Gropper, Sareen

Type 2 Diabetes Mellitus is a fast-growing global problem with vast social, health, and economic consequences. Approximately 382 million people worldwide have been diagnosed with the disease, and this number is expected to increase by 55% by 2035. Diabetes is the seventh leading cause of death in the United States. More than 34 million Americans have diabetes, including 2.4 million cases in Florida. The goal of this project was to improve the effectiveness of diabetes self-management information on selection of healthy carbohydrate-containing foods and blood glucose monitoring in a group of adults with uncontrolled type 2 diabetes receiving care in a primary care setting. Education from the National Diabetes Education Program using the 4 Steps to Manage Your Diabetes for Life along with follow up phone calls, a pre- and-post Diabetes Self-Management Questionnaire (DSMQ) were administered to ten participants (6 females and 4 males 64-85 years of age) at a primary care site. Descriptive statistics and paired sample T-tests were used to analyze data on the DSMQ pre-and post-intervention. Results were statistically significant and showed that selection of healthy carbohydrate-containing foods and blood glucose monitoring increased in all ten (100%) participants from pre to post intervention. Data analysis showed that the pre-mean selection of healthy carbohydrate-containing foods was 5.3 out of 12 (SD, .675) and a post mean of 10.4 out of 12 (SD, .843) [t(9) = 16, p<.001. In addition, data analysis showed the mean of blood glucose monitoring increased from 4.4 out of 15 (SD, 1.075) on the pre-test to 12.3 out of 15 (SD, .675) on the post-test [t(9) = 18, p<.001]. The increase in the scores reflect the participants’ ability to choose foods that are congruent with healthy eating habits. It is strongly recommended that the 4 Steps to Manage Your Diabetes for Life booklet be used in practice to improve patients’ knowledge and self-management behaviors regarding diabetes.

According to Kalra, Jena, & Yeravdekar (2018), type 2 diabetes mellitus (T2DM) is considered a life style disease. It is a progressive and a chronic illness, largely caused by obesity and a lack of exercise. If left untreated or poorly controlled, this disease can lead to debilitating complications and premature death. The aim of this quality improvement Doctor of Nursing Practice (DNP) project was to improve dietary behavior in adults with T2DM. The overall goal of the project was to improve diabetes outcomes through the implementation of evidence-based dietary information using a diabetes text-messaging program (mobile health technology). The project revealed that the implementation of telehealth measures, e,g, text messaging education and resource information on a weekly basis in between office visits, was beneficial to adult individuals with T2DM, improving health and dietary behavioral choices.

The loss of muscle (mass, strength, and function) occurs in many individuals in their 40’s and begins to accelerate after 50 years of age resulting from multiple understood mechanisms. While many factors are thought to contribute to the changes that are observed in muscle with aging, one significant, yet modifiable factor is dietary protein intake. This study proposed to improve dietary protein intake in a group of middle-aged women living in South Florida over a 12-week period using individualized per-meal protein prescriptions (1.2 g protein/kg body weight evenly distributed for all three meals) provided by a Registered Dietitian, followed by weekly diet coaching from a Nurse Practitioner (coach). Aims included: (1) An examination of the effect of diet coaching on protein intake, nutrition knowledge, muscle mass, strength, and function and (2) An understanding of how diet coaching sessions help in the process of making dietary changes. A parallel mixed methods research design allowed for a synthesis of inferences from each aim resulting in a meta-inference highlighting interdisciplinary collaboration.

Although there are effective medications to lower blood lipid levels, studies show that comprehensive nutritional counseling provides more effective and lasting results on blood lipids in comparison to standard of care with solely pharmacological intervention (Sialvera et al., 2017). Changes in diet such as reducing saturated fat and increasing fiber intake, are two of many alterations that have been proven to be successful and have consequently helped reduce the relative risk of ASCVD (Masana et al., 2017). The purpose of this quality improvement project was to direct participants with hyperlipidemia in the management of the condition using evidence-based nutrition guidelines and recommendations. The approach targeted underserved adults newly diagnosed with hyperlipidemia and seeking care at Broward Community and Family Health Center located in southeastern Florida. The community member, Mr. Laine, communicated that greater information on the dietary management of hyperlipidemia is beneficial to those who are determined to make changes to improve diet and lower blood cholesterol levels (S. Laine, oral communication, January 2019). Based on previous clinic data, there was a need for greater emphasis on nutritional education to assist clients in the control of hyperlipidemia.

Nutrition can play a significant role in health conditions especially diseases such as hypertension. Nutritional intake can positively or negatively affect blood pressure, and many authors have found impactful changes when proper diet is adhered. Individuals who follow DASH diet guidelines have especially made positive changes in blood pressure. This quality improvement project examined if DASH diet-based nutrition education in adults with hypertension improved dietary intakes of vegetables and fruits, and reduced sodium intake and blood pressure. This manuscript addresses this concern using current evidence by describing the steps taken in a quality improvement project at Community Health of South Florida, Inc. of South Florida. Results, evaluation, and recommendations are also included.

Obesity/overweight affects one-third of U.S. children. While the causes are multifactorial, increased consumption of away-from-home (versus at-home) meals has been shown to contribute to higher calorie and fat intakes. This study’s objective was to examine food/beverage provisions at faith-based children/youth events. Direct observation methodology was used for data collection from 10 churches (two to five observations/church) in Southeast FL. Food/beverages served on 31 occasions (26 meals, 5 non-meals) were documented/analyzed for nutrient content (Food Processor software). Main dishes were mostly pizza and pasta-based casseroles (45%) with white bread/rolls (side dish) (27%). Vegetables (non-potato) were served twice, and fruits five times but seldom eaten. Provided beverages were primarily sugar-sweetened (87%). Desserts/snack-foods were served at 55% of events. Foods were generally high in fat and/or sugar and contributed little to needed fruit / vegetable servings. These findings provide nutritional evidence to initiate dialogues within faith-communities about healthier food provisions at children/youth-related activities.