Validation of an educational video on infant hearing health

ABSTRACT

Purpose  To develop and validate a video as a tool for children’s hearing health education.

Methods  A descriptive study of educational technology validation was conducted. The video was developed in three stages: pre-production (script development), production (video production), and post-production (video validation). The validation occurred in two phases: the first with five experts, selected by non-probabilistic sampling, of the intentional type, based on curriculum analysis, and the second with the target population (50 mothers), from a convenience sample. Each group answered a specific questionnaire, and the Net Promoter Score (NPS) metric was additionally applied to the target population. Descriptive analysis was performed using measures of central tendency and dispersion for continuous variables, and frequencies for categorical variables.

Results  The experts evaluated the video positively. In the general impression section, responses ranged from “agree” to “strongly agree,” and four suggestions were made by the experts. Similarly, in the content evaluation section, most responses were “agree” or “strongly agree.” The target population reported that the video was useful for increasing knowledge on the topic (98.0%), easy to understand (94.0%), and presented an appropriate amount of information (92.0%). Regarding individual satisfaction, most participants provided positive responses for each item. In the NPS assessment, 84.0% of mothers were classified as promoters.

Conclusion  The video was developed and validated as a children's hearing health education tool, receiving positive evaluations from experts and the target population.

Keywords:
Health education; Hearing loss; Hearing; Educational technology; Instructional film and video

RESUMO

Objetivo  Desenvolver e validar um vídeo como ferramenta de educação em saúde auditiva infantil.

Métodos  Estudo descritivo de validação de tecnologia. O vídeo foi elaborado seguindo as etapas de pré-produção (desenvolvimento do roteiro), produção (elaboração do vídeo) e pós-produção (validação do vídeo). A validação ocorreu em duas fases: a primeira com cinco especialistas selecionadas por amostragem não probabilística, do tipo intencional, por julgamento da análise curricular e, a segunda, com a população-alvo (50 mães), oriunda de amostra por conveniência. Cada público respondeu a um questionário específico e, adicionalmente, aplicou-se a métrica Net Promoter Score (NPS) à população-alvo. Realizou-se análise descritiva por meio de medidas de tendência central e dispersão para variáveis contínuas e frequências para variáveis categóricas.

Resultados  As especialistas avaliaram o vídeo positivamente. No primeiro bloco, referente à impressão geral, as respostas variaram entre “concordo” e “concordo fortemente” e foram realizadas quatro sugestões. De forma semelhante, no bloco de avaliação do conteúdo a maioria das respostas foi marcada como “concordo” ou “concordo fortemente”. A população-alvo relatou que o vídeo é útil para aumentar o conhecimento (98%), fácil de entender (94%) e apresenta quantidade adequada de informações (92%). Quanto à satisfação individual, a maioria das participantes apresentou respostas positivas para cada item. Na avaliação pelo NPS, 84% das mães foram classificadas como promotoras.

Conclusão  O vídeo foi desenvolvido e validado como uma ferramenta de educação em saúde auditiva infantil, com avaliação positiva, tanto pelas especialistas, quanto pela população-alvo.

Palavras-chave:
Educação em saúde; Perda auditiva; Audição; Tecnologia educacional; Filme e vídeo educativo

INTRODUCTION

Hearing loss (HL) has a significant impact on an individual’s life, and when it comes to children, it can impair their development. Parents play an essential role in monitoring their children’s hearing; however, studies show that a large portion of this population still has limited knowledge about children’s hearing health(¹-³). Therefore, it is essential to provide this audience with high-quality information.

The use of social media has become increasingly important in disseminating health information. With the rapid development of digital technology, the demand for health-related knowledge is also increasing, and the use of videos has gained prominence in health education(⁴). When developing an educational video, it is essential to consider aspects such as clarity of language, the relevance of the content to the target audience, an appropriate length to maintain the viewer’s attention, and the presentation format(⁵).

The use of short educational videos can significantly increase viewers’ knowledge of health-related topics, with a positive impact on health promotion(⁶). The evidence also points to the importance of developing educational videos on children’s hearing, with the aim of improving parents’ knowledge of the subject(⁷).

Tailoring interventions to the needs of the target audience is essential, making the assessment of user satisfaction a key component in the development of health education strategies. This allows for the evaluation of the effectiveness and impact of proposed interventions(⁸). Therefore, it is essential to investigate whether the use of educational videos is an effective tool for disseminating knowledge about children’s hearing health, as well as to assess the population’s satisfaction with this resource. Educational videos are believed to be a viable strategy for interventions in this area. In this context, the objective of this study was to develop and validate a video as a tool for children’s hearing health education.

METHODS

This is a descriptive technology validation study, classified as methodological development research, which aimed to develop and validate an educational video on children’s hearing health to provide information to mothers, fathers, caregivers, and pregnant women.

The study was approved by the institution’s Research Ethics Committee (opinion No. 6,681,227), and all participants were included after signing the Informed Consent Form (ICF). The confidentiality and anonymity of the participants were preserved, in accordance with ethical principles and the Brazil's General Data Protection Law (LGPD; Law 13.709/2018).

The study was conducted between May and August 2024 in the mixed-occupancy wards and the high-risk unit of a public maternity hospital that serves as a referral center for the state.

The video was produced in three stages: pre-production (script development), production (video creation), and post-production (video review).

Pre-production

The pre-production phase consisted of the researchers developing the video script, based on a review of the scientific literature. Searches were conducted in the PubMed, SciELO, and Virtual Health Library (VHL) databases. Controlled descriptors were used, selected from the Health Sciences Descriptors (DeCS) and Medical Subject Headings (MeSH) and combined using the Boolean operators AND and OR, taking into account the specific indexing characteristics of each database. The search strategies included combinations such as (Neonatal Screening OR Newborn) AND (Hearing OR Hearing Loss) AND Health Education; and Hearing AND Health Education AND Maternal and Child Health.

The identified studies were analyzed for thematic relevance, and the information extracted from them informed the definition of the content covered in the guide. Priority was given to studies published in the last ten years, as well as technical documents and national and international guidelines relevant to the topic. Thus, the process included updating the risk indicators for hearing loss, ensuring alignment with current scientific and regulatory recommendations on children’s hearing health. In addition, simple and accessible language was used, appropriate for the target audience’s varying levels of education.

Production

The video was developed according to a prepared script and addressed the following topics: risk factors for different types of hearing loss, non-biomedical model beliefs, and the identification of and intervention for HL in childhood. Titled "Pílulas da Audição" (literally, Hearing Pills) (Figure 1), the video was produced on the Vimeo platform using the Vimeo Create tool. It featured narration generated by artificial intelligence (AI) using Microsoft Azure’s text-to-speech service, as well as subtitles and illustrative images obtained from free and public-domain image databases. The video is three minutes and 32 seconds long and is available on YouTube(⁹).

Figure 1
Representative screenshots from the educational video "Pílulas da Audição". The original video is in Portuguese; the text displayed in the screenshots was translated into English for illustrative purposes

Post-production (validation)

Post-production involved two phases. The first consisted of having the video reviewed by experts, followed by edits based on the suggestions provided by the participants. In the second phase, the revised version of the video was reviewed by the target population. Two separate questionnaires were used to evaluate the video: one for Brazilian audiologists (speech-language pathologists specialized in audiology) and the other for mothers.

First stage - experts

To validate the content and technical aspects of the video, five audiologists with direct experience in newborn hearing screening (NHS) participated. They were selected through purposive non-probabilistic sampling from the pool of professionals who were working or had previously worked as clinical audiologists, residents, or researchers at the maternity ward where the study was conducted. The selection was made at the researcher’s discretion, based on an analysis of the résumés registered on the Lattes Platform of the National Council for Scientific and Technological Development (CNPq), taking into account the length of experience in the field of children's hearing health and NHS, clinical and/or academic experience related to the topic, and participation in teaching, research, or clinical activities within the maternity ward. The following inclusion criteria were established: a bachelor’s degree in Speech-Language Pathology and Audiology, proven practical experience in NHS at the facility where the study was conducted, and a minimum qualification of a lato sensu specialization degree. Speech-language pathologists without experience in NHS, without a current or previous affiliation with the maternity ward, or who did not meet the minimum qualification requirement were excluded.

The video was sent by email, along with a Google Forms questionnaire to be completed after viewing it. The evaluation instrument(¹⁰) is divided into two sections: the first addresses overall impressions, with seven questions, and the second evaluates the content, with 18 questions. All questions use a Likert scale with four response options, ranging from “strongly disagree” to “strongly agree.” There is also a “don’t know” option for all questions and a field for comments and suggestions. The first section also includes two questions with “yes” or “no” response options, followed by a space for suggestions in the event of an affirmative response.

Stage two - target population

Fifty mothers participated in this phase; they were selected from a non-probabilistic, convenience sample and were cared for at a maternity ward during their hospital stay. Women in the immediate postpartum period or pregnant women admitted to the maternity ward’s high-risk unit during the study period were included, provided they were 18 years of age or older and capable of understanding and responding to the research instruments. Women who refused to participate in the study, who were illiterate, or who did not complete the questionnaires were excluded.

After accepting and signing the informed consent form, the participants watched the video in person on an Apple tablet (9.7-inch 4th-generation iPad). Next, they completed a questionnaire with questions based on and adapted from a previous study(¹¹), regarding their satisfaction with and perceived usefulness of the educational video. The questionnaire is divided into two sections: the first assesses overall satisfaction with the video, and the second assesses aspects of individual satisfaction. The questions in the second part use a Likert scale with five response options, ranging from “strongly disagree” to “strongly agree” for the first four questions; “very dissatisfied” to “very satisfied” for two questions; and “very useless” to “very useful” for the last question. For the purposes of analysis, the responses were grouped into three categories: positive, neutral, and negative.

In addition, the Net Promoter Score (NPS) metric was applied to measure the likelihood that participants would recommend the educational video to others. The scale ranges from 0 to 10, where 0 means “not at all likely” and 10 means “very likely”(¹²). The NPS assessment was conducted as follows: individuals who gave a score of 9 or 10 were considered “promoters”; those who responded with 7 or 8 were considered “passives”; and those who scored between 0 and 6 were considered “detractors”.

Data processing and analysis

The data collected were recorded on the questionnaires and then entered into a spreadsheet in Microsoft Excel 2010®, tabulated, and presented in the form of graphs. Descriptive analysis was performed, using measures of central tendency and dispersion for continuous variables and relative frequencies (%) for categorical variables.

RESULTS

The video was validated in two stages: the first with experts and the second with the target audience. In the expert group, years of training ranged from 4 to 16 (average of 8.6 years). All had postgraduate degrees, including two specialists, two with master’s degrees, and one with a doctorate.

In the group of mothers (the target population), the mean age was 31 (±7.0) years, ranging from 19 to 45 years old. Regarding educational attainment, 24.0% of the mothers had completed or partially completed elementary school, 18.0% had started but not completed high school, 42.0% had completed high school, and 16.0% had a college education. Regarding occupations, 42.0% identified as “homemakers,” 10.0% as farmers, 6.0% as teachers, 6.0% as self-employed, and 36.0% engaged in various other professional activities.

In the experts’ assessment, both the overall impression and the content were rated highly. In the first section (overall impression), all responses to the first five questions ranged from “agree” to “strongly agree” (Figure 2). In the second question, which addressed the use of animations as a resource to facilitate learning about the topic, a comment was included in the “observations/suggestions” section: “include images related to the indicators to better illustrate them; for example: hyperbilirubinemia—a child with this condition.”

Figure 2
Relative frequency of the responses provided by the experts regarding the general aspects of the video

Regarding suggestions for modifying the video, two comments were made: “include that the NHS failure occurs after a retest,” and adjust the “speed of the narrator’s voice, as a slightly slower pace would be more comfortable to watch.” In addition, as a suggestion for additional content, it was recommended to “show the screening result in the child’s health record.” Among the points listed, the change in narration speed and the inclusion of images to illustrate the risk indicators were not adopted, as they would have increased the video’s length. One of the researchers’ concerns was to keep the video short, so it could hold the target audience’s attention.

Similarly, in the content evaluation section, most responses fell into the “agree” or “strongly agree” categories. Only one of the audiologists responded “disagree” to the statement: “The educational video enables learning based on the user’s prior experience” and selected “don’t know” for the question “The presentation of sounds is relevant to the information included in the text.” However, no additional comments were recorded for these questions (Figure 3).

Figure 3
Relative frequency of the responses provided by the experts in their evaluation of the video's content

In the assessment of satisfaction with the video from the target population’s perspective, 49 (98.0%) participants reported that the video is useful for increasing knowledge about the topic covered, while only one (2.0%) disagreed. As for how easy the video was to understand, 47 (94.0%) found it easy to understand, while 3 (6.0%) found it difficult. Regarding the amount of information provided, 92.0% rated it as adequate, 4.0% rated it as excessive, and another 4.0% rated it as insufficient.

In the assessment of individual satisfaction items, positive responses predominated for each item, as shown in Figure 4.

Figure 4
Relative frequency (%) of mothers' responses to the individual satisfaction items in the educational video

In the NPS assessment, which measured the likelihood of recommending the “Pílulas da Audição” video, 41 of the 50 participating mothers (82.0%) gave a score of 10; one (2.0%) gave a score of 9; 5 (10.0%) gave a score of 8; 2 (4.0%) gave a score of 7; and one (2.0%) gave a score of 6. According to the NPS evaluation criteria, 42 participants (84.0%) were classified as promoters (Figure 5).

Figure 5
Percentage of mothers classified as promoters, passives, and detractors in the Net Promoter Score

DISCUSSION

With the advancement of technology and the digital age, the dissemination of information has come to incorporate new means of transmission, including educational videos, a tool used in this study.

The validation of the video as a tool for children’s hearing health education highlights its usefulness in disseminating knowledge in an accessible and scientifically grounded manner. Through validation by professionals specializing in the field and the adaptations made, it was ensured that the material was appropriate for the target population, as favorable results were obtained from the mothers participating in the study. Therefore, the video “Pílulas da Audição” is a resource that can be used to promote knowledge about childhood hearing health, contributing to awareness and potential changes in attitude regarding the detection and prevention of hearing disorders in children.

Although studies using educational videos to convey specific information about children’s hearing health are scarce in the literature, one study observed an increase in parents’ knowledge regarding hearing and language development in childhood after they watched a video addressing this topic(¹³). In matters of general health or in specific areas, video is a widely used tool for health education among different populations or as a complement to the information provided to patients(¹⁴), leading to improved understanding of the information in various clinical settings.

Despite the broad reach and ease of disseminating knowledge, for an educational tool to be truly effective, it must be validated; evaluation by experts with expertise in the subject is therefore essential. These experts possess the technical and scientific insight required for the content covered, thereby lending greater credibility to the resource(¹⁵,¹⁶). Additionally, to ensure that the material is accessible to different audiences with varying levels of education, it is essential to understand the target population’s perception in order to confirm the validation performed by the experts(¹⁷).

According to a previous study, the use of video as a strategy for disseminating information must meet certain basic criteria, such as video length and presentation format. However, it is not only the technical aspects that should be considered, but also the viewer’s emotional state at the time of watching the video(⁵). The "Pílulas da Audição" video is short, uses simple language, and addresses relevant aspects of children’s hearing health, just like the video used in a study conducted with mothers on oral health in infants and children(¹⁸), which confirmed its effectiveness as a means of providing guidance and increasing these mothers’ knowledge.

Still on the subject of video length, it is recommended that audiovisual educational materials not exceed 15 minutes in order to prevent viewer fatigue and maintain their attention, in addition to using accessible language(¹⁹). The video validated in this study follows these recommendations, with a duration of three minutes and 32 seconds.

It was observed that 84.0% of the mothers would act as promoters—that is, they would recommend the video to others. This finding is consistent with a previous study, in which all participants indicated they would recommend the material used. The main reason given for this recommendation was that the video addressed previously unknown and relevant information, contributing to knowledge about the topic(¹⁷).

In addition to educational videos, Artificial Intelligence (AI) has been widely used in the healthcare field, including to promote healthy habits, through chatbots—software that simulates interactions with users. Studies have shown that this technology can be effective in disseminating health information, but it is essential to ensure its accessibility so that it is available to different population groups(²⁰). In this regard, social media also plays a significant role in disseminating information about hearing health, enabling the sharing of content and the exchange of experiences. However, caution is needed regarding the accuracy of the information disseminated through these channels(²¹).

In the Brazilian context, varying levels of education and health literacy pose challenges to the understanding and assimilation of information, especially in the area of hearing health. Therefore, it is essential to adopt strategies that facilitate this communication, promoting greater user engagement. The educational video “Pílulas da Audição” emerges as a promising tool for disseminating high-quality information; it can be shown in waiting rooms, shared via messaging apps, or posted on social media, thereby expanding the reach and interest in the topic(¹⁷,²²).

One limitation of this study relates to the number of experts participating in the validation phase, a common feature in methodological studies of this nature. This aspect led to the decision to use descriptive data analysis, which proved appropriate given the high degree of agreement observed among the evaluators. Regarding the target population, it is worth noting that the validation was conducted exclusively with mothers, although children are also cared for by other family members and caregivers, who could have contributed complementary perspectives. Furthermore, the mothers watched the video in a hospital ward, a setting with constant background noise, which may have interfered with their attention and understanding of the content presented. Future studies could explore the acceptance and impact of this material among other audiences, broadening our understanding of its applicability and effectiveness in promoting children’s hearing health.

CONCLUSION

The video "Pílulas da Audição" was positively evaluated as a tool for children’s hearing health education by both experts and the target audience. The high recommendation rate suggests that the material may be an effective strategy for increasing knowledge and awareness of the topic. In addition to providing access to essential information in an educational and accessible way, the video has the potential to engage families, making them active participants in promoting their children’s hearing health.

ACKNOWLEDGMENTS

The authors would like to thank the experts for their contributions to the validation process.

Study carried out at Universidade Federal do Rio Grande do Norte – UFRN – Natal (RN), Brasil.

Data Availability Statement:

Research data is available in the body of the article.

Funding:

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior – Brasil (CAPES) (Código de Financiamento 001).

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Conflict of interests:

No.

Correspondence

Corresponding author: Eliene Silva Araújo. E-mail: [e-mail]

Editor-in-Chief:

Maria Cecilia Martinelli Iorio.

Associate Editor:

Ana Cláudia Mirândola Barbosa Reis.

Publication Dates

• Publication in this collection
  21 Sept 2026
• Date of issue
  2026

History

• Received
  01 Sept 2025
• Accepted
  29 June 2026