Providing Nutritional Care in the Office Practice: Teams, Tools, and Techniques

Measuring professional self and collective efficacy for dietary advice in Primary Health Care

BACKGROUND

There is a lack of instruments to measure the ability of health professionals to promote dietary advice according to dietary guidelines.

AIM

To develop and validate a web-based and self-applied scale for measuring primary health care (PHC) professionals' self-efficacy and collective efficacy to apply the Brazilian Dietary Guidelines for dietary advice.

METHODS

Methodological procedures comprised six steps: development of the items; content validation with panel of experts; face validation through focus group conducted with PHC professionals; online reevaluation by the participants of content and face validation panels; online application with PHC professionals working all over Brazil's macro-regions; confirmatory factorial analysis to test construct validity.

RESULTS

The scale was initially developed with 22 items. After content and face validation panels, changes in content and semantics were performed. The second version consisted of 24 items equally divided into part A (self-efficacy) and B (collective efficacy). All items, when reevaluated, were considered clear and representative of the Brazilian Dietary Guidelines' chapters. The multidimensional model was shown to have excellent fit indices in the confirmatory factorial analysis. The scale's peak of information was centered around the mean, indicating that both domains are more precise for perception of self-efficacy and collective efficacy on average values.

CONCLUSION

The scale demonstrated validity for measuring PHC professionals' perceived self-efficacy and collective efficacy to apply the Brazilian Dietary Guidelines. To our knowledge, this is the first valid scale for measuring the capability of PHC professionals to apply national dietary guidelines for healthy diet promotion.

Development and Assessment of a Mobile Nutritional Counseling Tool for Primary Care Physicians

Background: Hypertension remains widely undetected, undertreated, and poorly controlled. Appropriate dietary changes can prevent and treat hypertension effectively. Primary care physicians (PCPs) have the opportunity to counsel patients about their diets and are able to facilitate long-term adherence to changes. However, they encounter several barriers to delivery of evidence-based counseling in daily medical practice. m-Health can make important contributions. Objective: To describe the development and assessment of a Brazilian mobile app for nutritional management of hypertension supported by evidence-based. Materials and Methods: App development used a user-centered approach that seeks to solve problems in a collective and collaborative way. The app was developed in Apache Cordova^® (Adobe Systems, San Jose, CA) for iOS and Android mobile phone platforms. Beta testing was performed with a sample of Brazilian PCPs (n = 62), who were asked to use the app in routine practice and evaluate it. Results: The process involved researchers, government, PCPs, nutritionists, and designers. Dieta Dash^® (Universidade Federal do Rio Grande do Sul-UFRGS, Porto Alegre, Brazil) app was divided into following sections: meal evaluation, Healthy meals, Healthy choices, and a database of Healthy recipes. The mean perceived usefulness and ease-of-use scores were 23.3 and 32.3 out of 42, respectively. Conclusions: It is a great source of up-to-date and summary guidelines, usable, acceptable, and positively impact clinical care. PCPs have identified improvements that could make the user experience better. The Dieta Dash app can be incorporated into Brazilian primary care practice.