garza JR, Prelip ML, Glik D, Brookmeyer R, Ortega AN (2013). Corner store inventories, purchases, and strategies for intervention: a review of the literature. Calif J Health Promot 11(3):1-13. https://doi.org/10.32398/cjhp.v11i3.1537
Lee RM, Rothstein JD, Gergen J, Zachary DA, Smith JC, Palmer AM et al (2015) Process evaluation of a comprehensive supermarket intervention in a low-income Baltimore community. Health Promot Pract 16(6):849–858. https://doi.org/10.1177/1524839915599359
Likert R (1932) A technique for the measurement of attitudes. Arch Psycho l22 140:55–55. https://legacyvoteviewcom/pdf/Likert_1932pdf. Acessed 30 Mar 2020
Lynn MR (1986) Determination and quantification of content validity. Nurs Res 35:382–385. https://doi.org/10.1097/00006199-198611000-00017
Machado PP, Claro RM, Canella DS, Sarti FM, Levy RB (2017) Price and convenience: the influence of supermarkets on consumption of ultra-processed foods and beverages in Brazil. Appetite 116:381–388. https://doi.org/10.1016/j.appet.2017.05.027
Middel CNH, Schuitmaker-Warnaar TJ, Mackenbach JD, Broerse JEW (2019) Systematic review: a systems innovation perspective on barriers and facilitators for the implementation of healthy food-store interventions. Int J Behav Nutr Phys Act 16(1):108. https://doi.org/10.1186/s12966-019-0867-5
Ministry of Health (BR) (2014) Health care secretariat. Department of Primary Care. Dietary Guidelines for the Brazilian Population. Brasília (DF), p 158
Ministry of Health (UY) (2016) General Directorate of Health. Nutrition Program Area. Food Guide for the Uruguayan Population.102p
Monteiro CA, Cannon G, Levy RB, Moubarac J-C, Louzada ML, Rauber F et al (2019) Ultra-processed foods: what they are and how to identify them. Public Health Nutr 22(5):936–941. https://doi.org/10.1017/S1368980018003762
Nazmi A, Tseng M, Robinson D, Neill D, Walker J (2019) A nutrition education intervention using NOVA is more effective than MyPlate alone: a proof-of-concept randomized controlled trial. Nutrients 11(12). https://doi.org/10.3390/nu11122965
Polit DF, Beck CT (2006) The content validity index: are you sure you know what’s being reported? Critique and recommendations. Res Nurs Health. 29(5):489–497
Rahnama H, Rajabpour S (2017) Identifying effective factors on consumers’ choice behavior toward green products: the case of Tehran, the capital of Iran. Environ Sci Pollut Res Int 24(1):911–925. https://doi.org/10.1007/s11356-016-7791-x
Rethink Food Waste (2018). Retail Food Waste: Action Guide. Available in: https://www.refed.com/downloads/Retail_Guide_Web.pdf. Acessed 10 Apr 2020
Ribeiro ZMT, Spadella MA (2018) Content validation of educational material on healthy eating for children under two years of age. Rev Paul Pediatr 36(2):155–163. https://doi.org/10.1590/1984-0462/;2018;36;2;00007
Rubio DM, Berg-Weger M, Tebb SS, Lee ES, Rauch S (2003) Objectifying content validity: conducting a content validity study in social work research. Soc Work Res 27(2):94–104. https://doi.org/10.1093/swr/27.2.94
Sanches LD (2020) Evaluation of the implementation of an intervention program in the food environment in small food retailers located in a low socioeconomic level region. Federal University of São Paulo (UNIFESP), Tese
Sigurdsson V, Larsen NM, Gunnarsson D (2011) An in-store experimental analysis of consumers’ selection of fruits and vegetables. Serv Ind J 31(15):2587–2602. https://doi.org/10.1080/02642069.2011.531126
Story M, Kaphingst KM, Robinson-O’Brien R, Glanz K (2008) Creating healthy food and eating environments: policy and environmental approaches. Annu Rev Public Health 29:253–272. https://doi.org/10.1146/annurev.publhealth.29.020907.090926
Stothard JR, Khamis AN, Khamis IS, Neo CHE, Wei I, Rollinson D (2016) Health education and the control of urogenital schistosomiasis: assessing the impact of the Juma na kichocho comic-strip medical booklet in zanzibar. J Biosoc Sci 48(Suppl 1):S40–S55. https://doi.org/10.1017/S0021932016000122
Stroebele N, De Castro JM (2004) Effect of ambience on food intake and food choice. Nutrition 20(9):821-838. https://doi.org/10.1016 /j.nut.2004.05.012
Swinburn B, Egger G (2002) Preventive strategies against weight gain and obesity. Obes Rev Off J Int Assoc Study Obes 3(4):289–301. https://doi.org/10.1046/j.1467-789X.2002.00082.x
Swinburn B, Egger G, Raza F (1999) Dissecting obesogenic environments: the development and application of a framework for identifying and prioritizing environmental interventions for obesity. Prev Med Rep 29(6):563–570. https://doi.org/10.1006/pmed.1999.0585
Swinburn B et al (2013) INFORMAS (international network for food and obesity/non-communicable diseases research, monitoring and action support): overview and key principles. Obes Rev 1:1–12. https://doi.org/10.1111/obr.12087 PMID: 24074206
Turner C, Aggarwal A, Walls H, Herforth A, Drewnowski A, Coates J, Kalamatianou S, Kadiyala S (2018) Concepts and critical perspectives for food environment research: a global framework with implications for action in low- and middle-income countries. Glob Food Sec 18:93–101. https://doi.org/10.1016/j.gfs.2018.08.003
Vandevijvere S, Waterlander W, Molloy J, Nattrass H, Swinburn B (2018) Towards healthier supermarkets: a national study of in-store food availability, prominence and promotions in New Zealand. Eur J Clin Nutr 72(7):971–978. https://doi.org/10.1038/s41430-017-0078-6
Vaughan CA, Cohen DA, Ghosh-Dastidar M, Hunter GP, Dubowitz T (2017) Where do food desert residents buy most of their junk food? Supermarkets. Public Health Nutr 20(14):2608–2616. https://doi.org/10.1017/S136898001600269X
Wansink B (2004) Environmental factors that increase the food intake and consumption volume of unknowing consumers. Annu Rev Nutr 24:455–479. https://doi.org/10.1146/annurev.nutr.24.012003.132140
Zamanzadeh V, Ghahramanian A, Rassouli M, Abbaszadeh A, Alavi-Majd H, & Nikanfar AR (2015). Design and implementation content validity study: development of an instrument for measuring patient-centered communication. Int J Caring Sci 4(2):165. https://doi.org/10.15171/jcs.2015.017
Acknowledgments
We thank São Paulo Research Foundation (FAPESP) and National Council for Scientific and Technological Development (CNPq) for the research grants awarded to the authors of the study.
Funding
This study was funded by grants of research from São Paulo Research Foundation (FAPESP) and National Council for Scientific and Technological Development (CNPq).
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Scaciota, L.L., Jaime, P.C. & Borges, C.A. Development and validation of a guide to support public managers and retailers in promoting a healthy food environment. J Public Health (Berl.) 30, 2449–2459 (2022). https://doi.org/10.1007/s10389-021-01669-w
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DOI: https://doi.org/10.1007/s10389-021-01669-w