Do Primary Health Professionals in Brazil Have a Misperception about Food? The Role of Food Literacy as a Positive Predictor.

Risk perception is socially constructed; psychological elements control people's reactions to a hazard, and even health professionals may have difficulty determining what healthy food is. This work aimed to measure food literacy and food risk perceptions among primary healthcare professionals in a Brazilian city. In the first phase, 280 health professionals working in primary care in Rio Claro, Brazil, were studied. The Short Food Literacy Questionnaire (SFLQ-Br) and scales of risk and benefit perception of 50 foods were used. In the second phase, 20 professionals were interviewed to investigate the responses to different foods observed in the first phase. In this second phase, 16 users of the health system were also enrolled to understand their perceptions and how the nutrition messages conveyed by the health team reached them. Professionals scored an average of 34.5 on food literacy (for which there is a maximum score of 52). They showed difficulty with dietary guidelines and their interpretation. Food's risk and benefit perception were generally consistent with the recommendations of the Food Guide for the Brazilian Population. However, some processed foods or those with no proven health benefits were considered healthy by the study participants, indicating a biased perception (e.g., gelatin, processed turkey breast, cream crackers, and cereal bars). Less misperception was observed when food literacy was higher, which positively predicted risk perception. The reasons for identifying benefits of these foods ranged from the false impression that they are natural and nutritious foods to the comparative claim that they are better for health than similar foods. The results indicate the need to educate health professionals based on current references to avoid bias in population counseling.

Translation, Adaptation, and Validity of the Short Food Literacy Questionnaire for Brazil.

Food literacy refers to the knowledge and skills related to healthy food choices. The aim of this study is to present the process of the cross-cultural adaptation and content validation of the Short Food Literacy Questionnaire (SFLQ) for the Brazilian population. The process of adaptation and validation of the SFLQ was conducted in four steps: (1) conceptual and item equivalence; (2) translation with semantic equivalence; (3) operational equivalence; (4) measurement equivalence. The study involved ten judges (food and nutrition experts) and 20 subjects (general population) in evaluating the semantic equivalence of the SFLQ. The semantic equivalence was assessed by calculating the content validity coefficient (CVC). All the items had a CVC greater than 0.80 considering all the evaluated parameters. The SFLQ has been adapted for the Brazilian context and guidelines. The adapted version of the questionnaire was referred to as the SFLQ-Br. The operational equivalence was conducted with 120 subjects using an online approach. The measurement equivalence was assessed using confirmatory factor analysis, a reliability assessment, and an instrument stability assessment. A single factor was extracted, and all the items had a factor loading of >0.40 and appropriate goodness-of-fit values. All the equivalence results show that the SFLQ-Br can be used in the Brazilian population as a reliable, consistent, and stable instrument to measure food literacy.