A guide designed to help Haitian immigrants learn about prevention and self-care for chronic non-communicable diseases received strong ratings for both its content and its Creole wording in a validation study conducted in Manaus. Healthcare professionals gave the Portuguese content an overall Concordance Index of 91%, while Haitian participants gave the Creole version an average score of 25.8 out of 26, reported as 99.2%. The results show that the guide was judged suitable by the groups who reviewed it. They do not establish how it performs in daily use, which the study did not test.
A language and content check
This was a validation study of two related questions: whether the Portuguese version contained appropriate health information, and whether the Creole version used language suitable for its intended audience. One Haitian researcher translated the Portuguese guide, and five native speakers reviewed the language. Content validation was carried out virtually. Semantic validation took place in person at the Fanm Nwa Association in Manaus.
The expert review involved 17 health professionals: 16 nurses and one physician. Four held a post-graduate degree, six held master's degrees and seven held doctorates. Their reported professional experience ranged from four to 39 years. The semantic review involved 30 Haitian immigrants, including 18 women and 12 men, aged 25 to 71. Thirteen participants were between 51 and 71.
Experts were recruited through the Lattes Platform and were included after meeting at least two selection criteria. Those criteria included at least three years of primary-care experience, scientific production, participation in events during the previous five years, or relevant specialist, master's or doctorate training. The immigrant participants were registered with Fanm Nwa, were at least 18 years old and could read Creole. The study's authors say this group may not represent Haitians with limited health literacy or reading difficulties.
What the scores mean
Experts rated the content on a four-point scale. Researchers counted responses marked totally adequate or adequate in a Concordance Index, a measure of how closely the ratings agreed, and calculated the overall result as the arithmetic mean across the content domains. The minimum content threshold was 70%. The Haitian group completed an adapted Suitability Assessment of Materials, or SAM, covering five domains and 13 items. Each item received a score of 0, 1 or 2, and a total of at least 10 points out of 26 was considered acceptable.
On content, the guide scored 93% for its objectives, 87% for structure and presentation, and 94% for relevance. Structure and presentation was the lowest-rated area and included 15 partially adequate responses, but all domains were judged satisfactory. The overall content score was 91%.
The semantic review produced near-maximum scores. Twenty-five of the 30 Haitian participants awarded the maximum 26 points, while the remaining five awarded 25. Their combined score was 775, producing an average individual score of 25.8 points, or 99.2%, and the study reported the result as semantically adequate.
From review to final guide
The guide was revised and translated through a staged process. Portuguese content validation took place from January to February 2023, revision and Creole translation followed in March, and semantic validation ran from April to May. The final versions were published in July 2023. The completed guide was 73 pages long, used 14-point type, and its Portuguese and Creole PDFs were reported as available through eduCAPES.
What remains unknown
The findings support the guide's acceptability among the people who reviewed it, but the study did not test its effectiveness in daily use. It did not include a post-validation application or effectiveness phase. The authors also note that the guide addresses only four non-communicable diseases and that the immigrant sample may not represent Haitians with limited health literacy or reading difficulties. They identify evaluation of the guide in daily use as a next step.
Paper data and sources
Original title: Educational technology on chronic non-communicable diseases for Haitian immigrants in the Creole language: a validation study*
Authors: Lexius O, Ribeiro M, Diniz C et al.
Journal/Repository: Revista latino-americana de enfermagem
Status: Peer-reviewed
First online: 2026-10-19
DOI: Not available
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