Development and validation of a contextualized healthy eating plate to improve dietary outcomes among selected adolescents in Ibadan, Oyo State

Abstract

In Nigeria, adolescents face a high burden of malnutrition, driven by a shift from traditional diets to Western style foods and limited access to practical nutrition guidance. While visual tools such as the USDA MyPlate have proven effective in other settings, no culturally tailored equivalent exists for Nigerian adolescents. This study aimed to develop and validate a contextualised healthy eating plate as a relevant nutrition education tool. A mixed-methods cross sectional study was conducted in Ibadan, Nigeria, in three phases. First, a prototype plate was co-created with 48 adolescents using the Nominal Group Technique. Second, the prototype was validated by a panel of 25 experts in nutrition, public health and education using a 19-item questionnaire. Finally, the revised tool was pilot tested with 45 adolescents to assess usability and acceptability. Content validity was assessed using Item Level and Scale Level Content Validity Indices. Female participants constituted 60.4%, 84.0%, and 62.2% across the three phases. The co-creation phase identified culturally appropriate foods such as yam, garri, waterleaf and local fish, alongside intuitive colour coding. Adolescents also generated practical dietary messages. Expert validation demonstrated excellent content validity (I-CVI = 0.96; S-CVI Ave = 0.97), while pilot testing confirmed high acceptability and relevance (I-CVI = 0.97; S-CVI Ave = 0.98). The study successfully developed the “Nigerian Healthy Eating Plate for Adolescents,” a culturally relevant tool with strong content validity, showing promise for improving nutrition education and dietary behaviours among Nigerian adolescents. Further research should evaluate its effectiveness in real world settings.