Elaboration and Content Validity of an instrument on the activities of Community Health Workers

Fernandes, Tatiana Fróes; Pinho, Lucinéia de; Brito, Maria Fernanda Santos Figueiredo; Lima, Clara Cynthia Melo e; Caldeira, Antônio Prates

doi:10.1590/2177-9465-EAN-2022-0070en

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RESEARCH • Esc. Anna. Nery 26 • 2022 • https://doi.org/10.1590/2177-9465-EAN-2022-0070en copy

Elaboration and Content Validity of an instrument on the activities of Community Health Workers

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective

to develop and validate the content and appearance of an instrument to identify activities performed by community health workers in Family Health Strategy.

Method

this is a methodological study composed of three stages: the first was the elaboration of the instrument based on a literature review, the second consisted of content validity by ten expert judges, and the third by apparent validity by the target population. For analysis, the content validity index was calculated.

Results

Initially, the instrument consisted of 45 items arranged in ten dimensions. The experts analyzed and suggested modification of terms and addition and dismemberment of items. All suggestions were accepted, and the final version of the instrument consisted of 60 items. The content validity index was ≥ 0.90 for all items. The instrument covered the activities recommended by ministerial regulations and activities that are outside the scope of action, but which are present in the practice of the community health workers.

Conclusion and implications for practice

The instrument presented satisfactory validity and reflected the reality of the community health workers, and its items are composed of the wide range of activities developed by these professionals.

Keywords:
Community Health Workers; Family Health Strategy; Primary Health Care; Professional Competence; Validity Study

Identification of the activities performed by community health workers
						CVI
Listed below are some activities performed by the community health workers in the team/health unit.

- Please indicate how often you perform these activities in your team:

0		1	2	3	4
Never		Rarely	Sometimes	Almost always	Always

- Please also indicate whether you agree or disagree with the performance of this activity by the Community health worker.
(1) Yes (2) No

Identifying the area/target population
1	Registration of individuals and families in the micro-area					1.00
2	Updating individual and household records					1.00
3	Identification of groups, families, and individuals exposed to risks and vulnerabilities (susceptible, in fragile situations, and living under precarious conditions)					1.00
Health care actions
4	Monthly home visits to all the families in the micro area					1.00
5	Follow-up of registered individuals, with emphasis on priority groups (children, pregnant women, people with chronic diseases or other health problems)					1.00
6	Collective activity aimed at social mobilization (stimulating community participation in the local management of services, such as, for example, the management council)					1.00
7	Collective activity for health education					1.00
8	Participation in a physical activity group					0.90
9	Participation in School Health Program activities					0.90
10	Orientation to the community about symptoms, risks, and agents that transmit diseases					1.00
11	Orientation to the community about individual and collective protection measures					1.00
12	Orientation regarding the adequate use of health services					1.00
13	User embracement					1.00
14	Identification of patients who need priority care (risk classification)					1.00
15	Scheduling of medical appointments for spontaneous demand					0.90
16	Scheduling of scheduled medical appointments					0.90
17	Scheduling of nursing appointments (cervical cancer prevention, prenatal, childcare, family planning, hypertensive, diabetic, and others)					0.90
18	Scheduling dental appointments					0.90
19	Scheduling a home visit with a higher-level professional					0.90
20	Disclosure of the groups, events, and other actions promoted by the FHS					1.00
Regulation process from primary care
21	Scheduling consultations and exams of users for other points in the care network					0.90
22	Information to users about scheduled appointments and exams					0.90
Information for planning and monitoring health actions and programs
23	Monitoring and recording of the health conditionalities (requirements) of beneficiary families of the Bolsa Família Program					1.00
24	Updating anthropometric data (weight and height) of the children					0.90
25	Updating the anthropometric data (weight and height) of the adults					0.90
26	Updating the anthropometric data (weight and height) of the elderly					0.90
27	Checking the children’s vaccination cards					0.90
28	Verification of adolescents’ vaccination cards					0.90
29	Checking the vaccination card of adults					0.90
30	Checking the vaccination cards of the elderly					0.90
31	Verification of the vaccination card of pregnant women					0.90
Health surveillance
32	Actions to combat Dengue Fever by inspecting homes for Aedes aegypti foci					0.90
33	Carrying out an active search for diseases and illnesses					1.00
34	Notification of compulsorily notifiable diseases and diseases					0.90
35	Reporting diarrhea cases to the Acute Diarrheal Disease Monitoring Program (ADDM)					1.00
36	Identification of respiratory symptoms during home visits					0.90
37	Making of the Unit’s Respiratory Symptom Map					0.90
38	Follow-up of the directly observed treatment (supervised dose) of tuberculosis patients					0.90
Health information systems
39	E-SUS Registration - Home visit form					1.00
40	E-SUS Registration - Collective activity form					1.00
41	E-sus registration - food consumption markers					1.00
42	Updating of the National Health Card data					0.90
Management of inputs required for the proper functioning of the basic health unit
43	Making of the Unit Material Map					0.90
44	Making of the Unit Condom Map					0.90
45	Making the Unit Vitamin A Map					0.90
Procedures
46	Blood pressure measurement					0.90
47	Capillary blood glucose measurement					0.90
48	Measurement of axillary temperature					0.90
49	Performing a dressing					0.90
Interdisciplinary and teamwork
50	Participation in team meetings					1.00
51	Use of matrix-based strategies (support provided to the team by professionals from different areas that enables the expansion and qualification of its actions)					1.00
52	Permanent education participation					1.00
53	Conducting case discussions with the team					1.00
Other activities according to local needs
54	Duties at the Health Unit’s reception desk					0.90
55	Home delivery of prescriptions and medications					0.90
56	Performing tasks outside of working hours					0.90
57	Conducting home visits in an uncovered area					0.90
58	Organization of attendance sheets and family envelopes					0.90
59	Organization of offices/replacement of materials					0.90
60	Caring for the unit’s janitorial activities					0.90

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[1] Corresponding author: Tatiana Fróes Fernandes. E-mail: tatifroesn@hotmail.com