Fluent Essays

Interventions to enhance adherence to dietary advice for preventing and managing chronic diseases in adults Sophie Desroches1,2, Annie Lapointe1,2, Stéphane Ratté1, Karine Gravel2, France Légaré3, and Stéphane Turcotte1 1Centre de recherche du Centre hospitalier universitaire de Québec (CHUQ), St-François d’Assise Hôpital, Québec, Canada 2Département des sciences des aliments et de nutrition, Université Laval, Québec, Canada 3Département de médecine familiale et d’urgence, Université Laval, Québec, Canada Abstract Background—It has been recognized that poor adherence can be a serious risk to the health and wellbeing of patients, and greater adherence to dietary advice is a critical component in preventing and managing chronic diseases. Objectives—To assess the effects of interventions for enhancing adherence to dietary advice for preventing and managing chronic diseases in adults. Search methods—We searched the following electronic databases up to 29 September 2010: The Cochrane Library (issue 9 2010), PubMed, EMBASE (Embase.com), CINAHL (Ebsco) and PsycINFO (PsycNET) with no language restrictions. We also reviewed: a) recent years of relevant conferences, symposium and colloquium proceedings and abstracts; b) web-based registries of clinical trials; and c) the bibliographies of included studies. Selection criteria—We included randomized controlled trials that evaluated interventions enhancing adherence to dietary advice for preventing and managing chronic diseases in adults. Contact address: Sophie Desroches, [email protected] *Indicates the major publication for the study CONTRIBUTIONS OF AUTHORS SD coordinated and contributed to all stages of the review. AL performed the search strategy, identified eligible studies, extracted data, performed analysis and interpreted result and wrote the first draft of the review. ST assisted with statistical analyses, contributed to the writing of the review. SR developed the search strategy, contributed to the writing of the review. KG contributed to the protocol development and to the writing of the review. FL contributed to the protocol development and to the writing of the review. DECLARATIONS OF INTEREST None known. DIFFERENCES BETWEEN PROTOCOL AND REVIEW The protocol was published in 2010 (Desroches 2010). Types of interventions: Multiple interventions are now defined as those with two or more interventions. Pubmed search strategy: Food habit*[TIAB] or Feeding behaviour*[TIAB] or Eating behaviour*[TIAB] were added to the Pubmed search strategy. Assessment of reporting biases: publication bias using funnel plot was not explored since multiple adherence outcome measures were reported in several studies and could not be pooled together. Cochrane Database Syst Rev. Author manuscript; available in PMC 2016 June 09. Published in final edited form as: Cochrane Database Syst Rev. ; (2): CD008722. doi:10.1002/14651858.CD008722.pub2. C IH R A u th o r M a n u scrip t C IH R A u th o r M a n u scrip t C IH R A u th o r M a n u scrip t Studies were eligible if the primary outcome was the client’s adherence to dietary advice. We defined ‘client’ as an adult participating in a chronic disease prevention or chronic disease management study involving dietary advice. Data collection and analysis—Two review authors independently assessed the eligibility of the studies. They also assessed the risk of bias and extracted data using a modified version of the Cochrane Consumers and Communication Review Group data extraction template. Any discrepancies in judgement were resolved by discussion and consensus, or with a third review author. Because the studies differed widely with respect to interventions, measures of diet adherence, dietary advice, nature of the chronic diseases and duration of interventions and follow- up, we conducted a qualitative analysis. We classified included studies according to the function of the intervention and present results in a narrative table using vote counting for each category of intervention. Main results—We included 38 studies involving 9445 participants. Among studies that measured diet adherence outcomes between an intervention group and a control/usual care group, 32 out of 123 diet adherence outcomes favoured the intervention group, 4 favoured the control group whereas 62 had no significant difference between groups (assessment was impossible for 25 diet adherence outcomes since data and/or statistical analyses needed for comparison between groups were not provided). Interventions shown to improve at least one diet adherence outcome are: telephone follow-up, video, contract, feedback, nutritional tools and more complex interventions including multiple interventions. However, these interventions also shown no difference in some diet adherence outcomes compared to a control/usual care group making inconclusive results about the most effective intervention to enhance dietary advice. The majority of studies reporting a diet adherence outcome favouring the intervention group compared to the control/usual care group in the short-term also reported no significant effect at later time points. Studies investigating interventions such as a group session, individual session, reminders, restriction and behaviour change techniques reported no diet adherence outcome showing a statistically significant difference favouring the intervention group. Finally, studies were generally of short duration and low quality, and adherence measures varied widely. Authors’ conclusions—There is a need for further, long-term, good-quality studies using more standardized and validated measures of adherence to identify the interventions that should be used in practice to enhance adherence to dietary advice in the context of a variety of chronic diseases. PLAIN LANGUAGE SUMMARY Interventions to enhance adherence to dietary advice for preventing and managing chronic diseases in adults Chronic diseases are the leading cause of mortality worldwide. Although the adoption of a healthy diet is recognized as an important component for their prevention and management, many individuals at risk of or having chronic diseases do not adhere to recommended dietary advice. The methods used to facilitate changes in dietary habits through dietary advice (defined in this review as ‘interventions’) could improve adherence of clients to dietary advice. Therefore, we reviewed trials of interventions aiming to enhance adherence to dietary advice for preventing and managing chronic diseases in adults. Desroches et al. Page 2 Cochrane Database Syst Rev. Author manuscript; available in PMC 2016 June 09. C IH R A u th o r M a n u scrip t C IH R A u th o r M a n u scrip t C IH R A u th o r M a n u scrip t We identified 38 studies involving 9445 participants examining several types of interventions for enhancing adherence to dietary advice for preventing and managing many chronic diseases. The main chronic diseases involved were cardiovascular diseases, diabetes, hypertension, and renal diseases. Interventions shown to improve at least one diet adherence outcome are: telephone follow-up, video, contract, feedback, nutritional tools and more complex interventions including multiple interventions. However, these interventions also showed no difference in some diet adherence outcomes compared to a control/usual care group making the results inconclusive about the most effective intervention to enhance dietary advice. Interestingly, all studies including clients with renal diseases reported at least one diet adherence outcome showing a statistically significant difference favouring the intervention group, no matter which intervention was provided. The majority of studies reporting a diet adherence outcome favouring the intervention group compared to the control/usual care group in the short-term also reported no significant effect at later time points. Studies investigating interventions such as a group session, individual session, reminders, restriction and behaviour change techniques reported no diet adherence outcome showing a statistically significant difference favouring the intervention group. Finally, interventions were generally of short duration, studies used different methods for measuring adherence and the quality of the studies was generally low. BACKGROUND Description of the condition Chronic diseases are defined as diseases of long duration that have generally a slow progression (WHO 2008). The most common chronic diseases include diabetes, cardiovascular diseases (CVD), cancers, asthma, chronic obstructive pulmonary diseases (COPD), arthritis, obesity and renal failure. Considering that chronic diseases are the leading cause of death and disability and account for 60\% of all deaths worldwide (WHO 2008), the Department of Chronic Disease and Health Promotion of the World Health Organization (WHO) emphasizes the importance of preventing and managing chronic diseases and their risk factors (WHO 2010). Some health conditions have been found to be risk factors, for example, patients with the metabolic syndrome have an increased risk of developing CVD (Mottillo 2010). Similarly, women with a previous history of gestational diabetes have an increased risk of developing type II diabetes (Bellamy 2009). These risk factors may be targeted in interventions aiming to prevent chronic diseases. Evidence from epidemiologic, experimental and clinical studies has demonstrated a strong relationship between dietary patterns or nutrient intakes, and prevention and management of chronic diseases including diabetes (Champagne 2009), CVD (Lavie 2009), and obesity (Kennedy 2004). Several authoritative health agencies have recommended the adoption of a healthy diet as the cornerstone in preventing and/or managing chronic diseases such as CVD (Lichtenstein 2006), diabetes (Bantle 2008) and cancer (Kushi 2006). For example, lifestyle interventions including dietary changes were shown to reduce the incidence of diabetes by 58\% compared to a control group in individuals at high risk in two large randomized controlled trials (RCTs): the Finnish Diabetes Prevention study (Lindstrom 2003) and the Diabetes Prevention Program (Knowler 2002). In line with this, dietitians and other health Desroches et al. Page 3 Cochrane Database Syst Rev. Author manuscript; available in PMC 2016 June 09. C IH R A u th o r M a n u scrip t C IH R A u th o r M a n u scrip t C IH R A u th o r M a n u scrip t professionals provide people with dietary advice designed to improve their nutritional intake (Baldwin 2011). The concept of ‘adherence’ recognizes the patient’s right to choose whether or not to follow advice, and implies a patient’s active participation in the treatment regimen (Cohen 2009). For chronic disease management including medication and lifestyle changes, non-adherence rates are estimated to be between 50\% and 80\% (WHO 2003). Thus, poor adherence can be a serious threat to patients’ health and wellbeing (DiMatteo 2002), and also carries an economic burden (DiMatteo 2004a). Adherence is particularly important in the context of chronic diseases requiring long-term therapy and a number of permanent rather than temporary changes in lifestyle behaviours, such as diet, physical activity and smoking (WHO 2003). The extent to which risk-reduction interventions proved to be as effective in research settings as in individuals’ real-life settings depends on the patient’s adherence to treatment advice. In that regard, results from an RCT assessing adherence to and effectiveness of four popular diets (Atkins, Zone, Weight Watchers, and Ornish) revealed that level of adherence to dietary advice, rather than the type of diet, was the key determinant of greater weight loss and CVD risk factor reductions (Dansinger 2005). Whether the number of intervention goals that an individual has to reach influences adherence was also addressed in a secondary analysis of the PREMIER study (Young 2009). In this RCT that tested the effects of two multicomponent lifestyle interventions on blood pressure control, the authors reported that individuals with the most physical activity and dietary behaviour goals to achieve reached the most goals (Young 2009). Measurement of adherence to prescribed dietary advice typically involves: 1) assessment of what the client eats through self-reported methods (e.g. 24-hour recall, food records, food frequency questionnaires, diet history); and 2) determination of the degree to which the diet approximates the recommended dietary plan (e.g. difference between clients’ recommended macronutrient goals and their self-reported intake). Although sparsely used, more objective measures of adherence to diets also exist (e.g. 24-hour urinary sodium excretion to assess adherence to a low sodium diet (Chung 2008)). However, there is no gold standard for the accurate determination of dietary intake. Self-report of energy intake is a characteristic inherent to nutrition-related topics and is found to be underestimated compared to objective measures such as resting energy expenditure assessed by indirect calorimetry (Asbeck 2002). Underreporting energy intake has been observed more frequently in women versus men, (Johnson 1994), in older versus young (Huang 2005), and in obese versus normal weight individuals (Briefel 1997). Although self-report measures are often regarded as susceptible to bias (e.g. over reliance on memory; report error related to meal composition or portion sizes; daily dietary variability; social desirability) (Kumanyika 2000; Wilson 2005) they are a direct, simple and inexpensive method (DiMatteo 2004b), and are readily available for use in practice. Self-report measures can be improved and validated by using multiple measures of adherence and controlling statistically for bias or by using constructs such as body weight, blood pressure or plasma cholesterol concentrations (Hebert 2001; DiMatteo 2004b). Desroches et al. Page 4 Cochrane Database Syst Rev. Author manuscript; available in PMC 2016 June 09. C IH R A u th o r M a n u scrip t C IH R A u th o r M a n u scrip t C IH R A u th o r M a n u scrip t Description of the intervention Adherence to dietary advice has been shown to vary according to gender (Chung 2006), socio-economic status (Reid 1984) and ethnicity (Natarajan 2009). Moreover, numerous barriers to client adherence in health care have been identified. Among them are complexity of treatment plan, and clients’ knowledge of disease and understanding of the importance of treatment in its control and in preventing adverse outcomes (Makaryus 2005; Harmon 2006; Robinson 2008). According to a WHO report, “interventions for removing barriers to adherence must become a central component of efforts to improve population health worldwide” (WHO 2003). Although non-adherence is often attributed to clients who are viewed as “non cooperative”, “non compliant” and “unable to follow instructions” (Kapur 2008), it is increasingly recognized that health professionals may help their clients overcome barriers to adherence (Harmon 2006) by improving how they approach their clients’ problems, how they provide advice, and how they involve their clients in treatment decision making. Although there is a wide diversity of interventions for enhancing adherence to dietary advice, their underlying aim is to prompt change to facilitate the adoption of recommended dietary behaviours. How the intervention might work Behaviour change theories have proved useful for explaining health-related behaviours, including dietary behaviours. They attempt to identify the determinants that will contribute to predict the adoption of a specific behaviour, and which should be taken into account when developing a behaviour change intervention, such as a method for providing dietary advice. Several models or theories to predict behaviour change can be used in health-related interventions, such as the Health Belief Model (Rosenstock 1974), the Theory of Planned Behaviour (Ajzen 1991), the Theory of Reasoned Action (Fishbein 1981) and the Social Cognitive Theory (Bandura 1986). More recently, Michie 2011 proposed a framework, the COM-B system, which includes three principal interrelated components of the determination of a behaviour: 1) the motivation (the direct brain process leading to a behaviour), 2) the capability (the individual’s psychological and physical capacity to engage a behaviour) and 3) the opportunity (the factors that lie outside the individual that make the behaviour possible or not) (Michie 2011). The authors also developed a system for characterizing behaviour change interventions and their components in order to facilitate the identification of the effective behaviour change interventions and the implementation of evidence-based practice in this area. According to this system, behaviour change interventions can be classified as nine intervention functions: education, persuasion, incentivisation, coercion, training, restriction, environmental restructuring, modelling and enablement (Michie 2011). These theories or models focus on different determinants or combinations of determinants of the behaviours which could be helpful for developing interventions for enhancing adherence to dietary advice. Why it is important to do this review As greater adherence to dietary advice is a critical component in preventing and managing chronic diseases, research is needed to identify the characteristics of interventions that will result in a better agreement between health professionals’ evidence-based dietary advice, Desroches et al. Page 5 Cochrane Database Syst Rev. Author manuscript; available in PMC 2016 June 09. C IH R A u th o r M a n u scrip t C IH R A u th o r M a n u scrip t C IH R A u th o r M a n u scrip t and their clients’ eating patterns. Despite growing recognition that non-adherence to dietary advice is a barrier to getting new nutrition knowledge into practice, previous knowledge syntheses have provided decision makers and knowledge users with little practical guidance on the development of useable interventions for enhancing adherence to dietary advice. Studies have reported on interventions designed to enhance adherence to dietary advice by overcoming barriers to adherence. Although some studies have reported positive effects of interventions to enhance adherence to dietary advice, no systematic review specifically assesses dietary interventions that lead to sustained dietary changes or that refer to a wide array of chronic diseases. Haynes 2008 summarized the results of RCTs of interventions to help clients adhere to prescriptions for medications for medical problems, and excluded interventions targeting dietary advice. Bosch-Capblanch 2007 systematically reviewed the effects of contracts between clients and health professionals for improving clients’ adherence to treatment, prevention and health promotion activities. Although this review is relevant to our review, it reported only the effect of contracts (as opposed to other interventions), and was not specific to dietary advice. Several non-Cochrane reviews may overlap with our review, but these are not systematic (Brownell 1995b; Brownell 1995a; Burke 1997; Newell 2000; Fappa 2008) and/or are related to only one health condition and not specifically targeting dietary advice (Burke 1997; Newell 2000; Fappa 2008). This review will improve the knowledge base for adherence to dietary advice; a topic of immense importance for dietetics practice that will also be relevant to clients, and other health professionals. OBJECTIVES To assess the effects of interventions for enhancing adherence to dietary advice for preventing and managing chronic diseases in adults. METHODS Criteria for considering studies for this review Types of studies—Randomized controlled trials (RCTs) including cluster RCTs. Because interventions for enhancing adherence to dietary advice aim to initiate dietary changes, a cross-over design in which each client received all interventions could induce a carry-over effect. Therefore, we excluded studies including a cross-over design. Types of participants—Clients, aged 18 years and over, in real-life settings. We define ‘client’ as an adult participating in a chronic disease prevention or chronic disease management study involving dietary advice. We included clients who had a diet related- chronic disease (e.g. obesity, cardiovascular disease, renal failure, hypertension) or at least one risk factor for a chronic disease (e.g. overweight, hyper-lipidaemia). We included family or non-family caregivers such as wife/husband or individual living with the client and involved in meal planning and preparation. We also included studies involving health professionals delivering dietary advice. Desroches et al. Page 6 Cochrane Database Syst Rev. Author manuscript; available in PMC 2016 June 09. C IH R A u th o r M a n u scrip t C IH R A u th o r M a n u scrip t C IH R A u th o r M a n u scrip t Types of interventions—We included studies assessing the effects of a single intervention or multiple interventions involving chronic disease prevention and management, on adherence to dietary advice. ‘Intervention’ was defined as the method used to facilitate changes in dietary habits through dietary advice. To structure the presentation of results, we grouped interventions according to the intervention functions of the behaviour change wheel developed by Michie and colleagues (Michie 2011). Therefore, we classified interventions to enhance adherence to dietary advice as: • Education (increasing knowledge or understanding); • Persuasion (using communication to induce positive or negative feelings or stimulate action); • Incentivisation (creating expectation of reward); • Coercion (creating expectation of punishment or cost); • Training (imparting skills); • Restriction (using rules to reduce the opportunity to engage in the target behaviour); • Environmental restructuring (changing the physical or social context); • Modelling (providing an example for people to aspire to or imitate); • Enablement (increasing means/reducing barriers to increase capability or opportunity); • Multiple (combination of two or more different interventions). We included studies making the following comparisons: • Single intervention for enhancing adherence to dietary advice versus no intervention (control) or a reference standard of care (usual care); • Single intervention for enhancing adherence to dietary advice versus single or multiple interventions with a similar purpose (to enhance adherence to dietary advice); • Multiple interventions for enhancing adherence to dietary advice versus no intervention (control) or a reference standard of care (usual care); • Multiple interventions for enhancing adherence to dietary advice versus single or multiple interventions for enhancing adherence to dietary advice. The term ‘reference standard of care’ refers to the usual dietary intervention performed to address a specific health condition. For example, in Amato 1990 two approaches were used with patients who were severely obese using the same dietary advice: 1) weight loss advice versus 2) weight loss advice combined with psychotherapy. The approach with weight loss advice was the reference standard of care while the approach with weight loss advice combined with psychotherapy was the intervention for enhancing adherence to dietary advice. Furthermore, only studies comparing interventions with the same dietary advice component (e.g. increase consumption of fruits and vegetables, decrease fat intake) but Desroches et al. Page 7 Cochrane Database Syst Rev. Author manuscript; available in PMC 2016 June 09. C IH R A u th o r M a n u scrip t C IH R A u th o r M a n u scrip t C IH R A u th o r M a n u scrip t differing in terms of the method for changing dietary habits through dietary advice (e.g. education (counselling and follow-up with health professional, educational tools)) were included. We excluded studies assessing adherence to dietary advice for which interventions were not a method for facilitating changes in dietary habits through dietary advice (e.g. medication for weight loss, exercise, etc.). We excluded studies that aimed primarily to evaluate the effects of an experimental diet or a food plan on health outcomes, and for which adherence was monitored as a secondary outcome to justify, for example, the validity of the results, as these interventions were not designed for enhancing adherence to dietary advice. We only included studies including food-based dietary advice and representing real-life conditions. Therefore, we excluded studies involving the provision of meals, food items or dietary supplements (e.g. vitamin, mineral, omega-3 fatty acid). Types of outcome measures Primary outcomes • Client adherence to dietary advice (e.g. biochemical measures within acceptable limits, mean dietary intake, proportion of clients achieving the dietary advice). We included studies reporting adherence to dietary advice as a primary outcome, namely those clearly mentioning a measurement of diet adherence in the title or the objective of the study and/or those reporting the proportion of patients adhering to dietary advice. We excluded studies reporting mean dietary intake without specifically assessing adherence to dietary advice. Secondary outcomes • Process measures: e.g. attendance at or participation in individual counselling or group sessions, number of completed food records returned to research coordinators, client or family or non-family caregivers’ satisfaction with the dietary or counselling approaches, health professionals’ skills in performing the experimental interventions or their satisfaction with the counselling approach. • Client-based health or behaviour outcomes: e.g. blood pressure; plasma cholesterol concentration; plasma glucose concentration; body weight; relief of symptoms; smoking; physical activity; blood glucose monitoring. • Organisational outcomes: e.g. cost; time; resources required by client, family or non-family caregivers, or healthcare professionals. • Harms or secondary effects: e.g. confusion regarding new eating patterns; feelings of lack of confidence or skills in preparing meals; unhappiness at loss of traditional meals. Search methods for identification of studies Electronic searches—We conducted a systematic search, using 29 September 2010 as the cut-off date, in the following electronic databases: • The Cochrane Library, issue 9 2010 (via Wiley); • PubMed; Desroches et al. Page 8 Cochrane Database Syst Rev. Author manuscript; available in PMC 2016 June 09. C IH R A u th o r M a n u scrip t C IH R A u th o r M a n u scrip t C IH R A u th o r M a n u scrip t • EMBASE (Embase.com); • CINAHL (Ebsco); • PsycINFO (PsycNet). We present detailed search strategies in Appendix 1; Appendix 2; Appendix 3; Appendix 4; Appendix 5. There were no language restrictions and all databases were searched from their start date. Searching other resources—We conducted additional searches for unpublished studies through grey literature: • Recent years of relevant conference, symposium and colloquium proceedings and abstracts: – 2009–10 Scientific sessions of the American Diabetes Association; – 2009–10 Scientific sessions of the American Heart Association; – 2009–10 Food and Nutrition Conference and Expo of the American Dietetic Association; – 2010 Canadian Diabetes Association/Canadian Society of Endocrinology and Metabolism Professional Conference and Annual Meeting; – 2009 International Diabetes Federation World Diabetes Congress North America; – 2009–10 Dietitians of Canada National Conference; – 2009–10 Obesity Society Annual Scientific Meeting; – 2009–10 Experimental Biology Meeting; – 2009–10 Canadian Nutrition Society; • Web-based registries of clinical trials (US National Institutes of Health, The National Library of Medicine, Current Controlled Trials); • Bibliographies of included studies; • Contact with experts in the field to request details of any other known studies. Data collection and analysis Selection of studies—Two review authors independently assessed the eligibility of papers identified by the search strategy. All titles and abstracts were screened according to pre-established inclusion criteria (see Criteria for considering studies for this review). We retrieved full text copies of papers judged to be potentially relevant to … Purpose Skills Module: Nutrition To encourage critical thinking, problem solving, and collaboration through the use of evidence-based practice studies. Course outcomes: This assignment enables the student to meet the following course outcomes. CO 1: Examine the sources of knowledge that contribute to professional nursing practice. (PO 7) CO 2: Apply research principles to the interpretation of the content of published research studies. (POs 4 and 8) CO 3: Identify ethical issues common to research involving human subjects. (PO 6) CO 4: Evaluate published nursing research for credibility and clinical significance related to evidence-based practice. (POs 4 and 8) CO 5: Recognize the role of research findings in evidence-based practice. (POs 7 and 8) Due date: Your faculty member will inform you when this assignment is due. The Late Assignment Policy applies to this assignment. Total points possible: 150 points Preparing the assignment Follow these guidelines when completing this assignment. Speak with your faculty member if you have questions. 1. Computer with internet access. 2. Recommend using Firefox browser and clearing your cookies and cache if you are accessing ATI on laptop or desktop computer. 3. Log into ATI, “My ATI”, and select the “Apply” tab. Click on Skills Module 3.0 and title “Nutrition.” Click on the “Begin Lesson” tab. Open the “Evidence-Based Research” tab on the left side. 4. There is one (1) study under the Evidence-Based Practice tab. You may review the entire module, but this is not a priority for this assignment. Other main topics and accompanying studies are listed in the table below. 5. Choose one of the main topics from the table and then choose one (1) article for review under that main topic. Read the article chosen and answer one (1) of the topic questions listed below. · What methods can be used to assess nutritional status? · What methods can be used to identify those at risk for malnutrition? · What specific health conditions increase the risk of malnutrition? · What associations exist between nutritional status and health outcomes? · What type of interventions improve adherence to recommendations on nutritional intake? Create a 2-3 page summary which supports the topic question. Provide a current research article (less than 5 years). The 2-3 page limit does not include title and reference pages. Main Topic: Person-centered feeding care. Article for review: · Bell, C., Lopez, R., Mahendra, N., Tamai, A., Davis, J., Amella, E., & Masaki, K. (2016). Person-centered feeding care: A protocol to re-introduce oral feeding for nursing home patients with tube feeding. Journal of Nutrition & Health Aging, 20(6), 621-627. doi:10.1007/s12603-016-0699-9. Main Topic: Evaluating nutritional status. Articles for review: · Vereecken, C., Covents, M., Maes, L., & Moyson, T. (2013). Formative evaluation of the feedback component of childrens and adolescents nutrition assessment and advice on the web (CANAA-W) among parents of school children. Public Health Nutrition, 16(1), 15-26. doi:10.1017/S1368980012003448. · Vyncke, K, Cruz, Fernandez E., Fajó-Pascual, M., Cuenca-García, M., De Keyzer, W., Gonzalez-Gross. M., Moreno, L., Beghin, L., Breidenassel, C., Kersting, M., Albers, U., Diethelm, K., Mouratidou, T., Grammatikaki, E., Vriedt, T., Marcos, A., Bammann, K., Bornhortst, C., Leclercq, C., Manios, Y….Huybrechts, I. (2013). Validation of the diet quality index for adolescents by comparison with biomarkers, nutrient and food intakes: the HELENA study. British Journal of Nutrition, 109(11), 2067-78. doi:10.1017/S000711451200414X. Main Topic: Identifying those at risk for malnutrition. Articles for review: · Isenring, E., Banks, M., Ferguson, M., & Bauer, J. (2012). Beyond malnutrition screening: Appropriate methods to guide nutrition care for aged care residents. Journal of the Academy of Nutrition and Dietetics, 112(3), 376-381. doi: 10.1016/j.jada.2011.09.038. · Tsai, A., Chang, T., Wang, Y., & Liao, C. (2010). Population-specific short-form mini nutritional assessment with body mass index or calf circumference can predict risk of malnutrition in community-living or institutionalized elderly people in taiwan. Journal American Dietetic Association, 110(9), 1328-1334. doi: 10.1016/j.jada.2010.06.003. PMID: 20800124. · Platek, M. E., Popp, J. V., Possinger, C. S., Denysschen, C. A., Horvath, P., & Brown, J. K. (2011). Comparison of the prevalence of malnutrition diagnosis in head and neck, gastrointestinal, and lung cancer patients by 3 classification methods. Cancer Nursing, 34(5), 410–416. https://doi.org/10.1097/NCC.0b013e318206b013. Main Topic: Malnutrition associated with specific health conditions. Articles for review: · Sheard, J., Ash., S., Mellick, G., Silburn, P., & Kerr, G. (2013). Malnutrition in a sample of community-dwelling people with Parkinsons disease. Public Library of Science, 8(1), e53290. doi: 10.1371/journal.pone.0053290. · Cheong, A., Oh, D., Seung, J., Min, G., C., Jae, H., Tae Sung, S., Jae, J., & Sung, K. (2012). Nutritional risk index as a predictor of postoperative wound complications after gastrectomy. World Journal Gastroenterology, 18(7), 673-678. doi: 10.3748/wjg.v18.i7.673. · Kvamme., J., Groni., O., Florholmen, J., & Jacobsen, B. (2011). Risk of malnutrition is associated with mental health symptoms in community living elderly men and women: The tromso study. BioMedical Central Psychiatry, 11(112). doi:10.1186/1471-244X-11-112. Main Topic: Outcomes associated with nutritional status. Articles for review: · Lis, C., Gupta, D., Lammersfeld, C., Markman, M., & Vashi, P. (2012). Role of nutritional status in predicting quality of life outcomes in cancer – a systematic review of the literature. Nutrition Journal, 11, 27. doi: 10.1186/1475-2891-11-27. · Koretz, R., Avenell , A., & Lipman, T. (2012). Nutritional support for liver disease. Cochrane Database of Systematic Reviews. Issue 5. doi: 10.1002/14651858.CD008344.pub2. Main Topic: Interventions to improve nutritional status. Article for review: · Desroches, S., Lapointe, A., Ratté, S., Gravel, K., Légaré, F., & Turcotte, S. (2013). Interventions to enhance adherence to dietary advice for preventing and managing chronic diseases in adults. Cochrane Database of Systematic Reviews. Issue 2. doi: 10.1002/14651858.CD008722.pub2. 6. The Summary must include the following headings (see rubric for criteria under each heading): a. Introduction and Key Points (10 Points) · Choose one of the assigned topics and identifies one of the questions · Defines the topic and question · States why it is a problem · Information presented in logical sequence b. Article Search (25 Points) · Current (less than 5 years) and credible resource · Database search - terms and methods used · Number of articles located · Source outside of ATI module used c. Article Findings (25 Points) · How it addresses the topic · Type of research conducted · Findings of research · Why this article was chosen d. Evidence for Practice (25 Points) · Summary of evidence · How it will improve practice · How this evidence will decrease a gap to practice · Any concerns or weaknesses located in the evidence e. Sharing of Evidence (25 Points) · Who would you share the information with? · How would you share this information? · What resources would you need to accomplish this sharing of evidence? · Why would it be important to share this evidence with the nursing profession? f. Conclusion (20 Points) · Summarizes the theme of the paper · Information presented in logical sequence · All key points addressed · Conclusion shows depth of understanding of topic g. APA Style (10 Points) · APA style used properly for citations · APA style used properly for references · APA style used properly for quotations · All references are cited, and all citations have references *NOTE: Must adhere to current APA guidelines and formatting. h. Writing Mechanics (10 Points) · No spelling errors · No grammatical errors, including verb tense and word usage · No writing errors, including sentence structure, and formatting · Must be all original work 7. Your instructor will provide guidance on the best way to submit this assignment. For writing assistance (APA, formatting, or grammar), visit the APA Citation and Writing page in the online library. NR449 Evidence-Based Practice Skills Module: Nutrition, Feeding, & Eating Guidelines Please note that your instructor may provide you with additional assessments in any form to determine that you fully understand the concepts learned in the review module. NR449_Skills_Module_Nutrition March21 Revised 2 Grading Rubric Criteria are met when the student’s application of knowledge demonstrates achievement of the outcomes for this assignment. Assignment Section and Required Criteria (Points possible/\% of total points available) Highest Level of Performance High Level of Performance Satisfactory Level of Performance Unsatisfactory Level of Performance Section not present in paper Introduction and Key Points (10 points) 10 points 8 points 7 points 4 points 0 points Required criteria 1. Choose one of the assigned topics and identifies one of the questions 2. Defines the topic and question 3. States why it is a problem 4. Information presented in logical sequence Includes 4 requirements for section. Includes 3 requirements for section. Includes 2 requirements for section. Includes 1 requirement for section. No requirements for this section presented. Article Search (25 points) 25 points 22 points 20 points 10 points 0 points Required criteria 1. Current (less than 5 years) and credible resource 2. Database search - terms and methods used 3. Number of articles located 4. Source outside of ATI module used Includes 4 requirements for section. Includes 3 requirements for section. Includes 2 requirements for section. Includes 1 requirement for section. No requirements for this section presented. Article Findings (25 points) 25 points 22 points 20 points 10 points 0 points Required criteria 1. How it addresses the topic 2. Type of research conducted 3. Findings of research 4. Why this article was chosen Includes 4 requirements for section. Includes 3 requirements for section. Includes 2 requirements for section. Includes 1 requirement for section. No requirements for this section presented. Evidence for Practice (25 points) 25 points 22 points 20 points 10 points 0 points Required Criteria 1. Summary of evidence 2. How it will improve practice 3. How this evidence will decrease a gap to practice 4. Any concerns or weaknesses located in the evidence Includes 4 requirements for section. Includes 3 requirements for section. Includes 2 requirements for section. Includes 1 requirement for section. No requirements for this section presented. Sharing of Evidence (25 points) 25 points 22 points 20 points 10 points 0 points Required Criteria 1. Who would you share the information with? Includes 4 requirements for Includes 3 requirements for Includes 2 requirements for Includes 1 requirement for No requirements for this section NR449 Evidence-Based Practice Skills Module: Nutrition, Feeding, & Eating Guidelines NR449_Skills_Module_Nutrition March21Revised 4 Assignment Section and Required Criteria (Points possible/\% of total points available) Highest Level of Performance High Level of Performance Satisfactory Level of Performance Unsatisfactory Level of Performance Section not present in paper 2. How would you share this information? 3. What resources would you need to accomplish this sharing of evidence? 4. Why would it be important to share this evidence with the nursing profession? section. section. section. section. presented. Conclusion (20 points) 20 points 18 points 17 points 10 points 0 points Required Criteria 1. Summarizes the theme of the paper 2. Information presented in logical sequence 3. All key points addressed 4. Conclusion shows depth of understanding of topic Includes 4 requirements for section. Includes 3 requirements for section. Includes 2 requirements for section. Includes 1 requirement for section. No requirements for this section presented. APA Style (10 points) 10 points 8 points 7 points 4 points 0 points Required criteria 1. APA style used properly for citations 2. APA style used properly for references 3. APA style used properly for quotations 4. All references are cited, and all citations have references *NOTE: Must adhere to current APA guidelines and formatting. Includes 4 requirements for section. Includes 3 requirements for section. Includes 2 requirements for section. Includes 1 requirement for section. No requirements for this section presented. Writing Mechanics (10 points) 10 points 8 points 6 points 4 points 0 points Required criteria 1. No spelling errors 2. No grammatical errors, including verb tense and word usage 3. No writing errors, including sentence structure, and formatting 4. Must be all original work Includes 4 requirements for section. Includes 3 requirements for section. Includes 2 requirements for section. Includes 1 requirement for section. No requirements for this section presented. Total Points Possible = 150 points