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Measuring Nutrition Literacy in Clinical Practice: Evaluating Effects Upon Providers and Patients

Not Applicable
Completed
Conditions
Health Knowledge, Attitudes, Practice
Interventions
Diagnostic Test: Nutrition Literacy Assessment Instrument (NLit)
Registration Number
NCT03681925
Lead Sponsor
University of Kansas Medical Center
Brief Summary

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.

Detailed Description

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.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
95
Inclusion Criteria
  • subjects must be at least 18 years old
  • subjects must be able to read English
  • subjects must be scheduled with a participating dietitian
Exclusion Criteria
  • subjects with cognitive disabilities or overt mental illnesses
  • subjects with vision issues severe enough to disrupt reading of the NLit.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
InterventionNutrition Literacy Assessment Instrument (NLit)Dietitians randomized to the intervention arm will have access to their participating patients' Nutrition Literacy Assessment Instrument (NLit) scores, and base their intervention on these results.
Primary Outcome Measures
NameTimeMethod
Change in Nutrition Literacy Assessment Instrument (NLit) score from baseline to post-session.Nutrition literacy will be measured prior to the patients' initial session with a dietitian, then again one month after the session.

Nutrition literacy will be assessed with the Nutrition Literacy Assessment Instrument (NLit)

Secondary Outcome Measures
NameTimeMethod
Patient-centeredness of the session between patient and dietitianOne month post-session

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.

Change in BRFSS 2011 Fruit and Vegetable Module scores from baseline to one month post-session.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.

Dietary patterns will be assessed using the BRFSS 2011 Fruit and Vegetable Module.

Patient view of patient-centeredness of the session with a dietitianPatients will complete the survey up to two months after they complete their 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

Change in Rapid Eating Assessment for Patients (REAP) score from baseline to one month post-sessionBRFSS 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.

Dietary patterns will be assessed using the Rapid Eating Assessment for Patients (REAP)

Readability of printed materials used by dietitians during interventionsOne month prior to first patient session with a dietitian

Reading level of all printed materials will be assessed using the Flesch-Kincaid Readability score.

Clearness of printed materials used by dietitians during interventionsOne month prior to first patient session with a dietitian

Clearness of printed materials will be assessed using the Center for Disease Control Clear Communications Index

Trial Locations

Locations (5)

University of Kansas Medical Center, Center for Physical Activity and Weight Management

🇺🇸

Kansas City, Kansas, United States

Encompass Medical Group

🇺🇸

Kansas City, Missouri, United States

The University of Kansas Health System Family Medicine and Internal Medicine Clinics

🇺🇸

Kansas City, Kansas, United States

University of Kansas Medical Center Bariatric and Weight Loss Surgery Clinic

🇺🇸

Overland Park, Kansas, United States

University of Kansas Medical Center Student Health Services

🇺🇸

Kansas City, Kansas, United States

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