This study evaluates the effects of assessing patient nutrition literacy prior to an initial session with an outpatient dietitian on the patient-centeredness of the session. We will randomize 6 dietitians, 4 of whom will have access to their participating patients' nutrition literacy scores. These dietitians will use this information to better inform their interventions, and hopefully improve their patients' nutrition literacy as a result.
Nutrition Literacy Assessment Tool (NLit): a validated, 64-question survey that assesses nutrition literacy across 6 subscales: * Nutrition and Health * Energy Sources in Food * Household Food Measurement * Food Label and Numeracy * Food Groups * Consumer Skills Dietitians who work within 6 different outpatient clinics (1 dietitian per clinic) will be recruited to the study; each dietitian will recruit 19 patients from their clinic. All patient participants will take the NLit survey prior to an initial visit with their dietitian. Dietitians randomized to the intervention arm (n=4) will have access to their participating patients' NLit results, and tailor their intervention to the patient's nutrition literacy weaknesses. Dietitians randomized to the control group (n=2) will not have access to their participating patients' NLit scores, and will provide the same standard-of-care intervention usually provided. All participating patients will then re-take the NLit a month after their initial session with their dietitian, and we will examine the results to see if a) nutrition literacy improved within groups, and b) if the patients of the intervention dietitians showed more improvement in nutrition literacy than their counterparts being treated by the control dietitians. We will also collect dietary pattern information from participating patients before their initial session with their dietitian, and again one month after their initial session with their dietitian. We will examine the results to see if a) dietary patterns improve with increased nutrition literacy, and b) if the dietary patterns of patients in the intervention group improve more than patients in the control group. Finally, we will collect survey information from patients pertaining to the perceived patient-centeredness of the session with their dietitian. We will also collect audio recordings of the sessions between patients and dietitians, which will be analyzed for patient-centeredness. We will also analyze readability and clearness of printed materials used by dietitians during their interventions with patients.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SCREENING
Masking
SINGLE
Enrollment
95
The NLit is a 64-question survey broken into 6 subscales. each subscale examines a different aspect of nutrition literacy (Nutrition and Health, Energy Sources in Food, Household Food Measurement, Food Label and Numeracy, Food Groups, and Consumer Skills). Global and subscale NLit scores will be generated for each participating patient.
The University of Kansas Health System Family Medicine and Internal Medicine Clinics
Kansas City, Kansas, United States
University of Kansas Medical Center Student Health Services
Kansas City, Kansas, United States
University of Kansas Medical Center, Center for Physical Activity and Weight Management
Kansas City, Kansas, United States
University of Kansas Medical Center Bariatric and Weight Loss Surgery Clinic
Change in Nutrition Literacy Assessment Instrument (NLit) score from baseline to post-session.
Nutrition literacy will be assessed with the Nutrition Literacy Assessment Instrument (NLit)
Time frame: Nutrition literacy will be measured prior to the patients' initial session with a dietitian, then again one month after the session.
Change in BRFSS 2011 Fruit and Vegetable Module scores from baseline to one month post-session.
Dietary patterns will be assessed using the BRFSS 2011 Fruit and Vegetable Module.
Time frame: BRFSS 2011 Fruit and Vegetable Module scores will be measured prior to the patients' initial session with a dietitian, then again one month after the session.
Change in Rapid Eating Assessment for Patients (REAP) score from baseline to one month post-session
Dietary patterns will be assessed using the Rapid Eating Assessment for Patients (REAP)
Time frame: BRFSS 2011 Fruit and Vegetable Module scores will be measured prior to the patients' initial session with a dietitian, then again one month after the session.
Patient view of patient-centeredness of the session with a dietitian
Patient view of patient-centeredness of the session will be assessed using a modified version of the Consumer Assessment of Healthcare Providers and Systems-Clinician and Group Survey (CAHPS), v.3.0
Time frame: Patients will complete the survey up to two months after they complete their session with a dietitian.
Patient-centeredness of the session between patient and dietitian
Patient-centeredness of the session between patient and dietitian will be assessed using the Teach back Loop Score, a validated tool used to examine the use of teach back, an essential part of patient-centered care.
Time frame: One month post-session
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Overland Park, Kansas, United States
Encompass Medical Group
Kansas City, Missouri, United States
Readability of printed materials used by dietitians during interventions
Reading level of all printed materials will be assessed using the Flesch-Kincaid Readability score.
Time frame: One month prior to first patient session with a dietitian
Clearness of printed materials used by dietitians during interventions
Clearness of printed materials will be assessed using the Center for Disease Control Clear Communications Index
Time frame: One month prior to first patient session with a dietitian