Desarrollo y validez de contenido de una batería para evaluar factores asociados a la adherencia alimentaria en cuidadores de pacientes pediátricos postrasplante de células hematopoyéticas progenitoras

Introduction: Adherence to recommendations following hematopoietic progenitor cell transplantation (HPCT) is essential for preventing infections. In pediatric patients, food-handling practices are primarily the responsibility of parents, and perceived barriers and low self-efficacy may be associated with poorer adherence. Objective: To develop and evaluate the content validity of a battery designed to assess knowledge, self-efficacy, and barriers as factors associated with dietary adherence among parents of pediatric patients undergoing HPCT. Method: An instrumental study conducted in three phases: 1) initial development of the assessment battery, comprising three scales; 2) evaluation of content validity by a panel of expert judges using Aiken’s V, I-CVI, S-CVI/Ave, S-CVI/UA, and modified kappa (k*); and 3) selection, review, and modification of the items. Results: The initial version comprised 56 items, of which 42 simultaneously met the established criteria for content validity and inter-rater agreement (V ≥ 0.70; I-CVI according to the number of judges; k* ≥ 0.60). The remaining items were reviewed, rewritten, or eliminated based on the joint consideration of quantitative indicators and the experts’ qualitative comments. Overall, the three scales showed favorable content validity indices (S-CVI/Ave ≥ 0.90), except for the knowledge questionnaire regarding the clarity criterion (S-CVI/Ave = 0.84). Universal agreement (S-CVI/UA) yielded more conservative values, with clarity being the main aspect requiring semantic adjustment. After incorporating the modifications derived from the quantitative and qualitative evaluation, a final 53-item battery was obtained. Conclusions: The battery provides favorable initial evidence of content validity for assessing knowledge, self-efficacy, and barriers associated with dietary adherence among parents of pediatric patients undergoing HPCT. Further psychometric evaluation through pilot testing and subsequent studies in the target population is recommended.