Developing and validating an educational brochure to promote breastfeeding and the infant’s complementary food

Ribeiro, Nalu de Moraes; Pereira, Ada Yukari Kanashiro; Ozela, Ciléa Maria dos Santos

doi:10.1590/1806-93042018000200006

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Revista Brasileira de Saúde Materno Infantil

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ORIGINAL ARTICLES • Rev. Bras. Saude Mater. Infant. 18 (2) • Apr-Jun 2018 • https://doi.org/10.1590/1806-93042018000200006 copy

Developing and validating an educational brochure to promote breastfeeding and the infant’s complementary food

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objectives:

to describe the stages of developing and validating two educational brochures to promote breastfeeding and the infant’s complementary food.

Methods:

an observational descriptive study was performed with eight health professionals and 60 caregiver of children under two years old divided into two groups of 30 (one for each brochure) in a Pediatric Outpatient Clinic at a Maternal and Child Reference Hospital. The research was developed in four stages: bibliographical survey, development of the brochures, validation by specialists and target audience and adequacy of the materials. The validation method used was the Índice de Validade de Conteúdo (Content Validity Index) calculation.

Results:

two nutritional orientation brochures for infants were developed. Experts validated the breastfeeding brochure on its relevance and the brochure on complementary food regarding its relevance and goal. The other items were validated after suggested modifications. In relation to the target audience, the concordance index found in brochures 1 and 2 was higher than 75%. The Índice de Validade de Conteúdo Global (Global Content Validity Index) of the materials was greater than 0.78.

Conclusions:

regarding its appearance and content after the adjustments, the brochures were considered valid by the experts and the representatives of the target audience.

Key words
Pamphlets; Nutritional education; Breastfeeding; Complementary food; Validation study

1.Item	Validation
	I	PA	A	TA	IVC

Aim
1.1 It is coherent for the caregivers' needs (mother, father, other relative, etc.).	-	-	1	7	1
1.2 It is coherent from the point of view for infants on eating healthy.	-	-	-	8	1
1.3 It can be used in scientific pediatric area.	-	2	1	5	0.75

Structure and presentation
2.1 The educational brochure is appropriate to orient infants' caregivers.	-	-	2	6	1
2.2 The messages are presented in a clear and objective way.	-	2	1	5	0.75
2.3 The information presented is scientifically correct.	-	1	2	5	0.88
2.4 The material is appropriate for the sociocultural level of the proposed target audience.	^-	1	3	4	0.88
2.5 Logical sequence of the proposed content.	-	-	-	8	1
2.6 The information is well structured in agreement and spelling.	-	-	2	6	1
2.7 The writing style corresponds to the target audiences' level of knowledge.	-	-	2	6	1
2.8 The presentation of the information is coherent.	-	1	2	5	0.88
2.9 The sizes of the title and topics are adequate.	-	-	-	8	1
2.10 The illustrations are expressive and sufficient.	-	1	2	5	0.88
2.11 The number of pages is adequate.	-	-	1	7	1

Relevance
3.1 The themes represent key aspects that need to be strengthened.	-	-	-	8	1
3.2 The nutritional orientation proposes the learner to acquire knowledge about eating healthy.	^-	^-	2	6	1
3.3 The brochure approaches necessary issues for the caregiver to practice with the infants about eating healthy.	^-	^-	2	6	1
3.4 It is indicated for any health professional to use the brochure in their educational activities.		1	2	5	0.88
IVC Global					0.93

1 .Item	Validation
1 .Item	I	PA	A	TA	IVC

Aim
1.1 It is coherent for the caregivers' needs (mother, father, other relative, etc.).	-	-	1	7	1
1.2 It is coherent from the point of view for infants on eating healthy.	-	-	1	7	1
1.3 It can be used in scientific pediatric area.	-	1	1	6	0.88

Structure and presentation
2.1 The educational brochure is appropriate to orient infants' caregivers.	-	1	1	6	0.88
2.2 The messages are presented in a clear and objective way.	-	2	2	4	0.75
2.3 The information presented is scientifically correct.	-	1	2	5	0.88
2.4 The material is appropriate for the sociocultural level of the proposed target audience.	^-	^-	2	6	1
2.5 Logical sequence of the proposed content.	-	-	-	8	1
2.6 The information is well structured in agreement and spelling.	-	-	1	7	1
2.7 The writing style corresponds to the target audiences' level of knowledge.	-	-	2	6	1
2.8 The presentation of the information is coherent.	-	1	1	6	0,88
2.9 The sizes of the title and topics are adequate.	-	-	1	7	1
2.10 The illustrations are expressive and sufficient.	-	1	3	4	0.88
2.11 The number of pages is adequate.	-	-	-	8	1

Relevance
3.1 The themes represent key aspects that need to be strengthened.	-	-	1	7	1
3.2 The nutritional orientation proposes the learner to acquire knowledge about eating healthy.	^-	^-	^-	8	1
3.3 The brochure approaches the necessary issues for the caregiver to practice with the infants about eating healthy.	^-	^-	^-	8	1
3.4 It is indicated for any health professional to use the brochure in their educational activities.		1	2	5	0.88
IVC Global					0.94

Variables	Brochure 1 Option 1		Brochure 2 Option 1
	n	%	n	%

1. Organization

1.1 Did the presentation call your attention? 1 .yes / 2.no	29	96.7	30	100.0
1.2 Does the issue show what they are referring to? 1 .yes / 2.no	30	100.0	30	100.0
1.3 Is the sequence of information adequate? 1 .yes / 2.no	30	100.0	30	100.0
1.4 Is the amount of information adequate? 1 .yes / 2.no	27	90.0	30	100.0

2. Writing Style

2.1 As for the understanding of the sentences, they are: 1. easy to understand / 2. difficult to understand	29	96.7	28	93.3
2.2 The written content is: 1. clear / 2.confused	29	96.7	29	96.7
2.3 The text is: 1.interesting / 2.uninteresting	30	100.0	30	100.0

3. Appearance

3.1 The illustrations are: 1.simple / 2. Complicated	30	100.0	30	100.0
3.2 Do the illustrations complement the text? 1.yes / 2.no	30	100.0	30	100.0
3.3 Do the presentation of the text and figures seem organized? 1.yes / 2.no	30	100.0	30	100.0

4. Motivation

4.1 Anyone reading this nutritional orientation will understand what it is about? 1 .yes / 2.no	30	100.0	29	96.7
4.2 Did you feel motivated to read to the end? 1 .yes / 2.no	29	96.7	30	100.0
4.3 Does the brochure approach the issues that the caregiver needs (mother, father, other relative, etc.) for children under 2 years of age? 1 .yes / 2.no	29	96.7	30	100.0
4.4 Does the brochure propose to the caregiver's knowledge about eating healthy? 1 .yes / 2.no	30	100.0	30	100.0

Evaluated category	The Specialists' Suggestions
Brochure 1
Aim Item 1.3	Include bibliographical references to the textual content.
Structure and presentation Items 2.2, 2.3, 2.4, 2.8 and 2.10	Remove the phrase "improves quality of life."
	Replace the term "develops" for "favors"
	Replace the phrase "glass recipient with screw on lid" for " sanitized glass recipient with plastic lid."
	Remove the term "sodium rich food."
	Exemplify fatty foods (salty, fried and canned).
	Explain why you cannot consume excessively some types of food.
	Alternate the illustration of a mother breastfeeding, suggesting to place her in a more comfortable position.
	Add an extended illustration representing the baby's handhold during breastfeeding.
Brochure 2
Aim Item 1.3	Include bibliographical references to the textual content.
Structure and presentation Items 2.1, 2.2, 2.3, 2.8 and 2.10	Include in the family's food orientation the phrase "non-fat and non-canned food."
	Add some regional food in the cereals and vegetables group.
	Include on the subtitle of the topic the number of spoons in the "Salty porridge - consistency and quantity".
Relevance Item 3.4	Indicate mealtime under the topic "Infant Food Planning."
The Target Audiences' Suggestions
The change of the color on brochure 1 cover to more vivid colors.
Add the type of spoon that should be used in the salty porridge in brochure 2.

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[TFN1] I= Inadequate; PA= Partially Adequate; A= Adequate; TA= Totally Adequate; IVC= Índice de Validade de Conteúdo (Content Validity Index) in the development of the instrument for infants' nutritional orientation by specialist judges.