Formação de nutricionistas do Programa de Alimentação Escolar do município de São Paulo sobre risco sanitário durante a pandemia de COVID-19
Arquivos
Data
2023-10-31
Autores
Dantas, Mirelly dos Santos Amorim 
Orientadores
Stedefeldt, Elke
Tipo
Tese de doutorado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Introdução: O Programa de Alimentação Escolar (PAE) no município de São Paulo atende aproximadamente 1.032.261 alunos em 4.116 unidades escolares, servindo cerca de 2.500.000 refeições diárias. Com a pandemia de COVID-19 em 2020 e o fechamento das escolas, foram implementadas medidas para conter a disseminação do vírus. Considerando a abrangência do PAE no município de São Paulo e a vulnerabilidade do público-alvo envolvido, foi primordial a discussão sobre a percepção de risco, do risco sanitário de Doenças de Transmissão Hídrica e Alimentar (DTHA) e o desvelar do território na perspectiva miltoniana pelos nutricionistas, visto que as Unidades de Alimentação e Nutrição Escolares (UANE) são reconhecidas como locais propícios para a ocorrência de surtos de DTHA e transmissão de COVID-19. Objetivos: O objetivo principal desta tese foi analisar uma formação online sobre percepção de risco, risco sanitário de DTHA e território com nutricionistas atuantes na alimentação escolar durante a pandemia de COVID-19. Especificamente no estudo 1, o objetivo foi identificar, descrever e analisar as principais recomendações para a reabertura das escolas brasileiras na pandemia de COVID-19; e no estudo 2 foi identificar os desafios e as potencialidades do estudo da percepção de risco e do risco sanitário de DTHA pelos nutricionistas na alimentação escolar. Métodos: O primeiro artigo consistiu em uma revisão integrativa, analisando documentos com recomendações para o retorno seguro às escolas no período de março a setembro de 2020. As recomendações mais frequentes e suas diferenças foram investigadas. O segundo artigo foi um estudo exploratório, transversal e qualitativo, baseado em entrevistas com nutricionistas que participaram de um curso de atualização online sobre segurança dos alimentos, DTHA, risco sanitário e outros temas relevantes. As entrevistas realizadas online seguiram um roteiro semiestruturado e foram analisadas usando a técnica de análise de conteúdo de Bardin. Resultados: O primeiro artigo revelou que as principais recomendações de higiene encontradas são oriundas de protocolos pré-existentes, sendo eles: Boas Práticas de Manipulação de Alimentos, capacitação, e surgiram medidas específicas como a vacinação, testagem, etiqueta respiratória e distanciamento social. No segundo artigo, a formação online obteve 95% de adesão. Os 57 nutricionistas participantes eram do sexo feminino, 52% com idade entre 29 e 38 anos, 65% com especialização completa e 47% estavam acima de 5 até 10 anos no cargo. Foram obtidas as seguintes categorias: contribuições dialógicas dos conceitos de segurança dos alimentos na prática do nutricionista; risco sanitário como norteador das práticas seguras e da atuação do nutricionista; território da comunidade escolar: identidade, valores e práticas políticas-sociais - construção e desenvolvimento pelo olhar do nutricionista, percepções do estudo da SA em tempos de pandemia da COVID-19. Conclusão: O primeiro estudo apontou um desalinhamento entre principais autarquias de educação e saúde do país na formulação de protocolos durante a pandemia. No artigo 2 a formação dos nutricionistas do PAE revelou os seguintes desafios: lacuna na formação do nutricionista; perspectiva higienista e da educação bancária; e falta de integrar a teoria à prática. E como potencialidades: ampliação do olhar e autorreflexão, discussão sobre a humanização e o reconhecimento da importância do território na tomada de decisão dos nutricionistas.
Introduction: The School Feeding Program (SFP) in the municipality of São Paulo serves approximately 1,032,261 students in 4,116 school units, providing around 2,500,000 meals daily. With the COVID-19 pandemic in 2020 and the closure of schools, measures were implemented to contain the spread of the virus. Considering the scope of SFP in São Paulo and the vulnerability of the targeted population, it was essential to discuss risk perception, the sanitary risk of Foodborne Diseases (FBD), and the unveiling of territory from a Miltonian perspective by the nutritionists, as the School Feeding and Nutrition Units (SFNU) are recognized as sites prone to outbreaks of FBD and transmission of COVID-19. Objectives: The main objective of this thesis was to analyze an online training on risk perception, sanitary risk of FBD, and territory with nutritionists working in school feeding during the COVID-19 pandemic. Specifically, in Study 1, the goal was to identify, describe, and analyze the main recommendations for reopening Brazilian schools during the COVID-19 pandemic; and in Study 2, to identify the challenges and potentialities of studying risk perception and sanitary risk of FBD by nutritionists in school feeding. Methods: The first article consisted of an integrative review analyzing documents with recommendations for a safe return to schools from March to September 2020. The most frequent recommendations and their differences were investigated. The second article was an exploratory, cross-sectional, and qualitative study based on interviews with nutritionists who participated in an online refresher course on food safety, FBD, sanitary risk, and other relevant topics. The online interviews followed a semi-structured script and were analyzed using Bardin's content analysis technique. Results: The first article revealed that the main hygiene recommendations found came from pre-existing protocols, including: Good Food Handling Practices, training, and specific measures such as vaccination, testing, respiratory etiquette, and social distancing. In the second article, the online training achieved 95% adherence. The 57 nutritionists who participated were female, 52% aged between 29 and 38 years, 65% with completed specialization, and 47% had been in their position for 5 to 10 years. The following categories emerged: dialogical contributions of the food safety concepts to the nutritionist’s practice; sanitary risk as a guide for safe practices and nutritionist’s work; the school community’s territory: identity, values, and socio-political practices - construction and development from the nutritionist’s perspective, and perceptions of FS studies during the COVID-19 pandemic. Conclusion: The first study pointed out a misalignment between the country’s main educational and health authorities in the formulation of protocols during the pandemic. In the second article, the training of SFP nutritionists revealed the following challenges: a gap in the nutritionist's prior education; a hygienist perspective and banking education approach; and a lack of integration between theory and practice. As potentialities, it highlighted: broadening of perspective and self-reflection, discussions on humanization, and the recognition of the importance of territory in the nutritionist’s decision-making.
Introduction: The School Feeding Program (SFP) in the municipality of São Paulo serves approximately 1,032,261 students in 4,116 school units, providing around 2,500,000 meals daily. With the COVID-19 pandemic in 2020 and the closure of schools, measures were implemented to contain the spread of the virus. Considering the scope of SFP in São Paulo and the vulnerability of the targeted population, it was essential to discuss risk perception, the sanitary risk of Foodborne Diseases (FBD), and the unveiling of territory from a Miltonian perspective by the nutritionists, as the School Feeding and Nutrition Units (SFNU) are recognized as sites prone to outbreaks of FBD and transmission of COVID-19. Objectives: The main objective of this thesis was to analyze an online training on risk perception, sanitary risk of FBD, and territory with nutritionists working in school feeding during the COVID-19 pandemic. Specifically, in Study 1, the goal was to identify, describe, and analyze the main recommendations for reopening Brazilian schools during the COVID-19 pandemic; and in Study 2, to identify the challenges and potentialities of studying risk perception and sanitary risk of FBD by nutritionists in school feeding. Methods: The first article consisted of an integrative review analyzing documents with recommendations for a safe return to schools from March to September 2020. The most frequent recommendations and their differences were investigated. The second article was an exploratory, cross-sectional, and qualitative study based on interviews with nutritionists who participated in an online refresher course on food safety, FBD, sanitary risk, and other relevant topics. The online interviews followed a semi-structured script and were analyzed using Bardin's content analysis technique. Results: The first article revealed that the main hygiene recommendations found came from pre-existing protocols, including: Good Food Handling Practices, training, and specific measures such as vaccination, testing, respiratory etiquette, and social distancing. In the second article, the online training achieved 95% adherence. The 57 nutritionists who participated were female, 52% aged between 29 and 38 years, 65% with completed specialization, and 47% had been in their position for 5 to 10 years. The following categories emerged: dialogical contributions of the food safety concepts to the nutritionist’s practice; sanitary risk as a guide for safe practices and nutritionist’s work; the school community’s territory: identity, values, and socio-political practices - construction and development from the nutritionist’s perspective, and perceptions of FS studies during the COVID-19 pandemic. Conclusion: The first study pointed out a misalignment between the country’s main educational and health authorities in the formulation of protocols during the pandemic. In the second article, the training of SFP nutritionists revealed the following challenges: a gap in the nutritionist's prior education; a hygienist perspective and banking education approach; and a lack of integration between theory and practice. As potentialities, it highlighted: broadening of perspective and self-reflection, discussions on humanization, and the recognition of the importance of territory in the nutritionist’s decision-making.
Descrição
Citação
AMORIM, Mirelly dos Santos. Formação de nutricionistas do Programa de Alimentação Escolar do município de São Paulo sobre risco sanitário durante a pandemia de COVID-19. 2023. 191 f. Tese (Doutorado em Nutrição) - Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, 2023