Medicine and Health Sciences Commons^™

Healthier Together: A Holistic Office Protocol Addressing The Chronic Nature Of Children And Adolescents With Adhd, Kimberly Olmos

Evidence-Based Practice Project Reports

Attention Deficit Hyperactivity Disorder (ADHD) is a highly prevalent, chronic condition with symptoms that include inattention, hyperactivity, and impulsivity. ADHD affects six million children in the United States (Tran et al., 2021). The purpose of this evidence-based practice project was to implement a holistic office protocol that addressed the chronicity and future health outcomes of children and adolescents, ages 2-17 years with ADHD through stimulant or non-stimulant medication prescriptions, behavioral therapy referrals, and education surrounding diet, and exercise. A comprehensive, systematic literature search yielded 16 articles to determine best practice when treating children and adolescents with ADHD in primary or …

Advancing School Nursing Practice: A Novel Approach To Screening For Gastrointestinal Disorders In Children, Ashley Bunting, Isabella Cavlan

Nursing | Student Research Posters

California schools currently only screen for vision and hearing, leaving many other health concerns unaddressed. Among these, gastrointestinal (GI) health is particularly significant, as digestive disorders can lead to severe consequences, like malnutrition and stunted growth. By incorporating routine GI screenings, school nurses can promote the early detection of disease, allowing for timely intervention and improved health outcomes in children.

Based on existing literature, we have developed a novel pediatric GI screening tool for school nurses to use in routine screenings, presented below.

Improving Nutrition Screening Practice In The Hospitalized Heart Failure Patient Population, Amanda J. Bourgeois

DNP Projects

Background: Heart Failure is a disease known to affect nearly 6.5 million adults in the United States. Characterized by recurrent hospitalizations, heart failure significantly contributes to morbidity, mortality, and healthcare costs in the United States and worldwide. Because malnutrition is prevalent in the heart failure population, healthcare providers must perform nutritional assessments on admission to intervene in the case of malnutrition, prevent deterioration, and improve patient prognosis. Without intervention and early identification of malnutrition, heart failure hospitalizations will remain a significant problem.

Purpose: The purpose of this study is to evaluate the effect of an evidence-based educational program for cardiac …

Evaluation Of Nutritional Guidance From Providers For Patients With Type 2 Diabetes In A Primary Care Setting, Whitney Rice

DNP Projects

Background: Adherence to diet is a challenging part of managing type 2 diabetes mellitus (T2DM). Guidelines recommend including a registered dietician and/or a diabetes educator. While this is the gold standard, there are barriers to implementation in primary care. The Starting the Conversation (STC) diet recall tool can aid primary care providers (PCPs) in providing brief nutrition counseling for patients with T2DM. Purpose: To evaluate the perceptions and practices of PCPs regarding dietary education and documentation for patients with T2DM after provider education and initiation of the STC tool. Methods: This was a quality improvement project using a quasi-experimental pretest …

The Nurse's Lived Experience Of Transferring Nutrition Knowledge To Patients: A Descriptive Phenomenology, Kendrah Lynne Cunningham

Doctoral Dissertations and Projects

This descriptive phenomenological qualitative study aimed to gain insight into the nurse’s lived experience of transferring nutrition knowledge to patients. Nurses play an important role in assisting the patient to become more proficient in health and nutrition literacy to make proper choices related to their nutrition. It is necessary to evaluate the lived experience of the nurse in transferring nutrition knowledge to patients. There is a gap in the literature on nurses’ experience in providing nutrition knowledge to their patients. This descriptive phenomenological qualitative study examines the lived experience of nurses in transferring nutrition education to their patients. This was …

Adapting The Aha’S Blood Pressure And Nutrition Management Program Into Digestible Teaching Plans For Low-Income Communities, Truc Huynh, Jemina Lynn B. Estepa, Fritz Reanne A. Obungen, Katelyn Marie Clasey, Kirsty Keitges, Serah M. Kimani, Hailey Rae Tauscheck, Andrew David Rhoades

Nursing Leadership in Community Engagement Projects

Executive Summary: Adapting the AHA’s blood pressure and nutrition management program into digestible teaching plans for low-income communities

According to the American Heart Association (AHA), 46% of American adults have high blood pressure (Whelton et al., 2017). High blood pressure, especially for those above the age of 50, is associated with a higher prevalence of heart disease and a shorter life expectancy. The AHA’s Check Change Control program (CCC), is an evidence based, self-directed blood pressure management guide (American Heart Association, 2021). The CCC program incorporates four lesson topics related to lifestyle changes to manage hypertension. The four topics are: …

Implementation Of Nutritional Screening In Adults (Ages 19-65) With Major Depressive Disorder: An Integrative Review, Laurie S. Stephens

Doctoral Dissertations and Projects

The World Health Organization estimates the total percentage of depression at 3.8% and projects it to be the leading cause of global disability by 2030 (WHO, 2023). The economic burden for adults with major depressive disorder in the United States is estimated at a staggering annual cost of 236 billion dollars (Greenberg et al., 2018). Nutritional psychiatry is a growing subspecialty focused upon how diet can improve mental health outcomes. The evidence shows a correlation between diet and depression, influencing questions on how this translates to current dietary recommendations and treatment. An integrative review of current literature was performed to …

Nutrition-Related Experiences Of Women With Perinatal Depression During The Covid-19 Pandemic: A Qualitative Study, Dahlia Stott, Cynthia Klobodu, Lisa A. Chiarello, Bobbie Posmontier, Mona Egohail, Pamela A. Geller, June Andrews Horowitz, Brandy-Joe Milliron

College of Nursing Faculty Papers & Presentations

Women with perinatal depression are at a high risk for unhealthy dietary behaviors but whether the coronavirus disease 2019 (COVID-19) pandemic has exacerbated this risk is unknown. Here we report the findings of a qualitative study exploring the impact of the COVID-19 pandemic on nutrition-related experiences of women with perinatal depression. Using a qualitative descriptive approach, in-depth interviews were conducted with 18 women with a history of perinatal depression and 10 healthcare providers. A semistructured format elicited how food and nutrition-related behaviors of women with perinatal depression were affected by the COVID-19 pandemic. Thematic analysis identified 4 themes related to …

A Lifestyle Modification Intervention In Hispanic Adolescents With Nonalcoholic Fatty Liver Disease, Brianne Miller

Evidence-Based Practice Project Reports

U.S. population studies have confirmed that the Hispanic population has the highest prevalence and the worst prognosis for non-alcoholic fatty liver disease (NAFLD) (Katz et al., 2021). The purpose of this evidence-based practice project was to implement a multicomponent, lifestyle modification intervention in Hispanic pediatric primary care patients to combat the disease process and sequela of NAFLD. The PICOT question for this project was: In Hispanic adolescents aged 10-21 with obesity and NAFLD (P), what is the effect of a multicomponent, lifestyle modification intervention (I), on alanine aminotransferase (ALT) (O), over a 12-week time period (T)? A comprehensive literature search …

Wellness Review 2022, Part 2, Martin Huecker, Brian A. Ferguson, Jacob Shreffler

Journal of Wellness

Introduction: Similar to prior reviews, the Journal of Wellness editors searched the literature from the second half of 2022 for an interesting and impactful selection of publications on wellness in healthcare professionals.

Methods: Editors conducted a standard keyword search in Pubmed, focusing chiefly on large journals, interventional trials, and other prospective research. We included papers published between July 1, 2022 and December 31, 2022.

Literature in Review: Finding several hundred publications, we excluded editorials, reviews, and some smaller, less generalizable papers. A final 25 significant studies focusing on wellness in medical professionals were sorted into the following categories: logistics, creativity …

How Lifestyle Implementations Affect The Health Of Obese Women Compared To Women Who Are Not Obese, Chloe Hensley, Callie Marshall, Adela Robles, Adrianna Winseman

Epsilon Sigma at-Large Research Conference

Obesity is a major risk factor for many health problems, including cardiovascular disease and diabetes. It is anticipated that the prevalence of obesity in the United States will grow as time passes. The objective of this study is to compare the health of obese women who engage in regular exercise to that of nonobese women. This literature review is drawn from eight library-based research articles at East Tennessee State University (ETSU). The search engine covers topics such as obesity, postmenopausal women, physical activity, nutrition, health, fitness, and lifestyle. Taking nutritional supplements and increased physical exercise minimizes the likelihood of health …

The Rising Rates Of Pediatric Health Conditions Due To Lack Of Nutrition Education, Amanda Healy

Nursing | Student Research Posters

Statistics show that there is an increase in childhood health conditions related to nutrition. Throughout the United States, the rates of childhood obesity have drastically increased along with the rates of type two diabetes. There is correlation between these two chronic problems in pediatric patients, but not all pediatrics diagnosed with DM2 are obese. Furthermore, there is a correlation between this increase of obesity/DM2 and the lack of nutrition education in schools. The public school system in the United States does not have the funding to provide adequate nutrition education to the children which is leading to substantial health consequences. …

Effects Of A Residential Lifestyle Intervention Program On Selected Lipid Measures And Nutritional Choices, Delores M. Rugless

DNP Research Projects

Abstract

Objective: Cardiovascular disease has been the leading cause of death since the early 1920s. As with other chronic diseases, cardiovascular disease is primarily influenced by behaviors and the environment, with poor nutrition being a major contributing factor. Despite knowing the importance of lifestyle modification to manage cardiovascular disease effectively, many individuals have difficulty adhering to lifestyle modification principles. Residential lifestyle modification centers provide the education and support necessary to assist individuals with implementing behavioral changes. This DNP project aimed to demonstrate the value of diet modification implemented at a residential lifestyle center to decrease specific cardiovascular risk factors. Method: …

A Lifestyle Management Coaching Intervention For Fear Of Cancer Recurrence In Young Breast Cancer Survivors, Lisa R. Murphy

DNP Research Projects

Abstract

Objective: A significant challenge facing young breast cancer (BC) survivors is learning how to manage fear of cancer recurrence (FCR) during survivorship. Limited tailored FCR interventions and age-appropriate support exist. This Doctor of Nursing (DNP) project, based upon best practice guidelines, aimed to evaluate how a Lifestyle Management Coaching Intervention (LMCI) could help young female BC survivors learn how to decrease and manage their FCR more effectively and experience improved health outcomes.

Method: Eligible participants were female BC survivors aged 18-59 with Stage I-III BC demonstrating elevated baseline FCR screening scores during the extended survival period recruited from the …

The Role That Diet And Lifestyle Factor Plays In An Increased Risk For Cardiovascular Disease In Asians And Pacific Islanders, Ethan Caragan

Nursing | Student Research Posters

Cardiovascular disease is the leading global cause of mortality, often resulting in heart attacks and strokes due to obstructed blood flow to vital organs. The risk of these events is influenced by dietary choices, smoking, and physical activity. Despite preventative measures, the impact of diet and lifestyle on cardiovascular health varies across ethnic groups. This thesis aims to evaluate how variations in dietary traditions and lifestyle among Asians and Pacific Islanders contribute to increased or decreased cardiovascular disease risks compared to other racial groups. The study focuses on the dietary and lifestyle factors of Asian Americans and Pacific Islanders in …

Evaluating The Feasibility And Efficacy Of A Brief Motivational Interviewing Nutrition Intervention For Women With Type 2 Diabetes In Primary Care, Charlotte M. Adams

DNP Projects

Background: The American Diabetes Association recommends lifestyle modification to prevent and treat diabetes in their 2021 Standards of Medical Care in Diabetes. Evidence suggests that motivational interviewing (MI) is an effective intervention that clinicians can use to facilitate behavior change in patients with type two diabetes.

Purpose: The purpose of this project was to evaluate a brief motivational interviewing intervention that could be delivered by a PCP to provide individualized nutrition counseling for adult women with type two diabetes in a primary care clinic in Lexington, KY. This study was a continuation of a previous quality improvement project at this …

The Emerging Epidemic Of Type 2 Diabetes And Obesity Amongst Young Children, Juliana Morales

Nursing | Senior Theses

Background:

In the past years childhood obesity has increased tremendously and currently ⅓ of children in the United States are obese today. Obesity and Type 2 Diabetes are illnesses that can later on lead to more severe health complications when as a child enters adulthood. Children who are obese have a greater risk of developing Type 2 diabetes, and currently more than 80% of children who already are diagnosed with Type 2 diabetes are obese. In school and often by health care providers we are told daily physical activity and healthy diet are the best ways to maintain optimal health, …

Pick Your Plate: A Nutrition Education Study, Emmalyn Tucker

Honors College Theses

Childhood obesity has become a cause for concern among many nutrition experts. Childhood obesity can contribute to several health problems such as type 2 diabetes, asthma, high blood pressure. The large percentage of children affected with childhood obesity suggests a lack of essential nutrition education in our country. Junk food consumption and inadequate intake of the USDA’s MyPlate food groups have become essential areas for intervention. Multiple school-based nutrition education interventions have been explored to improve both children’s nutrition knowledge and improve healthy eating behaviors. “Pick Your Plate” is a nutrition education study designed to improve nutrition knowledge regarding junk …

Prevalence Of Health-Risk Behaviours Among Indigenous Australians With Diabetes: A Review, Sharon Atkinson-Briggs, Alicia Jenkins, Christopher Ryan, Laima Brazionis

Journal of the Australian Indigenous HealthInfoNet

Aboriginal and Torres Strait Islander Australians are at high risk of Type 2 diabetes and its complications. Optimal lifestyle choices can improve health outcomes. A thematic review of original research publications related to smoking, nutrition, alcohol intake, physical activity and emotional wellness in Aboriginal and Torres Strait Islander Australians with diabetes was performed. Overall, 7118 English-language publications were identified by search engines (PubMed, CINAHL, Scopus, Medline-Web of Science, and Google Scholar) with search terms Indigenous Australians OR Aboriginal and Torres Strait Islanders AND diabetes AND lifestyle OR smoking OR nutrition OR alcohol OR physical activity OR emotional wellbeing and their …

The Importance Of Education In The Management Of Diabetes, Taylor Nicole Henry

Doctoral Dissertations and Projects

Type 2 diabetes continues to affect millions of people every day across the United States. Uncontrolled blood sugars pose a risk to individuals’ overall health by causing microvascular and macrovascular changes and ultimately lead to an earlier mortality. One’s blood sugar levels can be checked at any time, but an individual’s hemoglobin (hgb) A1c is a three-month average that allows the diabetic to have an overview on how they are managing their diabetes. Appropriate nutrition and having someone hold the diabetic accountable have proven to limit these risks by lowering the patient’s hgb A1c. Providers and staff need to do …

Implementing A Child Friendly Menu Guide In A Pediatric Unit: Promoting Healthful Choices, Lauren Hull

Dissertations

Problem: Over 1/3 of children in the United States are overweight or obese and children’s nutritional status while hospitalized worsens rather than improves. Hospital meals have too many calories, too much sugar, and too few nutrients compared to recommended guidelines for children. The primary purpose of this quality improvement project is to increase the amount of healthy foods ordered by children in a southeastern pediatric hospital unit through implementation of a menu guide.

Methods: A quality improvement pre-post interventional pilot study was done through implementation of a child friendly menu guide promoting healthful eating. Data was collected by retrospective and …

Examining Perceived Stress And Diet Quality Among Low-Income Families Engaged With A Nutrition-Based Food Assistance Program, Kelsey R. Wolfe, Kathryn L. Dambrino, David Phillippi, Laura Gray

DNP Scholarly Projects

Abstract

Introduction: Evidence suggests poor-quality diets and high levels of stress have negative impacts on health, especially in low-income families in the southern United States. Nutrition-based food assistance programs were developed to meet nutritional needs of food insecure clients. The purpose of this scholarly project was to explore the relationship between perceived stress and diet quality among low-income families engaged with a nutrition-based food assistance program.

Methods: A retrospective and observational design was used to analyze previously collected survey responses from clients participating in a nutrition-based food assistance program in Nashville, TN (N = 425). Descriptive statistics and Spearman’s …

Perioperative Tube Feeding Guidelines For The Pediatric Burn Patient, Jordan Swanberg

Doctor of Nursing Practice Projects

Pediatric burn patients require an astronomical amount of nutritional support to promote wound healing and prevent unwanted side effects. These patients often require multiple surgeries, and consequently, when following standard NPO guidelines, these patients go for hours without any nutritional support. For this reason, a protocol was implemented on how to administer tube feedings throughout the perioperative process safely. The purpose of this project was to give a PowerPoint presentation to the providers that tested their current knowledge on how to manage tube feedings in the operative setting best. A single group design consisting of CRNA’s and an anesthesiologist was …

Nutrition On The Prevention And Treatment Of Depression, Gracie Polen

Nursing | Senior Theses

Today, the general population consumes a diet high in sugars, saturated fats, incomplete protein sources, and the tendency to exceed the bodies caloric requirements. The trend of obesity due to poor dietary habits is alarming. Mental illness has increasingly risen over the past decade. Specifically, the incidence of depression has reached a startling rate. The relationship between poor dietary intake and depression have grown together and it is imperative that methods are introduced to aid in resolving this issue. The prevention and treatment of depression needs to be explored through alternative methods. Healthier dietary choices have been shown to have …

Is Dietary Teaching Via Telehealth Effective In Lowering Hgba1c In Adult Patients With Prediabetes Or Type 2 Diabetes?, Mia Mccallum-Crawford

UNLV Theses, Dissertations, Professional Papers, and Capstones

Prediabetes and Type 2 diabetes mellitus (T2DM) are two common conditions diagnosed in the primary care setting. Both conditions benefit from a healthy lifestyle, managing blood sugar levels, and getting diabetes self-management education and support (DSMES). Within the past two decades, the healthcare community in the US has witnessed a substantial rise in diabetes among adults. Overall, the self-management of diabetes continues to worsen nationally. The purpose of this project is to improve patients’ self-management of both Prediabetes and T2DM through nutrition and show how nutritional counseling via telehealth provided by a nurse practitioner can improve HgbA1C values over 3 …

Utilizing A Toolkit With Individualized Food Label Education For Healthy Food Choices To Reduce The Burden Of Chronic Disease Among Black Americans, Johanna M. Kasidi

Doctor of Nursing Practice (DNP) Projects

Background/Purpose: Black Americans are disproportionately affected by chronic diseases related to diet including hypertension, diabetes, obesity, and stroke when they lack healthy food options and healthy living environments. The purpose of this project was to implement and evaluate the feasibility and effectiveness of a toolkit that primary care providers could use to educate and support Black adults in adopting healthy diet habits to improve overall outcomes and work towards decreasing this disparity.

Methods: This quality improvement project took place at a Community Health Clinic in an urban neighborhood. Participants received nutrition education utilizing a graphic titled “Your Nutrition Facts” …

Testing The Effects Of Two Field-To-Fork Programs On The Nutritional Outcomes Of Elementary School Students From Diverse And Lower-Income Communities, Kimberly R. Hartson, Kristi M. King, Carol O'Neal, Aishia Brown, Toluwanimi Olajuyigbe, Shakeyrah Elmore, Angelique Perez

Faculty Scholarship

The purpose of this quasi-experimental study was to evaluate the effects of two farm-to-school programs, specifically the Field-to-Fork Multi-visit Program (N  =  264) and the Field-to-Fork After-school Club (N  =  56), on nutritional outcomes of elementary school students (third to fifth grade) from urban, diverse, and lower-income communities. Data were collected via self-report surveys measuring: (a) knowledge of recommendations for daily fruit and vegetable intake; (b) fruit and vegetable consumption; (c) knowledge of cooking a healthy recipe using vegetables; and (d) desire for farm fresh foods at school. Statistical analyses included McNemar’s and Wilcoxon signed rank tests. The …

Obesity Prevention Toolkit To Combat Weight Gain Related To Sedentary Behavior And Dietary Habits In College Students: An Evidence-Based Project, Maria Amos, Martha Fuller

Doctor of Nursing Practice Final Manuscripts

Abstract

Background: Forty percent of the US population ages 20-39 are categorized as obese,

their BMI is over 30, and 35% of college age students are obese or overweight. Issues related to obesity cost the US $147 billion annually. Between 40%-50% of college students are reported to be inactive. Inactivity can lead to increased morbidity and mortality related to increased risks of cardiovascular disease, diabetes, hypertension, musculoskeletal issues, and depression. Providing dietary and physical activity education and access to nutritional information promotes behavior change in young adults.

Aims of Service Change: This evidence-based project proposal aims to provide a toolkit …

Eating For Health, Tanya Reese

Theses and Graduate Projects

As anxiety and depression have increased exponentially, researchers have discovered a link between nutrition and incidences of anxiety and depression. The communication between the gut and the brain is imperative for mental health. The inflammatory process that is initiated in the intestinal tract can change the chemistry of the brain resulting in anxiety and depression. Newman’s Theory, Health as Expanding Consciousness, helps people to identify patterns in their food choices and change those patterns to choose healthier foods. This scholarly project was implemented to teach youth and adults living in a rural community about the link between food and anxiety …

Anemia Management In Rural Haitian Children: A Mixed Methods Study, Marc-Aurel Martial, Kathy A. Sward, Janice M. Morse, Andrew R. Wilson, Cempaka S. Martial, Debra S. Penney, Elie Nicolas

Faculty Publications

Introduction: We examined factors influencing anemia outcomes in rural children following implementation of a prevention program. Method: Mixed methods study of children, parents, and clinicians utilized statistical modeling and content/ ethnographic analysis. Retrospective chart abstraction evaluated treatments administered and measured hemoglobin in children aged 6 to 59 months (n = 161). Prospective interviews/questionnaires examined parent (n = 51) and clinician (n = 19) perceptions. Results: Anemia prevalence decreased by 21.2%. Predictors of increased hemoglobin were clinic visit number and age at first visit. Once anemia improved, children were likely to remain improved (P = .65). Despite favorable program perceptions, stakeholders …