Carol Boswell

Evidence Review of Technology and Dietary Assessment

SIGNIFICANCE Diets high in fruit and vegetable consumption are associated with a decrease in chronic diseases. Dietary factors are linked to 4 of the 10 leading noncommunicable causes of death: cardiovascular disease, some cancers, stroke, and type 2 diabetes. Accurately measuring dietary patterns has many challenges. Dietary intake measurement has traditionally relied on self-report instruments such as 24-hour recall, food record, and food frequency questionnaires to record consumption history. These methods have inherent limitations in detecting small but important changes in fruit and vegetable consumption patterns. Promising advances in technology have made more sophisticated techniques for recording dietary intake possible. Computers and Web-based programs, handheld personal digital assistants with cameras and telephone cards, smart phones, cameras, and video recorders options may reduce the burden of recording what has been consumed. Furthermore, technology-based methods of dietary assessment may provide a higher degree of reliability and validity in visually determining fruit and vegetable consumption, and additional study is warranted. PURPOSE The purpose of this article is to present a review of the evidence on the effectiveness of technology-based methods for dietary assessment, which included fruit and vegetable consumption. APPROACH One hundred and eighty-seven articles published between 1998 and 2008 were initially identified. Fifteen met the study inclusion criteria and were evaluated by an interdisciplinary team using the Stetler Strength of Evidence Scale. RESULTS Six technology-based methods for dietary assessment were identified. Findings from validity and reliability testing of technology-based methods are encouraging and need replication. Clinically important features offered through technology may reduce reporting burden and offer behavioral feedback to users. Methodologically sound, empirical research into using technology-based application for dietary assessment in a variety of populations of sufficient size is needed.

Developing and establishing online student learning communities.

Developing effective learning communities is an important component of Web-based courses. Learning communities offer a social context for learning that greatly enhances the knowledge acquisition of all involved parties. This article describes the development of an effective learning community among Web-based RN-BSN students. The characteristics of the cohort leading to an effective learning community included supportiveness, open sharing of oneself, and socialization.

Effectiveness of cell phones and mypyramidtracker.gov to estimate fruit and vegetable intake

AIM AND BACKGROUND Inadequate fruit and vegetable intake is linked to leading causes of global mortality and rise in obesity. Measuring fruit and vegetable intake is problematic. Advances in cell phone technologies may improve the accuracy and ease of recording diet. This study tested the effectiveness of using cell phones with digital pictures to prompt memory and mypyramidtracker.gov to estimate self-reported fruit and vegetable intake in 69 college students. METHODS A repeated measures design was used. Focus groups provided feedback on the acceptability, usability, and feasibility of cell phones for diet recording in this population. RESULTS A statistically significant difference in fruit and vegetable scores, F(1, 58)=4.64, p=.04, was supported between cell phone use for short-term memory prompt and mypyramidtracker.gov alone. CONCLUSIONS Cell phone pictures improved memory and accuracy of recall when using an online self-reported interactive diet record and was considered an easy, relevant, and accessible way to record diet.

Filling gaps in knowledge: educating nurses to provide appropriate patient materials.

Assessing and addressing health literacy is a key issue in providing quality patient education. Often, nurses do not know how to do this. Continuing nursing education provides a venue for filling this gap in knowledge, contributing to better and safer patient care.

Students' Perceptions of Holistic Nursing Care

AIM This qualitative study aimed to investigate the trends and perceptions related to the provision of spiritual care for patients. BACKGROUND Holistic nursing integrates the body, mind, and spirit into care. However, nursing students from a traditional program, an RN‐BSN program, and a graduate nurse practitioner program voiced discomfort with providing such spiritual care. METHOD The study was a retrospective review of a convenience sample of journal entries about specific questions of how and when three groups of students developed ideas and concepts about spirituality. RESULTS Students embraced the idea of spirituality connected to their experiences. As students developed as registered nurses, their manner of including spirituality mirrored Benners model. CONCLUSION Additional education is needed for professional nurses concerning spirituality and the provision of spiritual care in a holistic manner.

The need for a community diabetes education curriculum for healthcare professionals.

Healthcare professionals need valuable up-to-date information on diabetes management and skills to treat and educate patients with diabetes mellitus. The Diabetes Education for Healthcare Professionals program was developed to provide healthcare professionals with current diabetes management skills. It was also designed to increase the number of certified diabetes educators in the area in which it was delivered. The program enrolled 147 participants and was delivered on four different occasions. Fifty-five of those participants stated a strong interest in pursuing certified diabetes educator certification, which may significantly increase the number of certified diabetes educators in both rural and urban areas of West Texas.

Effects of Recording Food Intake Using Cell Phone Camera Pictures on Energy Intake and Food Choice.

BACKGROUND The well-documented increases in obesity and unhealthy dietary practices substantiate the need for evidence-based tools that can help people improve their dietary habits. The current spread of mobile phone-embedded cameras offers new opportunities for recording food intake. Moreover, the act of taking pictures of food consumed may enhance visual consciousness of food choice and quantity. The present study aimed to assess the effect of using cell phone pictures to record food intake on energy intake and food choice in college students. The effectiveness and acceptability of cell phone picture-based diet recording also was assessed. METHODS A repeated measures crossover design was used. One group of participants entered their food intake online during 3 days based on their memory, although a second group recorded their food intake using cell phone pictures as their reference. Participants then crossed over to complete 3 more days of diet recording using the alternate method. Focus groups were conducted to obtain feedback on the effectiveness and acceptability of cell phone picture-based diet recording. RESULTS Intake of meat and vegetable servings were significantly higher in the memory period compared with the cell phone period, regardless of the order. Results from the focus group indicated a positive attitude toward the use of cell phone pictures in recording food intake and an increased awareness of food choice and portion size. LINKING EVIDENCE TO ACTION Cell phone pictures may be an easy, relevant, and accessible method of diet self-monitoring when aiming at dietary changes. Future trials should combine this technique with healthy eating education.

Addressing the community research needs of baccalaureate students.

This article describes a course designed to prepare RN-BSN students to assimilate relevant research findings into clinical practice. The course was developed as faculty accepted the challenge of providing didactic content completely online. Guided by two faculty members, two groups of students developed research proposals to respond to community needs identified by a local hospital and a nursing center.

Validating graduate student programmatic outcomes.

One area of paramount importance for a school of nursings accreditation process is the evaluation of competencies and/or outcomes for the program. Each course within a program is expected to bring the students to the point of comprehending the selected programmatic outcomes while determining an improvement in the mastery of the designated competencies. Schools of nursing have used capstone courses to provide an avenue for the documentation of the synthesis and acquisition of material addressed by programmatic outcomes.This article provides a discussion of one such capstone endeavor used within a university setting, where the school of nursing elected to conduct a non-thesis-requiring program. The capstone experience employed for this program allows for synthesis of concepts, self-reflection, personal assessment, and striving for completeness.

Application of Evidence‐Based Practice Through a Float Project

Evidence-based practice must become a common, acceptable process for the bedside nurse. This paper demonstrates a process for engaging nurses in the use of evidence for direct practice. An example using the revision of a float policy is provided as a model for staff nurses to incorporate evidence in a mechanism to elicit change.