Hi, I’m Vanessa and I’m excited and honoured to write this blog and introduce myself as a Visiting PhD student of the SPRINT project team. I’m a dietitian and I work and research Public Health Nutrition. I’ll work with the SPRINT project team for the next six months in an important stage of my PhD.
I graduated in Nutrition in 2016 at the School of Public Health of the University of São Paulo, Brazil. In this same year, I was approved for a Residency program at the Oswaldo Cruz Foundation (Fiocruz) to become a specialist in Primary Health Care and to work at the Brazil’s universal health system, called Unified Health System (SUS, in Portuguese). Additionally, I did another Residency in Primary Health Care Management also at Fiocruz. After that I work for two years as a dietitian at Primary Health Care in two big cities from Brazil: Rio de Janeiro e São Paulo.
Image description: photo of my group of residents during a visit to the primary health care unit in Rocinha, Rio de Janeiro. In the background, a beautiful view of the city.
Image description: photo of me working as a dietitian at the primary healthcare unit in Rocinha, Rio de Janeiro, with the people who participated in the physical activity group.
During all these years of providing care in Primary Health Care, the Dietary Guidelines for the Brazilian Population has been the central tool of my work. Using this material for nutritional care in the clinic always made a lot of sense to me and to the patients, and I could see many benefits for the people I served. However, I noticed that other primary health care professionals were not familiar with this document and had difficulties in providing dietary advice when they need to.
Image description (left): photo of patients and healthcare professionals at a meeting of the rehabilitation therapy group of the primary healthcare unit in Rocinha, Rio de Janeiro, where we discussed the Brazilian Dietary Guidelines, and each person brought a healthy dish to share.
Image description (right): photo of an activity conducted with patients from the healthy eating promotion group at the primary healthcare unit in Bela Vista, São Paulo.
It was at this point that I began working on a research project for my PhD, together with my supervisor in Brazil, Prof. Patrícia Constante Jaime. She was coordinating a group of researchers who were developing and validating a series of Protocols based on the Brazilian Dietary Guidelines for Individual Dietary Advice. The protocols aim to support health professionals in providing dietary advice during individual consultations for adults, the elderly, pregnant people, children aged 2 to 10, and adolescents. The protocols have three steps for use: performing a dietary assessment of the individual, then following a stepwise flowchart for decision-making that proposes a priority order for dietary advice, adhering to the golden rule of the Dietary Guidelines. From there, the professional has a series of possible recommendations to provide, according to the assessment of everyone they attend to.
In my PhD, we proposed an intervention project to test a strategy for implementing the Brazilian Dietary Guidelines. This project is part of one of the research lines of our research group in Brazil, the Centre for Epidemiological Research in Nutrition and Health. We presented this project within a Ministry of Health programme and secured funding for its implementation. This project was named QualiGuia. We developed and validated a qualification course on the Protocols, in the model of a Massive Open Online Course. Then, we partnered with 64 small municipalities in Brazil that receive federal funding to qualify the care in food and nutrition to implement the course in the annual training programme for professionals – the training and qualification of health professionals is a policy of the Brazilian health system.
Image description: Series of photos representing the experience of the team that worked with me on the QualiGuia project. Photos from left to right and top to bottom: Photo 1: Meeting with the health department team of the city of Brasil Novo, Pará, Brazil. Photo 2: Boat trip along the Amazon River to reach the city of Faro, Pará, Brazil. Photo 3: Meeting with healthcare professionals from the city of Água Azul do Norte, Pará, Brazil. Photo 4: Meeting with healthcare professionals from the city of Barrolândia, Tocantins, Brazil. Photo 5: Visit to the primary health care unit in the city of Carmo de Minas, Minas Gerais, Brazil. Photo 6: Meeting with the health department team of the city of Mendes, Rio de Janeiro, Brazil. Photo 7: Tools developed by the dietitian from the city of Barrolândia, Tocantins, Brazil, to discuss the Dietary Guidelines in her consultations. Photo 8: Visit to the primary health care unit in the city of Nobres, Mato Grosso, Brazil. Photo 9: Visit to the primary health care unit in the city of Santana dos Garrotes, Paraíba, Brazil.
Making a good evaluation of this process is essential, and that is why I came to the University of Birmingham and the SPRINT Project. We will use a training process evaluation model, the New World Kirkpatrick Model, that considers not only the knowledge acquired but also other crucial factors for implementation, such as the confidence to apply the knowledge and the assessment of benefits for the health system. With all the data collected, I will be working with the SPRINT project’s Dr Mary Quinton to dive into these analyses.
I have talked a lot about work, but this is also the first time I have crossed the ocean and left Latin America, so I will have much to learn and share with the group!
To read more about how we’ve used the Kirkpatrick model of evaluation, you can read Mary’s publication using the model to underpin our process evaluation of MST4Life™ here. You can also find an associated blog here.
Don’t forget to also check out our commissioning and evaluation toolkit, where we provide top tips on how you can use the Kirkpatrick model to underpin a strengths-based evaluation.
References
Quinton, M. L., Tidmarsh, G., Parry, B. J., & Cumming, J. (2022). A Kirkpatrick model process evaluation of reactions and learning from my strengths training for life™. International Journal of Environmental Research and Public Health, 19(18), 11320.
Louzada, M. L. C., Tramontt, C. R., Jesus, J. G. L., Rauber, F., Hochberg, J. R. B., Santos, T. S. S., Jaime, P. C. Developing a protocol based on the Brazilian Dietary Guidelines for individual dietary advice in the primary healthcare: theoretical and methodological bases. Family Medicine and Community Health. 2022;10:e001276. doi: 10.1136/fmch-2021-001276.
Image credit: Vanessa del Castillo Silva Couto
Written by Vanessa del Castillo Silva Couto, Visiting PhD Researcher in the SPRINT Project.
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