- Email: [email protected]
Cost-Benefit Analysis of an Enteral Nutrition Feeding System
MONDAY, OCTOBER 8
Poster Session: Food/Nutrition Science; Education; Management; Food Services/Culinary; Research Cost-Benefit Analysis of an Enteral Nutrition Feeding System Author(s): K. Glassman,1 W. Phillips,1 A. Brewer2; 1Univ. of Virginia Hlth. Systems/Morrison, Charlottesville, VA, 2Intern, Univ. of Virginia Hlth. Systems, Charlottesville, VA. Learning Outcome: Participants will determine methods for a cost analysis of the enteral nutrition delivery system. Research Outcome: Closed enteral nutrition systems (C-ENS) are more cost effective than open enteral nutrition systems (O-ENS). Methods: Costs associated with an O-ENS were compared to a C-ENS using contract pricing for each system. Potential for wastage of formula with either system was evaluated based on total formula delivered in a 24 hour period. Data was collected over a 3 week period in forty-seven enterally fed patients resulting in data points for 189 enteral feeding days. Waste was determined based on the amount leftover in a 24 hour period with each system. Results: Not accounting for waste, the average cost to feed these patients was $4.21/day with the O-ENS and $4.86/day with a C-ENS. The cost to feed the patients with the O-ENS increased to $6.54/day when the cost of the feeding bag was included. The average amount of waste was 107 mL/feeding day with the O-ENS and 358 mL/feeding day with the C-ENS. The average cost of this waste with the O-ENS was $0.37/day and $0.55/day with C-ENS. Conclusions: The contract price of the C-EN formulas is slightly higher per mL than the price of the O-EN formulas. Additionally, the potential for waste is increased by using a one liter container versus an 8 oz can of formula. However, once the cost of the feeding bag is factored in, it is more economical for the facility to use the C-ENS. The cost savings is likely even higher once nursing time for administration of the formula is considered. Funding Disclosure: None.
Perceptions, Attitudes, Knowledge and Clinical Use of Evidence-Based Practice among U.S. Registered Dietitians - A Prospective Descriptive Pilot Study Author(s): E. A. M. Vogt,1 L. D. Byham-Gray,2 J. Parrott,2 R. Touger-Decker3; 1Doctoral Student, School of Health Related Professions, Univ. of Med. and Dentistry of New Jersey, Newark, NJ, 2Associate Professor, Nutritional Sciences, School of Health Related Professions, Univ. of Med. and Dentistry of New Jersey, Newark, NJ, 3Professor and Chair of Nutritional Sciences, School of Health Related Professions, Univ. of Med. and Dentistry of New Jersey, Newark, NJ Learning Outcome: Describe perceptions, attitudes, knowledge (PAK) and clinical use of EBP among U.S. credentialed RDs. Objective: The objective was to describe perceptions, attitudes, knowledge (PAK) and clinical use of evidence-based practice (EBP), and to investigate the relationships between PAK score and demographic characteristics and clinical use among US credentialed RDs. Methods: The study was a prospective descriptive survey using a randomized sample of 2,500 RDs in clinical practice. Inferential statistics were used for data analysis. Results: Most respondents were female (n⫽171, 96.1%), white (n⫽157, 88.2%), worked full-time (n⫽136, 76.8%) in acute care (n⫽63, 39.9%) and were members of the Academy of Nutrition and Dietetics (AND) (n⫽123, 62.1%). Most respondents had access to databases (n⫽112, 56.6%) but used evidence-based resources less than once a month (n⫽100, 52.6%). The most frequent use of the AND Evidence Analysis Library (EAL) was yearly (n⫽79, 41.4%). Main barriers to implementation were lack of access to mentors (n⫽64, 32.3%), lack of training in critical appraisal (n⫽105, 55.3%), and time constraints (n⫽70, 36.3%). Respondents considered EBP to be valuable (n⫽146, 75.3%) and relevant to their practice (n⫽135, 68.9%) and increased frequency of use of EBP (F⫽11.97, p⬍0.0001) and reading professional journals (F⫽6.34, p⬍0.0001) was associated with increased PAK score. Conclusions: Most RDs had access to databases, but used resources less than once a month. Perceptions and attitudes were higher than levels of knowledge of EBP. Increased frequency of use of resources and reading journals was significantly associated with increased ability to incorporate EBP in practice. Results suggest that education is needed to increase knowledge and appraisal skills of EBP. Funding Disclosure: None.
Costs of Traditional Recruitment Methods Favor Examination of Novel Strategies to Recruit Low-Income Women to Nutrition Education Impact Studies
Effectiveness of Exercise Equivalents and Calorie Information on Vending Machine Usage among College Students
Author(s): B. A. Lohse, K. Arnold, P. M. Wamboldt; Nutritional Sciences, The Pennsylvania State Univ., State College, PA
Author(s): C. Platkin,1 E. A. Kelvin,2 M. Yeh1; 1Nutrition, CUNY Sch. of Publ. Hlth. at Hunter Coll., New York, NY, 2Epidemiology & Biostatistics, CUNY Sch. of Publ. Hlth. at Hunter Coll., New York, NY
Learning Outcome: Examine non-personnel costs associated with recruiting low-income women to a nutrition education program. Background: Current legislative and policy environments call for evidence of impact from nutrition education interventions. Non-personnel costs to recruit low-income women to a web-based nutrition education program were examined as part of an impact assessment. Methods: About Eating, a 5-lesson, web-based module on eating behaviors was studied in low-income women using a randomized, controlled design. Traditional recruitment methods (e.g., phone, flyers, postcards) using low-income venues (e.g., WIC, career centers, discount stores) or state-supplied lists of supplemental nutrition assistance program (SNAP) participants were used. Non-personnel expenses to recruit low-income women were calculated and documented. Websites unique to recruitment strategy enabled portal entry identification to detail costing and effectiveness. Results: Estimated reach from over 5 months of recruitment effort was 19,950 and was similarly divided between the two strategies. Phone calls, flyers and postcards targeting SNAP lists recruited 64% of the sample. Of 1,010 recruited to the website, 588 were eligible; 302 completed the study. Postcards were the most expensive method to recruit from SNAP participant lists ($4.51 per recruit vs. $.20 for phone calls and $.35 for flyers printed inhouse). Final non-personnel cost to recruit 648 to the website (384 eligible) was $5.06/ person. Final cost to recruit 364 to the website from low-income venues was $3.11/person using professionally printed flyers ($2.89/recruit) and mileage ($.22/recruit). Conclusions: For low-income women, high costs associated with traditional recruitment methods may hinder nutrition intervention impact assessment. Attention to alternative recruitment methods (e.g., social media or smart phones) is suggested to effect evidencebased nutrition education. Funding Disclosure: USDA, PA SNAP-Ed (PA Nutrition Education TRACKS).
Learning Outcome: The participants will be able to describe the use of calorie labeling on vending machines. Background: Vending machines are common sources for snack food and beverages among students. Although these items are typically high in calories and low in nutritional value, vending machines offer little or no nutritional information prior to purchasing. This study tested the effect of providing some nutritional information on the vending machine display on sales of snack foods and beverages in an urban college with a young, multi-ethnic student population. Methods: Three intervention conditions were tested: calorie only, exercise equivalents (EEs) (defined as the amount of time doing particular physical activities that would be needed to burn off calories in foods) only, and calorie plus EEs. The information was displayed under each food and beverage item in the vending machines on a university campus for one, two, and two weeks, respectively. Washout periods were introduced between conditions. Mean number of food and beverage items sold within categories of calories (low, medium & high) and type of item (chips, candy, water, soda, coffee drinks, etc.) during each of the conditions was calculated and compared to baseline using the Mann Whitney U test to assess statistical significance at ␣⫽0.05. Results and Conclusion: No significant differences in mean number of items sold were observed between the three intervention conditions and baseline by calorie or snack/drink category. Our results suggest that calorie and EEs labeling information on vending machines may not change point of purchase behaviors among college students. Future studies need to investigate nutritional information displays in different populations and different settings. Funding Disclosure: None.
A-64
JOURNAL OF THE ACADEMY OF NUTRITION AND DIETETICS
September 2012 Suppl 3—Abstracts Volume 112 Number 9
Poster Session: Food/Nutrition Science; Education; Management; Food Services/Culinary; Research Cost-Benefit Analysis of an Enteral Nutrition Feeding System Author(s): K. Glassman,1 W. Phillips,1 A. Brewer2; 1Univ. of Virginia Hlth. Systems/Morrison, Charlottesville, VA, 2Intern, Univ. of Virginia Hlth. Systems, Charlottesville, VA. Learning Outcome: Participants will determine methods for a cost analysis of the enteral nutrition delivery system. Research Outcome: Closed enteral nutrition systems (C-ENS) are more cost effective than open enteral nutrition systems (O-ENS). Methods: Costs associated with an O-ENS were compared to a C-ENS using contract pricing for each system. Potential for wastage of formula with either system was evaluated based on total formula delivered in a 24 hour period. Data was collected over a 3 week period in forty-seven enterally fed patients resulting in data points for 189 enteral feeding days. Waste was determined based on the amount leftover in a 24 hour period with each system. Results: Not accounting for waste, the average cost to feed these patients was $4.21/day with the O-ENS and $4.86/day with a C-ENS. The cost to feed the patients with the O-ENS increased to $6.54/day when the cost of the feeding bag was included. The average amount of waste was 107 mL/feeding day with the O-ENS and 358 mL/feeding day with the C-ENS. The average cost of this waste with the O-ENS was $0.37/day and $0.55/day with C-ENS. Conclusions: The contract price of the C-EN formulas is slightly higher per mL than the price of the O-EN formulas. Additionally, the potential for waste is increased by using a one liter container versus an 8 oz can of formula. However, once the cost of the feeding bag is factored in, it is more economical for the facility to use the C-ENS. The cost savings is likely even higher once nursing time for administration of the formula is considered. Funding Disclosure: None.
Perceptions, Attitudes, Knowledge and Clinical Use of Evidence-Based Practice among U.S. Registered Dietitians - A Prospective Descriptive Pilot Study Author(s): E. A. M. Vogt,1 L. D. Byham-Gray,2 J. Parrott,2 R. Touger-Decker3; 1Doctoral Student, School of Health Related Professions, Univ. of Med. and Dentistry of New Jersey, Newark, NJ, 2Associate Professor, Nutritional Sciences, School of Health Related Professions, Univ. of Med. and Dentistry of New Jersey, Newark, NJ, 3Professor and Chair of Nutritional Sciences, School of Health Related Professions, Univ. of Med. and Dentistry of New Jersey, Newark, NJ Learning Outcome: Describe perceptions, attitudes, knowledge (PAK) and clinical use of EBP among U.S. credentialed RDs. Objective: The objective was to describe perceptions, attitudes, knowledge (PAK) and clinical use of evidence-based practice (EBP), and to investigate the relationships between PAK score and demographic characteristics and clinical use among US credentialed RDs. Methods: The study was a prospective descriptive survey using a randomized sample of 2,500 RDs in clinical practice. Inferential statistics were used for data analysis. Results: Most respondents were female (n⫽171, 96.1%), white (n⫽157, 88.2%), worked full-time (n⫽136, 76.8%) in acute care (n⫽63, 39.9%) and were members of the Academy of Nutrition and Dietetics (AND) (n⫽123, 62.1%). Most respondents had access to databases (n⫽112, 56.6%) but used evidence-based resources less than once a month (n⫽100, 52.6%). The most frequent use of the AND Evidence Analysis Library (EAL) was yearly (n⫽79, 41.4%). Main barriers to implementation were lack of access to mentors (n⫽64, 32.3%), lack of training in critical appraisal (n⫽105, 55.3%), and time constraints (n⫽70, 36.3%). Respondents considered EBP to be valuable (n⫽146, 75.3%) and relevant to their practice (n⫽135, 68.9%) and increased frequency of use of EBP (F⫽11.97, p⬍0.0001) and reading professional journals (F⫽6.34, p⬍0.0001) was associated with increased PAK score. Conclusions: Most RDs had access to databases, but used resources less than once a month. Perceptions and attitudes were higher than levels of knowledge of EBP. Increased frequency of use of resources and reading journals was significantly associated with increased ability to incorporate EBP in practice. Results suggest that education is needed to increase knowledge and appraisal skills of EBP. Funding Disclosure: None.
Costs of Traditional Recruitment Methods Favor Examination of Novel Strategies to Recruit Low-Income Women to Nutrition Education Impact Studies
Effectiveness of Exercise Equivalents and Calorie Information on Vending Machine Usage among College Students
Author(s): B. A. Lohse, K. Arnold, P. M. Wamboldt; Nutritional Sciences, The Pennsylvania State Univ., State College, PA
Author(s): C. Platkin,1 E. A. Kelvin,2 M. Yeh1; 1Nutrition, CUNY Sch. of Publ. Hlth. at Hunter Coll., New York, NY, 2Epidemiology & Biostatistics, CUNY Sch. of Publ. Hlth. at Hunter Coll., New York, NY
Learning Outcome: Examine non-personnel costs associated with recruiting low-income women to a nutrition education program. Background: Current legislative and policy environments call for evidence of impact from nutrition education interventions. Non-personnel costs to recruit low-income women to a web-based nutrition education program were examined as part of an impact assessment. Methods: About Eating, a 5-lesson, web-based module on eating behaviors was studied in low-income women using a randomized, controlled design. Traditional recruitment methods (e.g., phone, flyers, postcards) using low-income venues (e.g., WIC, career centers, discount stores) or state-supplied lists of supplemental nutrition assistance program (SNAP) participants were used. Non-personnel expenses to recruit low-income women were calculated and documented. Websites unique to recruitment strategy enabled portal entry identification to detail costing and effectiveness. Results: Estimated reach from over 5 months of recruitment effort was 19,950 and was similarly divided between the two strategies. Phone calls, flyers and postcards targeting SNAP lists recruited 64% of the sample. Of 1,010 recruited to the website, 588 were eligible; 302 completed the study. Postcards were the most expensive method to recruit from SNAP participant lists ($4.51 per recruit vs. $.20 for phone calls and $.35 for flyers printed inhouse). Final non-personnel cost to recruit 648 to the website (384 eligible) was $5.06/ person. Final cost to recruit 364 to the website from low-income venues was $3.11/person using professionally printed flyers ($2.89/recruit) and mileage ($.22/recruit). Conclusions: For low-income women, high costs associated with traditional recruitment methods may hinder nutrition intervention impact assessment. Attention to alternative recruitment methods (e.g., social media or smart phones) is suggested to effect evidencebased nutrition education. Funding Disclosure: USDA, PA SNAP-Ed (PA Nutrition Education TRACKS).
Learning Outcome: The participants will be able to describe the use of calorie labeling on vending machines. Background: Vending machines are common sources for snack food and beverages among students. Although these items are typically high in calories and low in nutritional value, vending machines offer little or no nutritional information prior to purchasing. This study tested the effect of providing some nutritional information on the vending machine display on sales of snack foods and beverages in an urban college with a young, multi-ethnic student population. Methods: Three intervention conditions were tested: calorie only, exercise equivalents (EEs) (defined as the amount of time doing particular physical activities that would be needed to burn off calories in foods) only, and calorie plus EEs. The information was displayed under each food and beverage item in the vending machines on a university campus for one, two, and two weeks, respectively. Washout periods were introduced between conditions. Mean number of food and beverage items sold within categories of calories (low, medium & high) and type of item (chips, candy, water, soda, coffee drinks, etc.) during each of the conditions was calculated and compared to baseline using the Mann Whitney U test to assess statistical significance at ␣⫽0.05. Results and Conclusion: No significant differences in mean number of items sold were observed between the three intervention conditions and baseline by calorie or snack/drink category. Our results suggest that calorie and EEs labeling information on vending machines may not change point of purchase behaviors among college students. Future studies need to investigate nutritional information displays in different populations and different settings. Funding Disclosure: None.
A-64
JOURNAL OF THE ACADEMY OF NUTRITION AND DIETETICS
September 2012 Suppl 3—Abstracts Volume 112 Number 9