Medicine and Health Sciences Commons^™

Nutrition Care For The Transgender Population: A Retrospective Study To Investigate Relationships Between The Nutrition Care Process Model And Patient Outcomes, Alana Minnee Marrero Gonzalez

UNF Graduate Theses and Dissertations

One of the most important roles of the registered dietitian nutritionist is to provide medical nutrition therapy that is fitting to an individual’s culture, reality, ethnicity, and dietary preferences. A review of existing literature exposes the lack of information available on LGBTQ (lesbian, gay, bisexual, transgender, queer) health, for transgender communities. The purpose of this research was to generate knowledge of the nutrition-related problems and barriers to adequate nutrition and health, and their impact in nutrition assessment in a sample of Hispanic transgender adult patients living in San Juan, Puerto Rico. A retrospective observational study was conducted, data from 114 …

Walking The Talk: A Qualitative Exploration Of Gatekeeping Staff Perceptions Surrounding Implementation Of Nutrition Policy In Florida Food Banks, Rachel Lynn Mccandless

UNF Graduate Theses and Dissertations

Food insecurity is an independent risk factor for adverse health outcomes; providing nutrient-dense food through the emergency food system to individuals who regularly seek assistance can impact population-level health disparities. This research explored the extrinsic and intrinsic barriers and facilitators surrounding formal nutrition policy implementation as seen by the logistical gatekeepers in a sample of Feeding Florida food banks. A secondary aim of this research was to explore the change readiness of these same logistical decision-makers in nutrition policy implementation. Research Questions included the following: What are the critical gatekeeping staff perceptions of the barriers and facilitators to implementing formal …

Virtual Supervised Practice During The Covid-19 Pandemic. Does Virtual Learning Affect The Quality Of Preparation For The Rd Exam Or Beginning Dietetics Practice?, Shaynee M. Roper

UNF Graduate Theses and Dissertations

The Covid-19 pandemic has seemingly altered the practice of Dietetics, and its essential supervised practice component of the Dietetic Internship programs. Telehealth, in particular telenutrition, became a necessity of practice for the entire United States and many parts of the world. Medicare and many private insurance companies amended policies for the expansion, inclusion, and provision of MNT via telephone.¹ In addition, numerous Dietetic Interns were forced to complete the supervised practice (SPE) components of ACEND (Accreditation Council for Education in Nutrition and Dietetics) accredited programs virtually. The practice of telehealth is not a new concept. Indeed, this area of …

A Two-Day Virtual Workshop On The Micronutrient-Directed Nutrition-Focused Physical Exam For Ghanaian Nutrition Professionals: Examining Perceived Self-Efficacy And Innovation, Leah Anne Qubty

UNF Graduate Theses and Dissertations

Micronutrients are key components of various physiological processes. Therefore, in the setting of deficiency, poor health outcomes ensue. In Ghana, micronutrient deficiencies are common and medical resources are limited. The Ghanaian dietetics profession is growing, and this growth is propitiously timed to address micronutrient deficiencies. Biochemical markers of nutrition status are considered the gold standard to detect micronutrient deficiencies, but are costly and require specialized medical equipment. In the absence of available biochemical markers of nutrition status, the micronutrient-directed nutrition-focused physical exam is a viable tool. Nutrition professionals such as Registered Dietitians are qualified to conduct this exam, but feel …

Implementation Of A Transitions Of Care Nutrition Intervention For Malnourished Patients, Nina Rocca

UNF Graduate Theses and Dissertations

The topic of Transitions of Care (TOC) has been investigated by physician and nursing professions for years, while only more recently by nutrition professionals. Registered Dietitians are not always involved in TOC planning. RDs can play an important role in TOC by communicating patients’ nutrition information across health care settings, especially for patients with malnutrition. The primary aim was to use a CDC based process evaluation to evaluate if a case management, nursing focused care transitions framework, adapted for a TOC nutrition intervention, can result in a successful intervention implementation. The secondary aim was to use a CDC outcomes evaluation, …

Nutrition Perception, Dietary Intake, And Anthropometric Correlations Between Autism Spectrum Disorder And Typically Developing Adolescents., Kristin M. Berg

UNF Graduate Theses and Dissertations

The adolescent’s nutrition perception is reflected in dietary intake and body composition. Obesity is prevalent among adolescents with Autism Spectrum Disorder (ASD). Dietary habits of children with ASD are affected by sensory issues, gastrointestinal factors, and parental provision of diet. This cross-sectional study identifies the relationships among variables for dietary intake, nutrition perception of intake, and anthropometric measurements for adiposity for 19 adolescents, ages 11 to 17, with ASD. Twenty-four children who are typically developing (TD) were assessed to compare all variables for significant differences. Measurements of variables of interest were obtained from the adolescent subjects: a 24-hour recall of …

Interprofessional Education Activities And New Practitioner Competence: Implications For Practice In Nutrition And Dietetics Education, Stephanie N. Petrosky

UNF Graduate Theses and Dissertations

Interprofessional education (IPE) and interprofessional collaborative practice (IPCP) are associated with improved perception, values, attitudes towards collaborative practice, and therefore benefits patients, practitioners, and health care systems. Notable organizations have long promoted standardized guidelines for best practices in interdisciplinary team-based learning to improve patient safety and health outcomes. The state of IPE in nutrition and dietetics practice was recently addressed by the Nutrition and Dietetic Educators and Preceptors (NDEP) practice group of the Academy of Nutrition and Dietetics. The authors generated a call to action to engage in IPCP while pushing the boundaries of leadership in teaching, research, and practice. …

Estimation Of 24-Hour Urinary Creatinine Excretion Through The Development Of A Model And Its Relationship To Outcomes In Hospitalized Critically Ill Veterans, Lynn Diane Hiller

UNF Graduate Theses and Dissertations

Background: Muscle mass is highly correlated with patient outcomes. Techniques to identify patients with low muscularity include computed tomography (CT) and bioelectrical impendence analysis (BIA) however disadvantages of cost, exposure to radiation and access make these measurements unavailable to the average dietitian. Urinary creatinine excretion (UCE) and estimation of creatinine height index (CHI) are strongly associated with muscularity and outcomes, however, require a 24-hour urine collection. The postulation that UCE may be predicted from patient variables, through mathematical modeling, would avoid the need for a 24-hour urine collection and may be clinically useful.

Methods: Input variables of age, …

Childhood Food Insecurity: A Program Impact And Evaluation Study Of The Meals On Wheels For Kids Program, Claudia Rivero

UNF Graduate Theses and Dissertations

In America, millions of families and children face hunger and food insecurity every day. According to the United States Department of Agriculture, more than thirty-eight million people experienced hunger in 2020. As many as 13 million children in the United States live in food-insecure homes. Many households that experience food insecurity do not qualify for federal nutrition programs. While valuable, barriers to these programs can block food-insecure households with children and prevent access to healthy food. The impact of adverse health and nutritional consequences, of a food-insecure household, will continue to plague our communities until efficient programming connects to those …

Exploring The Health Outcomes And Patient’S Viewpoint Of Pediatric Patients Receiving Medical Nutrition Therapy Visits With In-Person, Telephonic, And Tele-Video Modalities At A Rural Community Health Center, Valerie L. Muehleman

UNF Graduate Theses and Dissertations

The Covid-19 pandemic advanced telephonic (TP) and tele-video (TV) visits for medical nutrition therapy (MNT). This study explored the health outcomes and patient’s viewpoints of MNT by modalities in a community health center (CHC). Participants ranged in age from 1-18 years, diagnosed with overweight/obesity, and received MNT from a registered dietitian nutritionist (RDN) from January 1, 2019 to August 31, 2021. Health outcomes measured were health goal achievement, BMI percentile, pre/post lipid panel, and A1C%. Show/no-show rates and demographic characteristics of gender, age, race, insurance, county, language, and ethnicity were also compared by the visit modality. Ten interviews in the …

Physician Knowledge, Attitudes, And Behaviors Towards Registered Dietitian Nutritionists, Amy Motley Jones

UNF Graduate Theses and Dissertations

Diet is increasingly linked with overall quality of life, and a healthy diet is now being considered one of the cornerstones of preventative care. Physicians rely on Registered Dietitian Nutritionists (RDNs) as most doctors lack the nutrition knowledge to properly treat their patients, especially during their residency. Little published information exists on the specific collaboration of RDNs and resident physicians. This study aimed to determine whether mentoring with an RDN increased physician nutrition knowledge, increased consults to RDNs, and whether physician attitudes improved regarding their understanding of the role of the RDN in healthcare. Knowledge or attitude alone are not …

The Effects Of Fermented Vegetable Consumption On The Composition Of The Intestinal Microflora And Levels Of Inflammatory Markers In Women: A Pilot And Feasibility Study, Amy Galena

UNF Graduate Theses and Dissertations

Background: The gut microbiome plays a key role in metabolic disease development. Diet is a modifiable factor that significantly influences gut microbial composition, and fermented foods are a reliable source of probiotic microorganisms that can contribute to gut homeostasis. The primary objective of this study was to explore the feasibility of fermented vegetable consumption for six weeks on markers of inflammation and gut microflora profiles in women.

Methods: Thirty-one women consumed 100 g/day of fermented vegetables (group A), non-fermented vegetables (group B), or no vegetables (group C) for six weeks. Dietary intake was assessed twice during the intervention by a …

Factors Associated With Overall Experience In Advanced-Practice Doctoral Programs, Kristi Chipman

UNF Graduate Theses and Dissertations

Advanced-Practice Doctoral (APD) students are working professionals who are often returning to school after several years of practice. Multiple areas and concerns may affect overall experience as well as retention rates in doctoral programs.

This mixed-methods research study utilized both qualitative (interview) and quantitative (survey) methods. Students from three different APD programs (Doctorate in Clinical Nutrition, Doctor of Education, and Doctor of Nursing) were asked to participate in a semi-structured interview. The interview was used to help guide the development of a survey. Students from the three groups (n=65) were asked to participate in a one-time, non-incentivized, survey. The survey …

Investigation Of The Multidimensional Determinants Of Nutritionally Risky Coping Strategies And Tradeoffs In Adults, Cheryl Marsland

UNF Graduate Theses and Dissertations

Multidimensional determinants influence use of negative nutrition coping strategies and tradeoffs in households accessing food relief. The objective of this study is to examine negative nutrition coping strategies and tradeoffs at different levels of food insecurity in households accessing food relief and investigate how these behaviors relate to experience-based food insecurity dimensions and populations at risk. This secondary data analysis is from the cross-sectional Sunshine State Hunger Survey (SSHS) conducted June 2018 to August 2018. Over 600 adults were surveyed capturing households of Floridians who accessed 18 direct service charities and community groups that provide food relief across the Tampa …

A Mixed Methods Study Examining The Barriers And Facilitators To Research Utilization And Evidence-Based Practice In Adult Weight Management, Kevin B. Metcalf

UNF Graduate Theses and Dissertations

Background

Obesity is a disease with many associated comorbidities and its prevalence in the U.S. continues to increase despite the majority of people with obesity attempting weight loss. Dietitians are responsible for using evidence-based practice to mitigate the effects of obesity, however, differences in practice philosophies, opinion leaders, misinformation, a sense of competence, and the complexity of nutrition research have been identified as barriers to implementing practice guidelines into daily practice. It is unclear how dietitians strike a balance between empirical evidence, anecdotal evidence, and patient-centered practice.

Aims

The primary aim of this mixed-methods study was to identify the barriers …

Validation Of An Evidence-Based Dietetic Practice Instrument And The Association Between Level Of Education And Use Of Evidence-Based Dietetic Practices Among Registered Dietitian Nutritionists, Leslie Thompson Van Horn

UNF Graduate Theses and Dissertations

Evidence-based practice (EBP) is associated with improved and consistent patient care and reduced healthcare costs. While dietetic didactic and practice requirements emphasize EBP, there is a lack of a valid and reliable instrument that measures both objective and subjective knowledge of EBP among registered dietitian nutritionists (RDNs). Content validity was conducted with 11 experts and resulted in a 38-item survey that included ten items assessing objective knowledge of EBP. Items were deemed clear and appropriate for the survey goals and intended audience based on a face validity review among 16 RDNs with varying backgrounds. A pilot evaluation (n = …

Impacts Of Meals On Wings (Mow) Program On Volunteers' Perceptions And Motives, Juan Diego Salcedo

UNF Graduate Theses and Dissertations

INTRODUCTION: Food insecurity is a problem in the subpopulation of older adults and the elderly. The following study aimed to explore the perceptions and motives such as career benefits, impacts experienced through volunteering, skills in dietetics, comfort level with seniors, social responsibility, peer modeling, and empathy of student volunteers participating in a food recovery-meal delivery program known as Meals on Wings (MOW) on a college campus in the Southeast.

METHODOLOGY: The study was conducted during July 2021. Semi-structured interviews were administered over the video conference program Zoom to 10 (n=10) student volunteers who volunteered with MOW for at least one …

The Nutrition Care Process In Diabetes Medical Nutrition Therapy, Casey R. Colin

UNF Graduate Theses and Dissertations

The purpose of this study was to examine documentation quality and outcomes in a sample (n = 564 patient cases) of Diabetes Registry data from ANDHII, and to determine the validity and reliability of a revised NCP quality audit tool. RDNs have struggled to objectively demonstrate the value of MNT, which has limited MNT reimbursement and RDN recognition amongst allied healthcare providers. Development of a standardized process (the NCP), standardized language (the NCPT), and ANDHII have provided a means through which RDNs can improve MNT documentation and capture outcomes data, but gaps in adequate utilization exist. The most common …

An Examination Of The Impact Of The Covid-19 Health Threat, Stress, And Social Isolation On Lifestyle Habits As Analyzed Through The Protection Motivation Theory, Luciana Adib Soares

UNF Graduate Theses and Dissertations

The COVID-19 emerged in China in 2019 and quickly spread to other countries, leading to mandated lockdowns and social isolation. This cross-sectional study examined the impact of the COVID-19-generated stress, health threat, and social isolation on dietary, physical activity, and self-care habits of adults in Florida, utilizing the PMT as a framework. Participants (n = 478) completed online surveys about demographics, perceived stress, and changes in lifestyle habits. Significant positive changes were reported in cooking at home (p < .001) frequency, sweets (p < .001), and breakfast (p = .009) consumption, outdoors physical activity (p = .005), self-care (p < .001), relaxation (p < .001), and rest (p < .001) habits. Significant negative changes were reported in fast food (p = .004) and snack (p < .001) consumption. A significant relationship existed between self-reported stress, perceived threat, (r = .33, p < .001), and perceived efficacy, (r = -.15, p = .002). Perceived threat was the most important predictor of changes …

Exploring The Impact Of A Nutrition Support Workshop For Ghanaian Nutrition Professionals, Sarah D. Zeola

UNF Graduate Theses and Dissertations

Ghana, a middle-income country in West Africa, has long experienced high rates of malnutrition and is increasingly struggling with nutritional challenges from non-communicable diseases including overweight, obesity, hypertension and stroke. There is an inadequate number of trained Ghanaian nutrition professionals to meet the demands of providing nutrition care for the citizens of Ghana and those professionals providing nutrition care have limited opportunities for continuing education. This quasi-experimental prospective, single cohort pre-test/post-test research was conducted in Accra, Ghana in September 2019 to determine if providing a nutrition support workshop to Ghanaian nutrition professionals (dietitians, dietetic interns, dietetic students and nutritionists) would …

Colors Of Fruits And Vegetables And Diabetes Risk In The United States Latino Population, Raymond Anthony Colon

UNF Graduate Theses and Dissertations

Objectives: Fruits and vegetables (FV) play an important role in people’s health. The current study aimed analyzed if specific colors of FV are associated with type 2 diabetes mellitus (DM) risk in the United States (US) Hispanic/Latino population.

Methods: This study used participants from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). It is a multi-center, prospective cohort study with 5,740 self-identified Hispanic/Latino individuals from 2008-2011. Data collected include anthropometrics, oral glucose tolerance test (OGTT), dietary intake, medical history, physical activity, and sociodemographic information. FV are categorized into five color groups: green, white, yellow/orange, red/purple, and uncategorized.

Results: A total …

Development And Validation Of A Mindful Food Parenting Instrument To Assess The Relationship Between Parent Food Practices And Children’S Dietary Outcomes, Su-Nui Escobar

UNF Graduate Theses and Dissertations

American children’s diets are commonly recorded as deficient in nutrient rich foods such as vegetables, fruits, and whole grains. Such diets often exceed amounts of unhealthy items such as added sugars and sweetened beverages. In addition, 23% of children are considered overweight or obese. Mindfulness techniques in parents have been correlated with improved dietary outcomes in children and a healthier family eating environment.

The primary aim of this study was to develop and validate an instrument that reflects the theoretical framework drawn from current models of mindful eating, mindful parenting and mindful food parenting. The instrument is a practical tool …

Correlations Between Dietary Indicators And Cardiometabolic Profiles In Preschool Children., Kristin M. Berg

UNF Graduate Theses and Dissertations

ABSTRACT

Background: Recent literature suggests preschool children regardless of income, age, ethnicity, and gender are subject to future cardiometabolic risk. Dietary intake, when analyzed can indicate diversity and lack of meeting adequate nutrient standards. A combination of anthropometric and blood analysis with dietary intake assessment can provide practitioners the knowledge for adequate early nutrition intervention and education.

Objectives: This descriptive, cross-sectional study describes the relationship between dietary intake and cardiometabolic indicators in preschool children. There is also a comparison of mean subject values and referenced national standards.

Study Sample: Four hundred seventy-one preschool children, between the ages …

An Examination Of Oral Fed Post-Trauma Patients For Calorie And Protein Consumption As A Percentage Of Estimated Needs, And How It Impacts Length Of Hospital Stay And Wound Healing, Jamie Marchio

UNF Graduate Theses and Dissertations

Due to rising costs of healthcare, clinicians are responsible for decreasing costs by providing care that moves the patient from injury, to recovery, to discharge within a matter of just a few days. The Registered Dietitian is responsible for the nutrition assessment and nutrition diagnosis, nutrition prescription and plan, and for monitoring the patient to achieve nutritional repletion within this short time frame. Concerns for patients who require nursing staff and caregivers for feeding are evident, especially when increased demands are being placed on the nursing staff. This study aims to determine whether or not “feeder patients” are at a …

The Relationship Of Preschool Children's Television Viewing, Food/Brand Recognition/Recall, Weight Classification, And Parent's Knowledge Of American Academy Of Pediatrics' Recommendations Of Daily Television Viewing, Patricia Marley Howell

UNF Graduate Theses and Dissertations

The prevention of childhood obesity during the formative years is necessary because dietary patterns influenced by parents are developed early. A major obstacle to healthy feeding patterns in children is television advertising. The study tested three hypotheses. 1) Preschool children ages two to five years who watch more television are able to recognize/recall more food brands than those who view less television. 2) An increase in food brand recognition/recall in preschool children is associated with an overweight classification based on calculated Body Mass Index. 3) Children of parents who are unaware of the American Academy of Pediatrics (AAP) recommendations for …

Nutritional Assessment Of Rural Mossi People In Burkina Faso: A Comparison Of Pre- And Post-Harvest Status, Tamara Michelle Wood

UNF Graduate Theses and Dissertations

The purpose of this study was to compare the nutritional status of a rural population of Mossi people in Burkina Faso during the pre- and post-harvest seasons. Comparisons were made between the sample population and the American population, between the pre- and post-harvest seasons, between males and females in the sample population and between the various age groups in the sample population.

This nutritional assessment consisted of collecting demographical information, anthropometrical measurements such as weight and height, a clinical assessment to evaluate physiological signs of nutritional deficiencies and a food frequency questionnaire to describe the dietary practices of the population. …

The Relationship Between Percent Deficit Ideal Body Weight And The Prevalence, Severity, And Healing Of Pressure Ulcers, Cheryl Anne Masters

UNF Graduate Theses and Dissertations

This retrospective study determined whether percent deficit ideal body weight (IBW) was a risk factor for the prevalence, severity or healing of pressure ulcers. This study hypothesized that nursing home residents below their IBW with pressure ulcers have more severe, higher prevalence, and a slower healing rate than resident who are above their IBW. Medical record data were analyzed for all subjects that met the selection criteria from April, 1997 to April, 1998. Fifty-eight subjects aged 39 to 104 years were assigned to one of two groups (Group 1(n=28) were less than 99% of IBW; Group 2 (n=30) were greater …

Estimates Of Elderly At Nutritional Risk From The Determine Your Nutritional Health Checklist: The 1994 Northeast Florida Nutrition Screening Initiative, Lynn Marie Brokiewicz

UNF Graduate Theses and Dissertations

This study examined associations among the nutritional risks, the risk levels, and the ages of independently living elderly. The Checklist of the Nutrition Screening Initiative (NSI) was administered to a purposive sample of 1004 Northeast Florida elderly to estimate an age-profile at risk for malnutrition. Checklist nutritional scores (cumulative of ten risks) were grouped into risk levels of low (scores 0-2, 64.3%), moderate (3-5, 29.5%), and high (6 and greater, 24.2%). Within each level, Checklists were grouped by respondents' age into young-old (60-74), old-old (75-79), and fragile-old (80-102). Eight nutritional risks' distribution across risk levels was significantly greater in respondents …