Medicine and Health Sciences Commons^™

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 …

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 …

Fork It, Kylee Pipgrass

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Obesity prevalence is at an alarmingly high rate within the United States, but especially in rural areas of Kentucky. Obesity can lead to a variety of negative physical health outcomes including heart disease, diabetes, stroke, and some cancers. There are also mental disorders associated with obesity through mechanisms such as weight stigma and self-perception. Similar to obesity rates, prevalence and mortality associated of these health outcomes are also seen at disproportionately higher rates in rural, Appalachian Kentucky. Causes for increased obesity and obesity related consequences include some genetic factors as well as behavioral factors like physical inactivity, poor diet, stress, …

Nutritional Status In Critical Care Of Covid-19 Patients, Dolph Lewis Davis Iii

Theses and Dissertations--Nutrition and Food Systems

Critical care nutrition is a poorly researched, and such a sudden pandemic event requiring manipulation of nutritional status via propofol-induced sedation for mechanical ventilation is potentially impactful on patient outcomes. This paper seeks to provide context to the impact of critical care protocols on the nutritional status of obese patients suffering from COVID-19.

Assessing Self-Perceived Nutrition-Related Lifestyle Behaviors And Knowledge Of University Music Students Following A Targeted Presentation, Gretchen Trumbo

Theses and Dissertations--Nutrition and Food Systems

Although proven that nutrition can impact physical health, limited research examines the relationship between nutrition-related lifestyle behaviors, nutrition knowledge, and the prevalence of injury in university music students. The objective of this study is to evaluate nutrition-related lifestyle behaviors and self-perceived nutrition knowledge of university music students before and after a targeted nutrition education session. A baseline Qualtrics survey was administered to undergraduate and graduate music students (18+ years) via the University of Kentucky School of Music Listserv to gather data related to demographics, anthropometrics, history of playing-related injury, nutrition knowledge, attitudes, beliefs, and behaviors. A nutrition education presentation, focused …

Examining Cultural Influences On Dietary Behaviors Among Mexican Americans With Low Acculturation, Austyn Erickson

Theses and Dissertations--Nutrition and Food Systems

Mexican Americans represent approximately 63 percent of the total Hispanic population in the US and are disproportionately affected by health disparities related to poor nutrition status. With this community among the fastest growing populations in the US, it is critical to address the health disparities and the relationship between culture and diet to provide evidence-based nutrition interventions that are culturally sensitive to specific communities. The purpose of this cross-sectional exploratory study is to examine the relationship between cultural values and dietary behaviors among a low-income, urban, clinical sample of Mexican Americans using the Mexican American Cultural Values Scale, dietary assessment, …

Growing Green Minds: Implementation Of A School Garden & Nutrition Program For The Freedom Area School District In Rural Wisconsin, Marissa Schuh

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Most children in the U.S. consume too few fruits and vegetables which is putting them at risk to develop obesity and other lifestyle diseases. The 2015-2020 Dietary Guidelines for Americans recommends that individuals should increase the amount and variety of fruits and vegetables consumed in order to prevent weight gain and other chronic diseases. Research shows that garden-based educational programs can increase children’s fruit and vegetable intake as well as change their preferences and attitudes towards eating and trying new fruits and vegetables. Incorporating a garden and nutrition curriculum into a school setting is an ideal opportunity to improve children’s …

The Impact Of Covid-19 On Worksite Wellness Programs, Marilyn S. Campbell

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Introduction: Worksite wellness programs are popular employer offerings as of the last few decades. The COVID-19 pandemic has caused major shifts in behavior since these programs have been implemented. The purpose of this study was to see how the pandemic has affected various offerings within a university worksite wellness program.

Methods: This study is a secondary analysis of a university worksite wellness program, and it compares participation in the various offerings in response to the COVID-19 pandemic by evaluating 2019 participation (pre-pandemic) to 2020 participation (including onset of the pandemic and after). This worksite wellness program, which is available to …

Factors That Influence Maternal Feeding Decisions For Toddlers: Extending The Theory Of Planned Behavior, Elizabeth Lucas Combs

Theses and Dissertations--Kinesiology and Health Promotion

Establishing healthy eating behaviors is vital in the early years to help combat the development of obesity and other chronic diseases. Mothers play an invaluable role in shaping their children's eating habits through controlling what and when children eat as well as the overall food environment, which is why a better understanding of what influences mothers’ decisions about these behaviors is important.

The purpose of the dissertation was to gain a better understanding of what impacts maternal feeding decisions regarding toddler nutrition behaviors. This was a two-phased mixed methods study. The aim of the initial study was to explore, using …

Case-Control Study Of Nutrition And Lung Cancer In Appalachian Kentucky, Afton N. Wright

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Background and Objectives

Lung cancer is the most common cause of cancer-related deaths world-wide. Recent studies suggest a possible association between nutrition and risk for specific histological subtypes of cancer. We examined the relationship between nutrition and lung cancer histology in Kentucky, a largely rural U.S. state that ranks among the highest in the nation in lung cancer rates, as well as diseases related to diet, such as diabetes and obesity. The objective of this study was to examine the impact of nutrition on lung cancer risk and histology in Kentucky. More specifically, we wanted to investigate potential associations with …

Utilization Of Web‐Based App To Target Obesogenic Factors In Rural Kentucky Counties With High Rates Of Obesity, Erin M. Casey

Theses and Dissertations--Nutrition and Food Systems

Due to socioeconomic disparities and geographic isolation, rural Kentucky residents bear a greater burden of poor health compared to national averages. Specifically, rural Kentucky residents are at greater risk of becoming obese and suffering from comorbidities of obesity such as type 2 diabetes, hypertension and cardiovascular disease. The purpose of the present study was two-fold. First, we the barriers to nutrition and physical activity unique to rural Kentucky counties which high proportions of obese adults (< 40%) were examined and extrapolated. Second, this information was used to develop a health and wellness app tailored to rural Kentucky counties. The objective was met via a formative assessment regarding causes for obesity in three rural Kentucky counties using focus groups. From these discussions, two major themes arose: barriers to good nutrition and physical activity, and desired web‐app features. From this assessment, FitFaceoff was developed and released into the same counties. Usage and user interaction were assessed using GoogleAnalytics™ software. Analysis revealed poor user liking and unsuccessful implementation of FitFaceoff, however further qualitative research is needed to evaluate poor user reception of FitFaceoff and possible future directions.

Consumer Preference Of Vanilla Ice Cream, Julie Anne Martin

Theses and Dissertations--Nutrition and Food Systems

Consumers have a variety of ice cream available for purchase through retail stores, including: standard commercial, specialty store, organic, and premium commercial options. This study used a sensory analysis to solicit responses from a group of adults to determine consumer preference and acceptance of four vanilla ice creams based on taste. Consumers preferred (i) organic ice cream to standard, commercial ice cream and (ii) specialty store ice cream to standard, commercial ice cream. Additionally, consumers could identify (i) the organic ice cream when compared to the standard, commercial ice cream and (ii) the premium, commercial ice cream had more overrun …

Evaluation Of Oral Nutritional Supplement Use In Elderly Patients Admitted With Heart Failure, Geri L. Sipe

DNP Projects

PURPOSE: The purpose of this study is to evaluate the effects of enhanced ordering privileges among registered dieticians (RD) on oral nutritional supplement (ONS) ordering frequency and prevalence of oral nutritional supplement use among elderly patients admitted with heart failure (HF).

METHODS: This study was a single facility, retrospective pre-post implementation evaluation of the impact of expanded ONS ordering privileges among elderly patients (age ≥ 65 years old) hospitalized with heart failure at Frankfort Regional Medical Center (FRMC). The sample consisted of 105 patients for the pre-evaluation period and 259 for the post-evaluation period.

RESULTS: There were …

Color Your Plate: A Pilot Nutrition Education Intervention To Increase Fruit And Vegetable Intake Among Older Adults Participating In The Congregate Meal Site Program In Kentucky Senior Centers, Emily Dickens

Theses and Dissertations--Nutrition and Food Systems

The purpose of this study was to determine if the amount and variety of fruit and vegetable intake increased among community-dwelling older adults participating in Kentucky’s congregate meal site program following a series of educational nutrition lessons. A convenience sample (n=35) of community-dwelling older adults at two intervention (n=19) and two control (n=16) senior centers in central Kentucky participated in this quasi-experimental pre-post pilot study. Following the intervention there was a trend towards increased self-reported intake in the variety of fruit and vegetables among the intervention group (range:0.03±3.31 to 1.32±2.75 servings per week); a significant increase in the number of …

Assessment Of Obesity Management In A Primary Care Setting, Katie Diffenderfer

DNP Projects

Purpose: The purpose of this study was to evaluate the current practices related to obesity in the primary care setting in University of Kentucky’s Healthcare System. The specific aims were to: 1) Determine the proportion of obese patients who had an ICD-9/10 diagnosis code for obesity, 2) Determine the proportion of obese patients who received interventions related to their obesity, 3) Determine whether obesity diagnosis and interventions varied based on patient demographics, and 4) Compare actual obesity interventions to those outlined in the clinical practice guidelines.

Methods: A retrospective chart review of male and female patients between the ages of …

Lifestyle Contributors To Cardiovascular Disease Risk, Adam J. Berrones

Theses and Dissertations--Kinesiology and Health Promotion

Aortic stiffness is an independent risk factor that has prognostic value regarding future cardiovascular disease (CVD) events such as myocardial infarction, strokes, and heart failure. Although death rates due to coronary heart disease have declined in recent years, the leading global killer remains CVD and prevalence is still high. Understanding lifestyle contributors associated with aortic stiffness would provide the public with insight into targeting key health-related behaviors.

The purpose of this observational study was to examine the association of physical activity, physical function, and dietary quality as independent factors contributing to aortic stiffness in apparently healthy middle aged men. Fifty-two …

Childhood Nutrition And Lifestyle In Owensboro, Kentucky, Mckenzie J. Mattingly

DNP Projects

According to the CDC, childhood obesity is now one of the leading health problems in the United States. Thirty-five percent of adults in the United States are obese. Kentucky is the 12th most obese state for adults. and the 7th most obese state for children. The State of Obesity: Better Policies for a Healthier America, states that Kentucky’s adult obesity rate is currently 31.6 percent. This is up from 21.7 percent in 2000 and 12.7 percent in 1990. Primary care providers must work to help prevent these numbers from continuing to climb. Since our population of children who are overweight …

Improving Nutritional Status In The Hematologic Oncology Population, Mary A. Malone

DNP Projects

Background: Patients undergoing treatment for both solid tumor and hematologic malignancies experience numerous symptoms that greatly affect their nutritional status. Malnutrition can have a negative impact on oncology patient outcomes. There is a reduced response to treatment, reduced survival and quality of life. Early and consistent interventions have proven beneficial in the oncology population.

Most hematologic cancer patients have good nutritional health. However, as their treatments intensify, side effects compared to their solid tumor counterparts can adversely affect nutrition. Interventions, consisting of total parenteral or enteral nutrition are initiated but only after oral intake has been impeded for 2-3 days. …

Assessing The Perceptions Of Environmental Pollutants, Health And Nutrition Behavior To Improve Risk Communications In Kentucky, Elizabeth Virginia Willett

University of Kentucky Master's Theses

Nutrition interventions are an effective way to improve the dietary habits and lifestyle choices and reduce the risk of chronic disease. The Researchers in the UK-SRP Community Engagement Core develop nutrition programs for communities affected by environmental pollutants. Risk communication is a discipline that can be used to develop targeted nutrition interventions that will yield positive behavior change. The purpose of this study was to examine knowledge, risk perception, and actions concerning environmental pollutants and nutrition behavior. Data was collected using a modified survey instrument based on the validated Environmental Health Engagement Profile (EHEP). Survey participants from diverse regions of …