The use of nutritional knowledge assessments to guide nutrition counseling in primary care
Creators: name: Pichardo, Diana
Publisher: name: No Publisher Supplied
Year: 2020

description: 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 &amp; Rickett, 2010). Instead, discussion on nutrition is generally restricted to condition-specific topics with little investigation into patient nutritional knowledge or practices (Kahan &amp; Manson, 2017; Kolasa &amp; 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 &amp; 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 &amp; 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.