RBGO

+

Online submission +

Volume 44 - Novembro 2022

DOI: s-0042-1756213

Development and Validation of a Protocol for Pregnant Women Based on the Brazilian Dietary Guidelines

Desenvolvimento e validação de um protocolo para orientação de gestantes baseado no guia alimentar para a população brasileira

Cláudia Raulino Tramontt, Juliana Giaj Levra de Jesus, Thanise Sabrina Souza Santos, Fernanda Rauber, Maria Laura da Costa Louzada, Vanessa Del Castillo Couto, Jacqueline Resende Berriel Hochberg, Patrícia Constante Jaime

213 Visualizações

Objective
To develop and validate a protocol for the use of the Dietary Guidelines for the Brazilian Population (DGBP) in the individual dietary advice for pregnant women assisted in primary healthcare (PHC).

Methods
Methodological study that involved the elaboration of a protocol in six steps: definition of the format, definition of the instrument to evaluate food consumption, systematization of evidence on food and nutrition needs of pregnant women, extraction of DGBP recommendations, development of messages of dietary guidelines and content, and face validity. The analyses of the validation steps were carried out by calculating the Content Validity Index (CVI) and thematic content analysis.

Results
As products of the steps, the protocol structure was defined and the dietary advice for pregnant women were elaborated, considering physiological changes, food consumption, nutritional and health needs, and socioeconomic conditions of this population. The protocol was well evaluated by experts and health professionals in terms of clarity, relevance (CVI > 0.8), and applicability. In addition, the participants made some suggestions to improve the clarity of the messages and to expand the applicability of the instrument with Brazilian pregnant women.

Conclusion
The instrument developed fills a gap in clinical protocols on dietary advice for pregnant women focused on promoting a healthy diet, contributing to a healthy pregnancy. In addition, it demonstrates potential to contribute to the qualification of PHC professionals and to the implementation of the DGBP recommendations.
Keywords

dietary guidelines, practice guidelines, prenatal nutrition, primary health care, validation study

Objective

To develop and validate a protocol for the use of the Dietary Guidelines for the Brazilian Population (DGBP) in the individual dietary advice for pregnant women assisted in primary healthcare (PHC).

Methods

Methodological study that involved the elaboration of a protocol in six steps: definition of the format, definition of the instrument to evaluate food consumption, systematization of evidence on food and nutrition needs of pregnant women, extraction of DGBP recommendations, development of messages of dietary guidelines and content, and face validity. The analyses of the validation steps were carried out by calculating the Content Validity Index (CVI) and thematic content analysis.

Results

As products of the steps, the protocol structure was defined and the dietary advice for pregnant women were elaborated, considering physiological changes, food consumption, nutritional and health needs, and socioeconomic conditions of this population. The protocol was well evaluated by experts and health professionals in terms of clarity, relevance (CVI > 0.8), and applicability. In addition, the participants made some suggestions to improve the clarity of the messages and to expand the applicability of the instrument with Brazilian pregnant women.

Conclusion

The instrument developed fills a gap in clinical protocols on dietary advice for pregnant women focused on promoting a healthy diet, contributing to a healthy pregnancy. In addition, it demonstrates potential to contribute to the qualification of PHC professionals and to the implementation of the DGBP recommendations.

1 . . Conference outcome document: Framework for Action–from committments to action [Internet]. 2014;:-


2 . . Global nutrition report: action on equity to end malnutrition [Internet]. 2020;:-


3 Danielewicz H, Myszczyszyn G, Dębińska A, Myszkal A, Boznański A, Hirnle L. Diet in pregnancy-more than food. Eur J Pediatr. 2017;176(12):1573-1579


4 Santos IDS, Crivellenti LC, Franco LJ, Sartorelli DS. Relationship between the quality of the pregnant womans diet and birth weight: a prospective cohort study. Eur J Clin Nutr. 2021;75(12):1819-1828


5 Mason JB, Shrimpton R, Saldanha LS, Ramakrishnan U, Victora CG, Girard AW. The first 500 days of life: policies to support maternal nutrition. Glob Health Action. 2014;7:23623-23623


6 Shrimpton R. Global policy and programme guidance on maternal nutrition: what exists, the mechanisms for providing it, and how to improve them?. Paediatr Perinat Epidemiol. 2012;26:315-325


7 . . Good maternal nutrition: the best start in life [Internet]. 2016;:-


8 Tsakiridis I, Kasapidou E, Dagklis T, Leonida I, Leonida C, Bakaloudi DR. Nutrition in pregnancy: A comparative review of major guidelines. Obstet Gynecol Surv. 2020;75(11):692-702


9 Holand BL, Fonseca SG, Drehmer M, Bosa VL. Adequacy of prenatal care considering nutritional assistance in Southern Brazil: Maternar Cohort Study. Cad Saude Publica. 2021;37(06):-


10 Lacerda EM, Kac G, Braga da Cunha C, Leal MdoC. Consumo alimentar na gestação e no pós-parto segundo cor da pele no município do Rio de Janeiro. Rev Saude Publica. 2007;41(06):985-994


11 Gomes CB, Vasconcelos LG, Cintra RM, Dias LC, Carvalhaes MA. Hábitos alimentares das gestantes brasileiras: revisão integrativa da literatura. Ciênc Saúde Coletiva. 2019;24(06):2293-2306


12 Pereira MT, Cattafesta M, Santos ETD, Salaroli LB. Maternal and sociodemographic factors influence the consumption of ultraprocessed and minimally-processed foods in pregnant women. Rev Bras Ginecol Obstet. 2020;42(07):380-389


13 Naspolini NF, Machado PP, Fróes-Asmus CIR, Câmara VM, Moreira JC, Meyer A. Food consumption according to the degree of processing, dietary diversity and socio-demographic factors among pregnant women in Rio de Janeiro, Brazil: The Rio Birth Cohort Study of Environmental Exposure and Childhood Development (PIPA project). Nutr Health. 2021;27(01):79-88


14 McDonald SD, Pullenayegum E, Taylor VH, Lutsiv O, Bracken K, Good C. Despite 2009 guidelines, few women report being counseled correctly about weight gain during pregnancy. Am J Obstet Gynecol. 2011;205(04):333.e1-333.e6


15 de Jersey SJ, Nicholson JM, Callaway LK, Daniels LA. An observational study of nutrition and physical activity behaviours, knowledge, and advice in pregnancy. BMC Pregnancy Childbirth. 2013;13:115-115


16 Whitaker KM, Wilcox S, Liu J, Blair SN, Pate RR. Patient and provider perceptions of weight gain, physical activity, and nutrition counseling during pregnancy: a qualitative study. Womens Health Issues. 2016;26(01):116-122


17 Verma BA, Nichols LP, Plegue MA, Moniz MH, Rai M, Chang T. Advice given by community members to pregnant women: a mixed methods study. BMC Pregnancy Childbirth. 2016;16(01):349-349


18 Pires CC, Rodrigues ML, Capelli JC, Santos MM, Baião MR. Atenção nutricional e práticas alimentares na perspectiva de gestantes com excesso de peso. Demetra. 2020;15:-


19 . . Departamento de Atenção Básica. Guia alimentar para a população brasileira. 2014;:-


20 Johnston A, Kelly SE, Hsieh SC, Skidmore B, Wells GA. Systematic reviews of clinical practice guidelines: a methodological guide. J Clin Epidemiol. 2019;108:64-76


21 Grammatikopoulou MG, Theodoridis X, Gkiouras K, Lampropoulou M, Petalidou A, Patelida M. Methodological quality of clinical practice guidelines for nutrition and weight gain during pregnancy: a systematic review. Nutr Rev. 2020;78(07):546-562


22 Louzada MLDC, Tramontt CR, de Jesus JGL, Rauber F, Hochberg JRB, Santos TSS. Developing a protocol based on the Brazilian Dietary Guidelines for individual dietary advice in the primary healthcare: theoretical and methodological bases. Fam Med Community Health. 2022;10(01):-


23 . . Pesquisa de orçamentos familiares 2017-2018: análise do consumo alimentar pessoal no Brasil. 2020;:-


24 Rubio DM, Berg-Weger M, Tebb SS, Lee ES, Rauch S. Objectifying content validity: conducting a content validity study. Soc Work Res. 2003;27(02):94-104


25 Bardin L. . Análise de conteúdo. 2008;:-


26 . . Caderneta da gestante [Internet]. 2016;:-


27 Oliveira SC, Lopes MV, Fernandes AF. Development and validation of an educational booklet for healthy eating during pregnancy. Rev Latino-Am Enfermagem. 2014;22(04):611-620


28 Oliveira FB, Santos KE, Barros NV, Teixeira SA, Cavalcante RM. Elaboração e avaliação de material educativo sobre alimentação saudável para gestantes. Rev Eletrônica Extensão. 2020;17(37):18-33


29 Kramer MS. WITHDRAWN: Nutritional advice in pregnancy. Cochrane Database Syst Rev. 2007;(04):-


30 Martins AP, Benicio MH. Influência do consumo alimentar na gestação sobre a retenção de peso pós-parto. Rev Saude Publica. 2011;45(05):870-877


31 Crivellenti LC, Zuccolotto DC, Sartorelli DS. Association between the Diet Quality Index Adapted for Pregnant Women (IQDAG) and excess maternal body weight. Rev Bras Saúde Mater Infant. 2019;19(02):285-294


32 Lepre B, Trigueiro H, Johnsen JT, Khalid AA, Ball L, Ray S. Global architecture for the nutrition training of health professionals: a scoping review and blueprint for next steps. BMJ Nutr Prev Health. 2022;:-


33 Vieira TW, Sakamoto VTM, Moraes LC, Blatt CR, Caregnato RCA. Validation methods of nursing protocols: an integrative review. Rev Bras Enferm. 2020;73:-


34 . . Fascículo 3 protocolos de uso do guia alimentar para a população brasileira na orientação alimentar de gestantes. 2021;:-


Para otimizar sua experiência durante a navegação, fazemos uso de cookies. Ao continuar no site consideramos que você está de acordo com a nossa Política de Privacidade.

Aceitar e continuar no site