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Implementation of a Nutrition Assessment Laboratory as a Component of a University Worksite Wellness Program: A Model Immersive Learning Experience for Master’s Candidates in Nutrition and Dietetics
MONDAY, OCTOBER 20
Short Oral Presentations: Professional Skills; Nutrition Assessment; Medical Nutrition Therapy Part 2 Minority Health Perceptions in the Lower Mississippi Delta: A Grounded Theory Study Using PhotoVoice Methodology
Factors Associated with Weight-Loss Success Following the Laparoscopic Adjustable Gastric Banding Procedure
Author(s): S.B. Sims, H.F. Huye, A.S. Landry, C. Connell; Nutrition and Food Systems, The Univ. of Southern Mississippi, Hattiesburg, MS
Author(s): J.M. Emad1, S. Butler1, K. Cephas1, S.N. Hester1, I.A. Jorud1, A. Masinelli1, G. Naseri1, E.C. Radlowski1, S. Thorum1, K. Lamar2, K. Rohrscheib2, S. Rohrscheib2, S.M. Donovan1; 1 Graduate Dietetic Internship, Food Science and Human Nutrition, Univ. of Illinois, Urbana, Urbana, IL, 2Illinois Bariatric Ctr., Champaign, IL
Learning Outcome: Participants will learn about the cultural context and health perceptions of minority women in the Lower Mississippi Delta for development of future community programs. The Lower Mississippi Delta (LMD) region has a large minority population with concentrations of poverty and health disparities much higher than other parts of the country. The purpose of this project was to assess the health perceptions of minority women living in the LMD using a combination of PhotoVoice and journal reflections. After an initial interview, 10 women were provided digital cameras and asked to take photographs that reflected the health of their communities. A final interview was conducted to glean more information from the women about their photographs. Seven Black women and two Latinas completed the study. The photographs, journal reflections, and transcripts collected during the study were analyzed using grounded theory principles. The core category identified by the researchers was Hope for a Healthy Future. The participants were optimistic about the future of the LMD and were striving to attain the Ideal Healthy Community, which consisted of five pillars: nutrition education, physical activity, access to healthy food, safety and cleanliness, and positive role models. Participants identified barriers and facilitators to each of these pillars in their communities. The primary facilitator to health was a deep connection to family, church, and community. The primary barrier to health was resistance to change among community members. Overall, striving towards the Ideal Healthy Community was a source of participants’ Hope for a Healthy Future. Findings from this study can be used to further understand the health-related needs of minorities in the LMD and to advocate for positive change in LMD communities. Funding Disclosure: Committee on Services and Resources for Women, The University of Southern Mississippi
Implementation of a Nutrition Assessment Laboratory as a Component of a University Worksite Wellness Program: A Model Immersive Learning Experience for Master’s Candidates in Nutrition and Dietetics Author(s): C.A. Friesen, B.M. Cotten, R.R. Murr; Family and Consumer Sciences, Ball State University, Muncie, IN Learning Outcome: The learner will be able to describe the programs and services provided by the Nutrition Assessment Laboratory. The purpose of this presentation is to describe the development and implementation of a Nutrition Assessment Laboratory (NAL) as an essential component of a university worksite wellness program. The NAL helps university employees/family members/significant others take positive steps toward improving their health through nutrition screenings, counseling, and education. The lab, open 20 hours weekly, is staffed by an RD/RD-eligible graduate student in Nutrition and Dietetics who is supervised by a Registered Dietitian (RD). Free screenings and services offered by the NAL include: blood lipid panel (total cholesterol, HDL, LDL, triglycerides), blood glucose, blood pressure, BMI assessment, body fat analysis, osteoporosis risk assessment, resting energy expenditure, diet analysis, individual nutrition counseling, and group nutrition education. Clients receive individualized counseling based on their screening results. Follow-up with a physician is recommended for all clients with abnormal screening results. Employees and spouses insured through the university are incentivized to participate in all Working Well programs, including the monthly “Lunch-n-Learn” nutrition presentations. Individuals can obtain answers to their nutrition questions by connecting to the “Ask An RD” website. All answers written by the graduate assistant are reviewed by a registered dietitian. To date, the NAL has seen over 580 clients. The NAL is jointly funded through the university, Working Well, and the Department of Family and Consumer Sciences. The NAL can serve as a model for other universities as it offers an outstanding supervised experience for a master’s degree graduate student, while providing a much-needed service to all university faculty, staff and family members. Funding Disclosure: Ball State University Working Well budget
Learning Outcome: Understand the factors contributing to weight loss success following lap band surgery. Background: Obesity is a risk factor for a wide variety of conditions, including type II diabetes and cardiovascular disease. The laparoscopic adjustable gastric banding procedure (LAGB), a bariatric surgical procedure used to treat obesity and reduce comorbidities, has had variable success. The goal of this study was to identify factors associated with weight-loss success post-operative LAGB. Methods: Outpatients (n¼48) from the Illinois Bariatric Center, who were two or more months post-surgery, were recruited by telephone. Each participant was asked to complete the following surveys: 1) Demographic and Health History, (2) 3-Day Dietary Intake Recall, (3) Dutch Eating Behavior Questionnaire, (4) Block Food Frequency Questionnaire (BFFQ) and (5) International Physical Activity Questionnaire (IPAQ). Participants were asked to complete BFFQ and IPAQ twice: reflecting pre-surgical and current behavior. Percent excess weight loss (%EWL) was used as an indicator of success. Results: The mean %EWL was 3818, while the range was from 4 to 76%. Data was analyzed in SAS using a significance level of p<0.05. Stepwise multivariate linear regression revealed 7 factors (out of 33) to be statistically significant predictors of EWL: age (p<0.0001), race (p¼0.004), education level (p¼0.013), pre-surgery Metabolic Equivalent of Task minutes (p¼0.0003), eating when depressed or discouraged (p¼0.014), eating when irritated (p¼0.008), and eating when there is nothing to do (p¼0.004). Conclusion: These factors may be helpful in identifying patients who are good candidates for LAGB as well as in developing a directed approach to pre and postoperative counseling. Funding Disclosure: University of Illinois Research Board
Measuring the Impact of a Revised Bariatric Pre-operative Weight Loss Curriculum Author(s): K.A. Isom, L. Andromalos, P. Davidson, M. Robinson; Center for Metabolic and Bariatric Surgery, Brigham and Women’s Hospital, Boston, MA Learning Outcome: Determine efficacy of revised pre-operative weight loss curriculum for bariatric surgery patients. Relevance: There are no standards for pre-operative weight loss (POWL) programs and education prior to bariatric surgery. Despite insurancemandated participation in 6-month POWL programs, evidence is inconclusive as to its efficacy in generating weight loss and improving post-surgical outcomes. Priority: In a group POWL program setting at an urban teaching hospital, only 52.4% of 395 patients lost weight from 2008 to 2011. To improve the quality of the POWL program, feedback was elicited from both patients and clinicians. Sixty-three POWL patients completed evaluations identifying the most helpful POWL topics and 13 clinicians identified post-operative complications that could be avoided with pre-operative education. In July 2013, a new POWL curriculum was implemented based on this feedback. The new curriculum emphasizes bariatric nutrition and behavior concepts linked to positive long-term post-operative outcomes including hydration, protein needs, post-operative complications, and general weight loss strategies. Patients complete pre- and post-POWL program quizzes to assess comprehension of the six-month curriculum’s core concepts. Results: The average pre-POWL program quiz score was 6.05 out of 11 (n¼38). Patients completing post-POWL quizzes (n¼10) scored an average of 9.8 out of 11. Nine of 10 patients lost weight [(meanstandard deviation (range)], with an average weight loss of 9.111.84 (1.5-39.9) pounds and 3.0% change in weight. Synthesis: Preliminary findings suggest that relevant nutrition and behavior education in a POWL curriculum improves patient knowledge and can lead to better POWL outcomes. Future data will be collected to assess POWL curriculum impact on post-surgical outcomes. Funding Disclosure: None
September 2014 Suppl 2—Abstracts Volume 114 Number 9
JOURNAL OF THE ACADEMY OF NUTRITION AND DIETETICS
A-45
Short Oral Presentations: Professional Skills; Nutrition Assessment; Medical Nutrition Therapy Part 2 Minority Health Perceptions in the Lower Mississippi Delta: A Grounded Theory Study Using PhotoVoice Methodology
Factors Associated with Weight-Loss Success Following the Laparoscopic Adjustable Gastric Banding Procedure
Author(s): S.B. Sims, H.F. Huye, A.S. Landry, C. Connell; Nutrition and Food Systems, The Univ. of Southern Mississippi, Hattiesburg, MS
Author(s): J.M. Emad1, S. Butler1, K. Cephas1, S.N. Hester1, I.A. Jorud1, A. Masinelli1, G. Naseri1, E.C. Radlowski1, S. Thorum1, K. Lamar2, K. Rohrscheib2, S. Rohrscheib2, S.M. Donovan1; 1 Graduate Dietetic Internship, Food Science and Human Nutrition, Univ. of Illinois, Urbana, Urbana, IL, 2Illinois Bariatric Ctr., Champaign, IL
Learning Outcome: Participants will learn about the cultural context and health perceptions of minority women in the Lower Mississippi Delta for development of future community programs. The Lower Mississippi Delta (LMD) region has a large minority population with concentrations of poverty and health disparities much higher than other parts of the country. The purpose of this project was to assess the health perceptions of minority women living in the LMD using a combination of PhotoVoice and journal reflections. After an initial interview, 10 women were provided digital cameras and asked to take photographs that reflected the health of their communities. A final interview was conducted to glean more information from the women about their photographs. Seven Black women and two Latinas completed the study. The photographs, journal reflections, and transcripts collected during the study were analyzed using grounded theory principles. The core category identified by the researchers was Hope for a Healthy Future. The participants were optimistic about the future of the LMD and were striving to attain the Ideal Healthy Community, which consisted of five pillars: nutrition education, physical activity, access to healthy food, safety and cleanliness, and positive role models. Participants identified barriers and facilitators to each of these pillars in their communities. The primary facilitator to health was a deep connection to family, church, and community. The primary barrier to health was resistance to change among community members. Overall, striving towards the Ideal Healthy Community was a source of participants’ Hope for a Healthy Future. Findings from this study can be used to further understand the health-related needs of minorities in the LMD and to advocate for positive change in LMD communities. Funding Disclosure: Committee on Services and Resources for Women, The University of Southern Mississippi
Implementation of a Nutrition Assessment Laboratory as a Component of a University Worksite Wellness Program: A Model Immersive Learning Experience for Master’s Candidates in Nutrition and Dietetics Author(s): C.A. Friesen, B.M. Cotten, R.R. Murr; Family and Consumer Sciences, Ball State University, Muncie, IN Learning Outcome: The learner will be able to describe the programs and services provided by the Nutrition Assessment Laboratory. The purpose of this presentation is to describe the development and implementation of a Nutrition Assessment Laboratory (NAL) as an essential component of a university worksite wellness program. The NAL helps university employees/family members/significant others take positive steps toward improving their health through nutrition screenings, counseling, and education. The lab, open 20 hours weekly, is staffed by an RD/RD-eligible graduate student in Nutrition and Dietetics who is supervised by a Registered Dietitian (RD). Free screenings and services offered by the NAL include: blood lipid panel (total cholesterol, HDL, LDL, triglycerides), blood glucose, blood pressure, BMI assessment, body fat analysis, osteoporosis risk assessment, resting energy expenditure, diet analysis, individual nutrition counseling, and group nutrition education. Clients receive individualized counseling based on their screening results. Follow-up with a physician is recommended for all clients with abnormal screening results. Employees and spouses insured through the university are incentivized to participate in all Working Well programs, including the monthly “Lunch-n-Learn” nutrition presentations. Individuals can obtain answers to their nutrition questions by connecting to the “Ask An RD” website. All answers written by the graduate assistant are reviewed by a registered dietitian. To date, the NAL has seen over 580 clients. The NAL is jointly funded through the university, Working Well, and the Department of Family and Consumer Sciences. The NAL can serve as a model for other universities as it offers an outstanding supervised experience for a master’s degree graduate student, while providing a much-needed service to all university faculty, staff and family members. Funding Disclosure: Ball State University Working Well budget
Learning Outcome: Understand the factors contributing to weight loss success following lap band surgery. Background: Obesity is a risk factor for a wide variety of conditions, including type II diabetes and cardiovascular disease. The laparoscopic adjustable gastric banding procedure (LAGB), a bariatric surgical procedure used to treat obesity and reduce comorbidities, has had variable success. The goal of this study was to identify factors associated with weight-loss success post-operative LAGB. Methods: Outpatients (n¼48) from the Illinois Bariatric Center, who were two or more months post-surgery, were recruited by telephone. Each participant was asked to complete the following surveys: 1) Demographic and Health History, (2) 3-Day Dietary Intake Recall, (3) Dutch Eating Behavior Questionnaire, (4) Block Food Frequency Questionnaire (BFFQ) and (5) International Physical Activity Questionnaire (IPAQ). Participants were asked to complete BFFQ and IPAQ twice: reflecting pre-surgical and current behavior. Percent excess weight loss (%EWL) was used as an indicator of success. Results: The mean %EWL was 3818, while the range was from 4 to 76%. Data was analyzed in SAS using a significance level of p<0.05. Stepwise multivariate linear regression revealed 7 factors (out of 33) to be statistically significant predictors of EWL: age (p<0.0001), race (p¼0.004), education level (p¼0.013), pre-surgery Metabolic Equivalent of Task minutes (p¼0.0003), eating when depressed or discouraged (p¼0.014), eating when irritated (p¼0.008), and eating when there is nothing to do (p¼0.004). Conclusion: These factors may be helpful in identifying patients who are good candidates for LAGB as well as in developing a directed approach to pre and postoperative counseling. Funding Disclosure: University of Illinois Research Board
Measuring the Impact of a Revised Bariatric Pre-operative Weight Loss Curriculum Author(s): K.A. Isom, L. Andromalos, P. Davidson, M. Robinson; Center for Metabolic and Bariatric Surgery, Brigham and Women’s Hospital, Boston, MA Learning Outcome: Determine efficacy of revised pre-operative weight loss curriculum for bariatric surgery patients. Relevance: There are no standards for pre-operative weight loss (POWL) programs and education prior to bariatric surgery. Despite insurancemandated participation in 6-month POWL programs, evidence is inconclusive as to its efficacy in generating weight loss and improving post-surgical outcomes. Priority: In a group POWL program setting at an urban teaching hospital, only 52.4% of 395 patients lost weight from 2008 to 2011. To improve the quality of the POWL program, feedback was elicited from both patients and clinicians. Sixty-three POWL patients completed evaluations identifying the most helpful POWL topics and 13 clinicians identified post-operative complications that could be avoided with pre-operative education. In July 2013, a new POWL curriculum was implemented based on this feedback. The new curriculum emphasizes bariatric nutrition and behavior concepts linked to positive long-term post-operative outcomes including hydration, protein needs, post-operative complications, and general weight loss strategies. Patients complete pre- and post-POWL program quizzes to assess comprehension of the six-month curriculum’s core concepts. Results: The average pre-POWL program quiz score was 6.05 out of 11 (n¼38). Patients completing post-POWL quizzes (n¼10) scored an average of 9.8 out of 11. Nine of 10 patients lost weight [(meanstandard deviation (range)], with an average weight loss of 9.111.84 (1.5-39.9) pounds and 3.0% change in weight. Synthesis: Preliminary findings suggest that relevant nutrition and behavior education in a POWL curriculum improves patient knowledge and can lead to better POWL outcomes. Future data will be collected to assess POWL curriculum impact on post-surgical outcomes. Funding Disclosure: None
September 2014 Suppl 2—Abstracts Volume 114 Number 9
JOURNAL OF THE ACADEMY OF NUTRITION AND DIETETICS
A-45