- Email: [email protected]
Cultural Competence Across the Continuum of a Healthcare Organization
SUNDAY, OCTOBER 4
Poster Session: Professional Skills; Nutrition Assessment; Medical Nutrition Therapy Getting Better at Developing the Best: Predictors of Training Success for Military Graduate Program in Nutrition Students
The Relationship between Fruit and Vegetable Intake and Perceived Health Status by Ethnicity
Author(s): H.L. Clark1, R.E. Cole2, L.K. Funderburk3; 1US Military - Baylor Graduate Program in Nutrition, USAF, Wilford Hall Medical Center, 59th MDW, TX, 2US Army Res. Inst. of Environmental Med., Natick, MA, 3US Military - Baylor Graduate Program in Nutrition, US Army, AMEDD C&S, TX
Author(s): B.L. Ellcessor (Metzler), A. Haroldson; Family and Consumer Sciences, Ball State Univ., Muncie, IN
Learning Outcome: Describe student characteristics associated with success for GPN students; and apply those findings to graduate or undergraduate program or curriculum development; student mentorship or counseling; and to program evaluation. Background: The US Military-Baylor Graduate Program in Nutrition (GPN) has a 10% 7-year attrition rate. Evidence based selection criteria for dietetics MS programs do not exist; nor does descriptive information of students most likely to succeed. Objective: Identify GPN student characteristics predicting program success or failure in the didactic (Phase 1) and clinical (Phase 2, internship) phases. Design: Retrospective logistic regression using demographic, academic and nonacademic data extracted from existing files. Participants/Setting: 72 GPN students enrolled, 2006 - 2013, in San Antonio Texas. Main Outcome Measures: Categorization by Optimal Performance (no course grade <3.0, no internship rotation delays, first attempt pass RD exam) and GPN Completion. Results: The average GPN student is female (64%), Army (94%), single (64%) with a mean age of 26 years. The mean Quantitative, Verbal and Written GRE scores were 149, 153 and 4.2 points, respectively. Odds of GPN failure increased by 1.3% with each year increase in age at program start (p¼0.033). Optimal Performance was associated with a shorter time between BS degree and GPN (p¼0.016), higher undergraduate GPA (p¼0.013), having taken undergraduate Anatomy &Physiology (p¼0.037), and absence of Phase 1 personal challenges (p <0.001). Odds of attaining Optimal Performance decreased by w7.5% when challenges were experienced (p<0.05).
Learning Outcome: Participants will recognize that the relationship between fruit and vegetable intake and perceived health status varies by ethnicity. This secondary analysis sought to determine if the amount of fruit and vegetable intake per day was associated with the perceived overall health status among adults and to examine racial/ethnic differences in this relationship. Data was used from the 2009 Behavioral Risk Factor Surveillance System survey, which is collected by the Centers for Disease Control and Prevention, and made up of a nationally representative sample. Chi Square statistical analysis was conducted. For the total sample (n¼408,808), the number of fruit and vegetable servings per day was associated with perceived overall health status (p < 0.001). Of those who reported excellent health, 28.5% reported > 5 servings per day and 15.3% reported 2 servings per day compared to those who reported poor health (13.1% and 27.2% respectively). White (p < 0.001), Black (p < 0.001), Asian (p ¼ 0.007), and Hispanic (p < 0.001) participants all exhibited a statistically significant relationship in which a higher percentage of individuals reported >5 servings per day and excellent health compared to poor health, and a higher percentage of individuals reported 2 servings per day and poor health compared to excellent health. There was not a significant relationship for Native Hawaiian or Pacific Islanders, American Indians, or the Other race category. The findings demonstrate that there may be cultural differences in the perception of health status based on fruit and vegetable intake and nutrition practitioners should be aware of these possible differences. Further research is needed in this area to better understand this relationship. Funding Disclosure: None
Conclusions: Modification of selection criteria may not result in reduced attrition. Identification and mitigation of potential student weaknesses promotes student success and supports stewardship of government resources. Intentional development of students with optimal characteristics will strengthen the profession of dietetics during the transition to an MS requirement. Funding Disclosure: None
Cultural Competence Across the Continuum of a Healthcare Organization 1
2
1
Author(s): K. Haubrick , H. Huye ; Health and Human Performance, Univ. of Houston, Houston, TX, 2Nutrition and Food Systems, Univ. of Southern Mississippi, Hattiesburg, MS Learning Outcome: After this presentation, the learner will be able to describe a process to evaluate an organization for cultural competence. Training of cultural competence is one key strategy to reducing health and health care disparities, improving communication, and increasing patient satisfaction. The objective of this study was to evaluate a health care organization’s attitudes and beliefs related to cultural competence. A Likert-type scale questionnaire was developed based on the Cultural Competence Continuum by Glover to collect data. Questionnaires were distributed electronically. Participants included all employees (n¼1475) of a large healthcare organization. Frequency distributions were obtained and ANOVA testing was completed. A total of 172 employees returned the questionnaire (response rate ¼ 11.6%). Most of the participants worked in support/operations departments of the hospital (46.9%), were 45 years of age and older (60%), and predominately non-Hispanic (57.2%) with employment of zero to ten years (62.8%). Cronbach’s a for the 22 items on the questionnaire was .948. Mean scores indicated participants “disagreed” with cultural destructiveness (1.95 0.79), cultural incapacity (2.23 0.83), and cultural blindness (2.63 0.77) items and “agreed” with items related to cultural pre-competence (3.46 0-.97), cultural competence (3.72 0.86), and cultural proficiency (4.02 0.78). ANOVA testing revealed non-significant results when comparing composite scores to length of employment, age, and employee classification. Employees perceived their attitudes and beliefs as being culturally competent and proficient. Since the response rate was lower than desired, developing a cultural competence-training module for key employees and for continuing education for employees who already perceive themselves as culturally competent may benefit the organization. Funding Disclosure: None
Effects of a Culturally-Relevant Educational Intervention on College Retention and Self-Efficacy for Healthy Choices among American Indian College Students Author(s): J.F. Keith1, S.N. Stastny1, A. Brunt1, W. Agnew2, P. Aune2; 1Health, Nutrition & Exercise Sciences, North Dakota State Univ., Fargo, ND, 2United Tribes Technical Coll., Bismarck, ND Learning Outcome: The participant will be able to describe a culturally relevant educational program and its effects on barriers to education and healthy choices for American Indian college students. American Indians/Alaskan Natives (AI/AN) have the lowest rates of college retention and graduation in the U.S. Additionally, AI/AN face health disparities including higher rates of obesity/overweight and Type 2 diabetes. The study purpose was to explore the effects of a culturally relevant life skills curriculum delivered in a family-style environment on self-efficacy, healthy choices, and college retention in tribal college students during 1 year. A nonexperimental cohort design using mixed methods (quantitative and qualitative) was utilized for the study. Participants in the study (full study completion, n¼6; initial participants, n¼19) were purposively sampled newly enrolled, academically under-prepared tribal college students. Participant demographics included various tribal affiliations, ages, and number of dependents. Research instruments included pre- and post-questionnaires and pre- and post-telephone interviews. General self-efficacy did not increase significantly, nutrition knowledge increased but not significantly, and nutrition attitudes and beliefs were not different between pre- and post-intervention. Dietary analysis reflected improved intake, however none of the participants met dietary recommendations for any food group. Eating behaviors such as eating in front of the TV decreased. Retention of students was 29% (fall semester) and 42% (spring semester). However, semester to semester retention of completers was 100%. Qualitative analysis revealed a variety of themes and subthemes related to food and healthy choices. Addressing self-efficacy and perception of capabilities regarding making healthy food choices can help AI/AN students feel more capable of success and impact the quality of their diet. However, challenges remain to college retention and improving dietary intake to meet recommendations. Funding Disclosure: USDA National Institute of Food & Agriculture
September 2015 Suppl 2—Abstracts Volume 115 Number 9
JOURNAL OF THE ACADEMY OF NUTRITION AND DIETETICS
A-9
Poster Session: Professional Skills; Nutrition Assessment; Medical Nutrition Therapy Getting Better at Developing the Best: Predictors of Training Success for Military Graduate Program in Nutrition Students
The Relationship between Fruit and Vegetable Intake and Perceived Health Status by Ethnicity
Author(s): H.L. Clark1, R.E. Cole2, L.K. Funderburk3; 1US Military - Baylor Graduate Program in Nutrition, USAF, Wilford Hall Medical Center, 59th MDW, TX, 2US Army Res. Inst. of Environmental Med., Natick, MA, 3US Military - Baylor Graduate Program in Nutrition, US Army, AMEDD C&S, TX
Author(s): B.L. Ellcessor (Metzler), A. Haroldson; Family and Consumer Sciences, Ball State Univ., Muncie, IN
Learning Outcome: Describe student characteristics associated with success for GPN students; and apply those findings to graduate or undergraduate program or curriculum development; student mentorship or counseling; and to program evaluation. Background: The US Military-Baylor Graduate Program in Nutrition (GPN) has a 10% 7-year attrition rate. Evidence based selection criteria for dietetics MS programs do not exist; nor does descriptive information of students most likely to succeed. Objective: Identify GPN student characteristics predicting program success or failure in the didactic (Phase 1) and clinical (Phase 2, internship) phases. Design: Retrospective logistic regression using demographic, academic and nonacademic data extracted from existing files. Participants/Setting: 72 GPN students enrolled, 2006 - 2013, in San Antonio Texas. Main Outcome Measures: Categorization by Optimal Performance (no course grade <3.0, no internship rotation delays, first attempt pass RD exam) and GPN Completion. Results: The average GPN student is female (64%), Army (94%), single (64%) with a mean age of 26 years. The mean Quantitative, Verbal and Written GRE scores were 149, 153 and 4.2 points, respectively. Odds of GPN failure increased by 1.3% with each year increase in age at program start (p¼0.033). Optimal Performance was associated with a shorter time between BS degree and GPN (p¼0.016), higher undergraduate GPA (p¼0.013), having taken undergraduate Anatomy &Physiology (p¼0.037), and absence of Phase 1 personal challenges (p <0.001). Odds of attaining Optimal Performance decreased by w7.5% when challenges were experienced (p<0.05).
Learning Outcome: Participants will recognize that the relationship between fruit and vegetable intake and perceived health status varies by ethnicity. This secondary analysis sought to determine if the amount of fruit and vegetable intake per day was associated with the perceived overall health status among adults and to examine racial/ethnic differences in this relationship. Data was used from the 2009 Behavioral Risk Factor Surveillance System survey, which is collected by the Centers for Disease Control and Prevention, and made up of a nationally representative sample. Chi Square statistical analysis was conducted. For the total sample (n¼408,808), the number of fruit and vegetable servings per day was associated with perceived overall health status (p < 0.001). Of those who reported excellent health, 28.5% reported > 5 servings per day and 15.3% reported 2 servings per day compared to those who reported poor health (13.1% and 27.2% respectively). White (p < 0.001), Black (p < 0.001), Asian (p ¼ 0.007), and Hispanic (p < 0.001) participants all exhibited a statistically significant relationship in which a higher percentage of individuals reported >5 servings per day and excellent health compared to poor health, and a higher percentage of individuals reported 2 servings per day and poor health compared to excellent health. There was not a significant relationship for Native Hawaiian or Pacific Islanders, American Indians, or the Other race category. The findings demonstrate that there may be cultural differences in the perception of health status based on fruit and vegetable intake and nutrition practitioners should be aware of these possible differences. Further research is needed in this area to better understand this relationship. Funding Disclosure: None
Conclusions: Modification of selection criteria may not result in reduced attrition. Identification and mitigation of potential student weaknesses promotes student success and supports stewardship of government resources. Intentional development of students with optimal characteristics will strengthen the profession of dietetics during the transition to an MS requirement. Funding Disclosure: None
Cultural Competence Across the Continuum of a Healthcare Organization 1
2
1
Author(s): K. Haubrick , H. Huye ; Health and Human Performance, Univ. of Houston, Houston, TX, 2Nutrition and Food Systems, Univ. of Southern Mississippi, Hattiesburg, MS Learning Outcome: After this presentation, the learner will be able to describe a process to evaluate an organization for cultural competence. Training of cultural competence is one key strategy to reducing health and health care disparities, improving communication, and increasing patient satisfaction. The objective of this study was to evaluate a health care organization’s attitudes and beliefs related to cultural competence. A Likert-type scale questionnaire was developed based on the Cultural Competence Continuum by Glover to collect data. Questionnaires were distributed electronically. Participants included all employees (n¼1475) of a large healthcare organization. Frequency distributions were obtained and ANOVA testing was completed. A total of 172 employees returned the questionnaire (response rate ¼ 11.6%). Most of the participants worked in support/operations departments of the hospital (46.9%), were 45 years of age and older (60%), and predominately non-Hispanic (57.2%) with employment of zero to ten years (62.8%). Cronbach’s a for the 22 items on the questionnaire was .948. Mean scores indicated participants “disagreed” with cultural destructiveness (1.95 0.79), cultural incapacity (2.23 0.83), and cultural blindness (2.63 0.77) items and “agreed” with items related to cultural pre-competence (3.46 0-.97), cultural competence (3.72 0.86), and cultural proficiency (4.02 0.78). ANOVA testing revealed non-significant results when comparing composite scores to length of employment, age, and employee classification. Employees perceived their attitudes and beliefs as being culturally competent and proficient. Since the response rate was lower than desired, developing a cultural competence-training module for key employees and for continuing education for employees who already perceive themselves as culturally competent may benefit the organization. Funding Disclosure: None
Effects of a Culturally-Relevant Educational Intervention on College Retention and Self-Efficacy for Healthy Choices among American Indian College Students Author(s): J.F. Keith1, S.N. Stastny1, A. Brunt1, W. Agnew2, P. Aune2; 1Health, Nutrition & Exercise Sciences, North Dakota State Univ., Fargo, ND, 2United Tribes Technical Coll., Bismarck, ND Learning Outcome: The participant will be able to describe a culturally relevant educational program and its effects on barriers to education and healthy choices for American Indian college students. American Indians/Alaskan Natives (AI/AN) have the lowest rates of college retention and graduation in the U.S. Additionally, AI/AN face health disparities including higher rates of obesity/overweight and Type 2 diabetes. The study purpose was to explore the effects of a culturally relevant life skills curriculum delivered in a family-style environment on self-efficacy, healthy choices, and college retention in tribal college students during 1 year. A nonexperimental cohort design using mixed methods (quantitative and qualitative) was utilized for the study. Participants in the study (full study completion, n¼6; initial participants, n¼19) were purposively sampled newly enrolled, academically under-prepared tribal college students. Participant demographics included various tribal affiliations, ages, and number of dependents. Research instruments included pre- and post-questionnaires and pre- and post-telephone interviews. General self-efficacy did not increase significantly, nutrition knowledge increased but not significantly, and nutrition attitudes and beliefs were not different between pre- and post-intervention. Dietary analysis reflected improved intake, however none of the participants met dietary recommendations for any food group. Eating behaviors such as eating in front of the TV decreased. Retention of students was 29% (fall semester) and 42% (spring semester). However, semester to semester retention of completers was 100%. Qualitative analysis revealed a variety of themes and subthemes related to food and healthy choices. Addressing self-efficacy and perception of capabilities regarding making healthy food choices can help AI/AN students feel more capable of success and impact the quality of their diet. However, challenges remain to college retention and improving dietary intake to meet recommendations. Funding Disclosure: USDA National Institute of Food & Agriculture
September 2015 Suppl 2—Abstracts Volume 115 Number 9
JOURNAL OF THE ACADEMY OF NUTRITION AND DIETETICS
A-9