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The use of nutritional knowledge assessments to guide nutrition counseling in primary care

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Title
The use of nutritional knowledge assessments to guide nutrition counseling in primary care
Name (type = personal)
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Pichardo
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Diana
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1984-
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Diana Pichardo
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author
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Gunkel
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Kathy
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Kathy Gunkel
Affiliation
Advisory Committee
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chair
Name (type = corporate)
NamePart
Rutgers University
Role
RoleTerm (authority = RULIB)
degree grantor
Name (type = corporate)
NamePart
School of Nursing - RBHS
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school
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Text
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theses
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2020
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2020-05
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English
Abstract (type = abstract)
Purpose of Project: Nutritional intake and health maintenance are deeply interlinked. Poor diet has been associated with a number of acute and chronic health conditions, including cardiovascular disease, diabetes mellitus, dental disease, deficiencies and more (“Diet, nutrition and the prevention of chronic diseases,” 2016). Yet, the topic of nutrition in primary care is minimally discussed between patients and providers in the clinical sitting (“Data 2020,” n.d.; Kolasa & Rickett, 2010). Instead, discussion on nutrition is generally restricted to condition-specific topics with little investigation into patient nutritional knowledge or practices (Kahan & Manson, 2017; Kolasa & Rickett, 2010). According to data form the ODPHP, only 13.8 percent of adult and child office visits featured nutrition or diet counseling in 2010; and of those adults with known cardiovascular disease, diabetes, or hyperlipidemia, only 19.1 percent received nutrition or diet counseling (“Data 2020,” n.d.). As of 2015-2016, Centers for Disease Control statistics reveal that the prevalence of obesity remains at 39.8 percent in the United States; and, in 2016, $1.1 trillion was spent on direct health care treatment for chronic conditions, including those with nutrition-related disease (Waters and Graf, 2018). In New Jersey, approximately 27.3 percent are obese as of 2017 and $2.2 billion was spent on obesity health care costs in 2009 (New Jersey obesity, 2018). This project focused on enhancing nutritional counseling practices in one primary care practice site in central New Jersey. It was designed to provide an overview of the nutritional knowledge of a primary care population as a means of offering key information and areas of focus to guide providers in future nutrition counseling in the prevention of nutrition-related chronic disease.

Methodology: A cross-sectional observational study design was employed. The project featured the use of nutritional knowledge questionnaires (Kliemann, Wardle, Johnson & Croker, 2016) for adult patients at the primary care site in order to identify nutritional knowledge gaps and guide providers in addressing specific teaching needs during future patient encounters. The providers of the practice site were also asked to predict the average score on the General Nutritional Knowledge questionnaire in order to reveal their understanding and perceptions of the patient population’s nutritional knowledge. The project also utilized a Likert scale survey (Kushner, 1995; Wynn, Trudeau, Taunton, Gowans & Scott, 2010) for the practice site providers in order to identify current barriers and attitudes regarding nutrition counseling. Dietary teaching tools based on the knowledge gaps identified were then provided to the providers to help facilitate and enhance future nutrition counseling.

Results: There was a total of 92 participants, with 85 valid questionnaires and seven incomplete. The average score was 62.58 percent correct on the nutritional knowledge questionnaire. Nutritional knowledge gaps were identified based on questions that received scores of 33 percent correct or less. Among the gaps identified were issues with identifying: daily recommended servings of fruits or vegetables, levels of sodium in processed foods, types of fats in certain foods, and more. Relevant dietary teaching tools were then given to providers to enhance future nutrition teaching. The average patient scores were compared to provider estimations as well to identify discrepancies in the perception of nutritional knowledge in the patient population. Results of the Provider Likert scale were shared with providers to enable discussion regarding solutions to enhancing nutrition teaching in the office environment.

Implications for Practice: The information gathered helped to inform and shape clinical practice at one primary care site as it relates to nutrition counseling in the prevention of chronic disease. The activities performed and the knowledge gathered may serve as a case study for future health teaching and counseling as well.
Subject (authority = local)
Topic
Nutrition
Subject (authority = RUETD)
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Adult-Gerontology Primary Care Nurse Practitioner
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Rutgers University Electronic Theses and Dissertations
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ETD_10936
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application/pdf
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text/xml
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1 online resource (53 pages) : illustrations
Note (type = degree)
DNP
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Includes bibliographical references
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School of Nursing (RBHS) DNP Projects
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rucore10004500001
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Identifier (type = doi)
doi:10.7282/t3-y4ft-wr58
Genre (authority = ExL-Esploro)
ETD doctoral
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The author owns the copyright to this work.
RightsHolder (type = personal)
Name
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Pichardo
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Diana Pichardo
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Copyright Holder
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Permission or license
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2020-05-05 10:53:05
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Diana Pichardo Pichardo
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Rutgers University. School of Nursing - RBHS
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Author Agreement License
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I hereby grant to the Rutgers University Libraries and to my school the non-exclusive right to archive, reproduce and distribute my thesis or dissertation, in whole or in part, and/or my abstract, in whole or in part, in and from an electronic format, subject to the release date subsequently stipulated in this submittal form and approved by my school. I represent and stipulate that the thesis or dissertation and its abstract are my original work, that they do not infringe or violate any rights of others, and that I make these grants as the sole owner of the rights to my thesis or dissertation and its abstract. I represent that I have obtained written permissions, when necessary, from the owner(s) of each third party copyrighted matter to be included in my thesis or dissertation and will supply copies of such upon request by my school. I acknowledge that RU ETD and my school will not distribute my thesis or dissertation or its abstract if, in their reasonable judgment, they believe all such rights have not been secured. I acknowledge that I retain ownership rights to the copyright of my work. I also retain the right to use all or part of this thesis or dissertation in future works, such as articles or books.
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Type
Embargo
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2020-05-31
DateTime (encoding = w3cdtf); (qualifier = exact); (point = end)
2099-12-31
Detail
Access to this PDF has been restricted at the author's request.
Copyright
Status
Copyright protected
Availability
Status
Open
Reason
Permission or license
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