Expert-Based Content Validation of a Culturally Adapted Therapeutic Education Workbook for Gestational Diabetes in Moroccan and Arabic-speaking Contexts

Abstract

This study evaluated the face validity, content validity, and applicability of a newly developed Therapeutic Patient Education (TPE) workbook for gestational diabetes (GD) in Morocco. GD is an increasing public health concern requiring a multidimensional approach integrating biomedical, educational, and psychosocial aspects, with TPE as a key component. A cross-sectional mixed-methods study combining quantitative and qualitative approaches was conducted with 35 experts from various disciplines (gynecologists, endocrinologists, nutritionists, psychologists, public health specialists, and nurse managers) in the Rabat-Salé-Kénitra region. The evaluation questionnaire comprised five dimensions: scientific relevance, pedagogical methodology, diagnostic educational tools, clinical feasibility, and psychosocial-economic adaptability, using a five-point Likert scale and open-ended questions. Quantitative analysis (Cronbach’s alpha = 0.82; overall mean score = 4.09 out of 5; Kruskal–Wallis tests) and qualitative thematic analysis (29 identified themes for improvement) were conducted. The workbook was validated across all five dimensions, indicating satisfactory acceptance. Scientific relevance received the highest ratings (mean = 4.56 out of 5), particularly for content on nutrition, physical activity, and glucose self-monitoring. Experts recommended improvements in content clarity, personalization of materials, cultural appropriateness, and adaptability to clinical constraints. Suggestions included adding summary sheets, decision-making algorithms, digital resources, and context-specific adaptations. Following these revisions, further validation with healthcare professionals and patient evaluations will be conducted to confirm the workbook’s alignment with practical educational needs and enhance its implementation in Arabic-speaking contexts.