Validation of an educational tool on healthy eating for schoolchildren

VASCONCELOS, Celia Maria Ribeiro de; VASCONCELOS, Eliane Maria Ribeiro de; VASCONCELOS, Maria Gorete Lucena de; AZEVEDO, Suelen Brito de; RAPOSO, Maria Cristina Falcão; VASCONCELOS, Ana Lucia Ribeiro de

doi:10.1590/1678-98652018000500005

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ORIGINAL ARTICLES • Rev Nutr 31 (5) • Sep-Oct 2018 • https://doi.org/10.1590/1678-98652018000500005 copy

Validation of an educational tool on healthy eating for schoolchildren

Validação de uma tecnologia educacional sobre alimentação saudável para escolares

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective

The purpose of this study was to validate the card game The Enigma of the Pyramid about healthy eating, using judges (expert) for the validation of content and design; and the target population (students from the 4^th and 5^th grades, aged 9-10 years) for the semantic validation (pilot test).

Methods

The Item-Level Content Validity Index was used to verify the degree of agreement among the experts’ opinions, item by item; and the Scale Level Content Validity Index to determine the arithmetic mean of the proportion of items that receive judgments of “non-disagreement” by the judges. The item that obtained Item-Level Content Validity Index greater or equal to 0.80 and Scale Level Content Validity Index greater or equal to 0.90 was considered validated, which was the coefficient of validity. The binominal test was used to select the items that should be revised/modified, using the p-value of ratio (reject H₀ if p≤0.8). Items were validated at significance level of ≤0.05.

Results

Twenty-two judges and 12 schoolchildren participated in the study. Of the 23 items of the card game, nine were selected for review/modification, of which five were from the language component and four from the suitability component for the target population.

Conclusion

Once the modifications were made, they were all approved by all participating students, making this educational tool on healthy eating habits available for use with the student population.

Keywords
Food and Nutrition Education; Health Education; Preschool Education

	Items	Disagreement		Non-Disagreement				I-CVI	p-value^* * Binomial test, using the means of the p-value of the proportion, reject H0 if p≤0.8
	Items	Total	Partial	Neither agree nor disagree	Partial	Total	∑ (%)
Content	1.1 Is the game in accordance with the recommendations of the Ministry of Health on healthy eating?	0	0	2	7	13	22 (100)	1	0.00939^ Validated Items, at the level of significance ≤0.05); Mean=Σ of non-agreement points (=474)/Number of expert judges (=22)/Number of items evaluated (=23); Adopted scores (Likert scale): Strong agreement=2; Partial agreement=1; Neither agree nor disagree=Zero; Partial agreement=minus 1; Strong disagreement=minus 2.
	1.2. Do the instruction cards address the issue of healthy eating?	0	0	0	9	13	22 (100)	1	0.00939^ Validated Items, at the level of significance ≤0.05); Mean=Σ of non-agreement points (=474)/Number of expert judges (=22)/Number of items evaluated (=23); Adopted scores (Likert scale): Strong agreement=2; Partial agreement=1; Neither agree nor disagree=Zero; Partial agreement=minus 1; Strong disagreement=minus 2.
	1.3. Do the challenge cards address the issue of healthy eating?	0	0	0	10	12	22 (100)	1	0.00939^ Validated Items, at the level of significance ≤0.05); Mean=Σ of non-agreement points (=474)/Number of expert judges (=22)/Number of items evaluated (=23); Adopted scores (Likert scale): Strong agreement=2; Partial agreement=1; Neither agree nor disagree=Zero; Partial agreement=minus 1; Strong disagreement=minus 2.
Language	2.1. Are the cards for each segment of the pyramid clear?	0	2	1	11	8	20 (90.9)	0.9091	0.10000
	2.2. Are the cards referring to each segment of the pyramid objective?	0	2	0	11	9	20 (90.9)	0.9091	0.10000
	2.3. Are the instruction cards clear?	0	1	2	10	9	21 (95.5)	0.9545	0.0352^ Validated Items, at the level of significance ≤0.05); Mean=Σ of non-agreement points (=474)/Number of expert judges (=22)/Number of items evaluated (=23); Adopted scores (Likert scale): Strong agreement=2; Partial agreement=1; Neither agree nor disagree=Zero; Partial agreement=minus 1; Strong disagreement=minus 2.
	2.4. Are the instruction cards objective?	0	1	1	12	8	21 (95.5)	0.9545	0.0352^ Validated Items, at the level of significance ≤0.05); Mean=Σ of non-agreement points (=474)/Number of expert judges (=22)/Number of items evaluated (=23); Adopted scores (Likert scale): Strong agreement=2; Partial agreement=1; Neither agree nor disagree=Zero; Partial agreement=minus 1; Strong disagreement=minus 2.
	2.5. Are the challenge cards clear?	0	1	1	12	8	21 (95.5)	0.9545	0.0352^ Validated Items, at the level of significance ≤0.05); Mean=Σ of non-agreement points (=474)/Number of expert judges (=22)/Number of items evaluated (=23); Adopted scores (Likert scale): Strong agreement=2; Partial agreement=1; Neither agree nor disagree=Zero; Partial agreement=minus 1; Strong disagreement=minus 2.
	2.6. Are the challenge cards objective?	0	0	2	11	9	21 (95.5)	0.9545	0.0352^ Validated Items, at the level of significance ≤0.05); Mean=Σ of non-agreement points (=474)/Number of expert judges (=22)/Number of items evaluated (=23); Adopted scores (Likert scale): Strong agreement=2; Partial agreement=1; Neither agree nor disagree=Zero; Partial agreement=minus 1; Strong disagreement=minus 2.
	2.7. Are the rules of the game clear?	0	1	2	13	6	21 (95.5)	0.9545	0.0352^ Validated Items, at the level of significance ≤0.05); Mean=Σ of non-agreement points (=474)/Number of expert judges (=22)/Number of items evaluated (=23); Adopted scores (Likert scale): Strong agreement=2; Partial agreement=1; Neither agree nor disagree=Zero; Partial agreement=minus 1; Strong disagreement=minus 2.
	2.8 Are the rules of the game objective?	0	2	1	13	6	20 (90.9)	0.9091	0.1000
	2.9. Do the rules of the game arouse interest?	0	2	1	13	6	20 (90.9)	0.9091	0.1000
	2.10. Are the rules of the game appropriate for the age group?	1	2	2	10	7	19 (86.4)	0.8636	0.2267
Design	3.1. Are the illustrations compatible with the content?	0	0	0	9	13	22 (100)	1	0.00939^ Validated Items, at the level of significance ≤0.05); Mean=Σ of non-agreement points (=474)/Number of expert judges (=22)/Number of items evaluated (=23); Adopted scores (Likert scale): Strong agreement=2; Partial agreement=1; Neither agree nor disagree=Zero; Partial agreement=minus 1; Strong disagreement=minus 2.
	3.2. Are the illustrations adjusted for the age group?	1	0	2	9	10	21 (95.5)	0.9545	0.0352^ Validated Items, at the level of significance ≤0.05); Mean=Σ of non-agreement points (=474)/Number of expert judges (=22)/Number of items evaluated (=23); Adopted scores (Likert scale): Strong agreement=2; Partial agreement=1; Neither agree nor disagree=Zero; Partial agreement=minus 1; Strong disagreement=minus 2.
	3.3. Are the illustrations adequate?	0	1	1	9	11	21 (95.5)	0.9545	0.0352^ Validated Items, at the level of significance ≤0.05); Mean=Σ of non-agreement points (=474)/Number of expert judges (=22)/Number of items evaluated (=23); Adopted scores (Likert scale): Strong agreement=2; Partial agreement=1; Neither agree nor disagree=Zero; Partial agreement=minus 1; Strong disagreement=minus 2.
	3.4. Are food illustrations appropriate for the region?	0	1	2	13	6	21 (95.5)	0.9545	0.0352^ Validated Items, at the level of significance ≤0.05); Mean=Σ of non-agreement points (=474)/Number of expert judges (=22)/Number of items evaluated (=23); Adopted scores (Likert scale): Strong agreement=2; Partial agreement=1; Neither agree nor disagree=Zero; Partial agreement=minus 1; Strong disagreement=minus 2.
Adequacy	4.1. Are the cards for each segment of the pyramid appropriate for the age group?	1	2	4	4	11	19 (86.4)	0.8636	0.2267
	4.2. Are the instruction cards appropriate for the age group?	1	0	5	8	8	21 (95.5)	0.9545	0.0352^ Validated Items, at the level of significance ≤0.05); Mean=Σ of non-agreement points (=474)/Number of expert judges (=22)/Number of items evaluated (=23); Adopted scores (Likert scale): Strong agreement=2; Partial agreement=1; Neither agree nor disagree=Zero; Partial agreement=minus 1; Strong disagreement=minus 2.
	4.3. Are the challenge cards appropriate for the age group?	1	1	4	7	9	20 (90.9)	0.9091	0.1000
	4.4. Are the rules of the game appropriate for the age group?	1	0	4	11	6	21 (95.5)	0.9545	0.0352^ Validated Items, at the level of significance ≤0.05); Mean=Σ of non-agreement points (=474)/Number of expert judges (=22)/Number of items evaluated (=23); Adopted scores (Likert scale): Strong agreement=2; Partial agreement=1; Neither agree nor disagree=Zero; Partial agreement=minus 1; Strong disagreement=minus 2.
	4.5..Regarding motivation, are they appropriate for the age group?	1	2	4	8	7	19 (86.4)	0.8636	0.2267
	4.6..Regarding motivation, do cards arouse interest in the game?	1	2	3	9	7	19 (86.4)	0.8636	0.2267
						Média: 0,94

Judges	Disagreement		Non-Disagreement				S-CVI/AVE
Judges	Strongly disagree	Disagree	Neither agree nor disagree	Agree	Strongly agree	∑ (%)	S-CVI/AVE
1				10	13	23 (100.0)	1
2				6	17	23 (100.0)	1
3				20	3	23 (100.0)	1
4		6	8	9		17 (73.9)	00.74
5				2	21	23 (100.0)	1
6			1	22		23 (100.0)	1
7				1	22	23 (100.0)	1
8		1		11	11	22 (95.6)	00.96
9				21	2	23 (100.0)	1
10			7	13	3	23 (100.0)	1
11		12	1	10		11 (47.8)	00.48
12			8	15		23 (100.0)	1
13	8	5		10		10 (43.5)	00.43
14			6	15	2	23 (100.0)	1
15				17	6	23 (100.0)	1
16					23	23 (100.0)	1
17					23	23 (100.0)	1
18				23		23 (100.0)	1
19			2	16	5	23 (100.0)	1
20				7	16	23 (100.0)	1
21			8	10	5	23 (100.0)	1
22					23	23 (100.0)	1
							20.61
					S-CVI 20.61/22=0.94

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E-mail: sbi.submissionrn@puc-campinas.edu.br

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[1] Note: Validity coefficient Item-Level Content Validity Index (I-CVI) ≥.80;

[TFN01] ^*
Binomial test, using the means of the p-value of the proportion, reject H₀ if p≤0.8

[TFN02] ^**
Validated Items, at the level of significance ≤0.05); Mean=Σ of non-agreement points (=474)/Number of expert judges (=22)/Number of items evaluated (=23); Adopted scores (Likert scale): Strong agreement=2; Partial agreement=1; Neither agree nor disagree=Zero; Partial agreement=minus 1; Strong disagreement=minus 2.