Document Type
Article
Publication Date
2025
DOI
10.1016/j.cjco.2025.08.015
Publication Title
CJC Open
Volume
7
Issue
12
Pages
1662-1671
Abstract
Background
Cardiovascular disease (CVD) remains a leading cause of death in Canada. Although the Portfolio Diet, a dietary pattern of cholesterol-lowering foods, is supported by CVD clinical practice guidelines, its uptake in clinical practice remains limited. This study assessed the content and face validity of a healthcare provider (HCP)-facing toolkit (infographic and video), designed to support implementation of the Portfolio Diet.
Methods
HCPs were recruited for a 2-round evaluation. They assessed the toolkit using a questionnaire. Content validity of the infographic was assessed using a 4-point Likert scale (1 = irrelevant to 4 = extremely relevant) and face validity of the infographic and video was assessed using a 5-point Likert scale (1 = strongly disagree to 5 = strongly agree). Content-validity indices (CVIs) and face-validity indices (FVIs) were calculated, with ≥ 0.70/1.0 indicating validity. Qualitative feedback informed revisions made between rounds.
Results
In round 1 (N = 21), all but one section of the infographic met the CVI threshold, and all FVI values exceeded 0.70. Feedback highlighted the need for explicit food examples, an improved layout, and reduced use of jargon. In round 2 (N = 28), CVI (0.86-1.0) and FVI (0.79-1.0, infographic; 0.89-1.0, video) improved. HCPs reported that the toolkit increased their knowledge, their confidence in recommending the Portfolio Diet and PortfolioDiet.app to patients, and their confidence in recommending the toolkit to other clinicians (FVI(infographic) = 0.89 to 1.0; FVI(video) = 0.89).
Conclusions
The toolkit demonstrated strong content and face validity. Repeated assessments and refinement guided by end-user feedback enhanced the toolkit, supporting HCPs in implementing the Portfolio Diet for CVD prevention and management in practice.
Clinical Trial Registration
NCT05915455.
Rights
© 2025 The Authors.
This is an open access article under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) License.
Data Availability
Article states: "All data generated or analyzed during this study are available in the article, supplemental material, or from the corresponding author upon reasonable request."
Original Publication Citation
Viscardi, G., Eskandari, S., Chen, A., Chiang, N., Kavanagh, M. E., Back, S., Vallis, M., Scourboutakos, M. J., Malik, V. S., Kendall, C. W. C., Jenkins, D. J. A., Sievenpiper, J. L., & Chiavaroli, L. (2025). Translating cardiovascular clinical practice guidelines on nutrition therapy: Validation of the Portfolio Diet toolkit for healthcare providers. CJC Open, 7(12), 1662-1671. https://doi.org/10.1016/j.cjco.2025.08.015
Repository Citation
Viscardi, G., Eskandari, S., Chen, A., Chiang, N., Kavanagh, M. E., Back, S., Vallis, M., Scourboutakos, M. J., Malik, V. S., Kendall, C. W. C., Jenkins, D. J. A., Sievenpiper, J. L., & Chiavaroli, L. (2025). Translating cardiovascular clinical practice guidelines on nutrition therapy: Validation of the Portfolio Diet toolkit for healthcare providers. CJC Open, 7(12), 1662-1671. https://doi.org/10.1016/j.cjco.2025.08.015
Supplementary Tables 1-5.
1-s2.0-S2589790X25005621-mmc2.docx (17 kB)
Appendix S1
Included in
Cardiovascular Diseases Commons, Dietetics and Clinical Nutrition Commons, Nutritional Epidemiology Commons