Limited research exists to evaluate nutrition guideline impact on clinical practice
and patient health outcomes. In this study we investigate (1) the impact of guideline
training on the implementation of the diabetes prevention Evidence-Based Nutrition
Practice Guideline (EBNPG), and (2) the relationship between EBNPG congruence and
resulting health outcomes in patients with prediabetes. We conducted an implementation
study in which registered dietitian nutritionists (RDNs) provided nutrition care with
3-month follow-up to 102 pre-diabetes patients before and after a professional training
on the implementation of the Diabetes Prevention EBNPG. Using the RDNs’ Nutrition
Care Process (NCP) documentation, we measured percent guideline congruence and health
outcomes (body weight, waist circumference, fasting glucose, glycosylated hemoglobin),
and modeled health outcomes. Guideline congruence improved after training by 4.3%
(P < 0.05). However, no significant associations were observed between guideline training,
or guideline congruence and health outcomes. Our model showed a reduction in waist
circumference (2.1 ± 0.92 cm; P = 0.023), and body weight (-1.78 ± 0.55 kg; P = 0.001) throughout the course of the study. Training of nutrition professionals
improved congruence to EBNPG for Diabetes Prevention. Nevertheless, improved guideline
congruence did not impact related health outcomes. Standard care including nutrition
intervention resulted in body weight and waist circumference reductions. Future research
needs to further address the impact of evidence-based guidelines on outcomes in all
areas of practice.
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Biography
W. J. Murphy is a data scientist, Academy of Nutrition and Dietetics, and a data scientist, Lumere Inc, a GHX Company, Chicago, IL.
Biography
R. K. Hand is an assistant professor, Department of Nutrition, Case Western Reserve University, Cleveland, OH. At the time of the study she was director, Dietetics Practice Based Research Network, Research International and Scientific Affairs with the Academy of Nutrition and Dietetics, Chicago, IL.
Biography
J. K. Abram is manager, Nutrition Research Network (former Dietetics Practice Based Research Network), Research International and Scientific Affairs with the Academy of Nutrition and Dietetics, Chicago, IL.
Biography
C Papoutsakis is senior director, Nutrition and Dietetics Data Science Center, Research International and Scientific Affairs with the Academy of Nutrition and Dietetics, Chicago, IL.
Article Info
Publication History
Published online: December 03, 2020
Accepted:
November 2,
2020
Received in revised form:
October 29,
2020
Received:
August 27,
2020
Footnotes
Supplementary material: Supplemental Figure 1 is available at www.jandonline.org
STATEMENT OF POTENTIAL CONFLICT OF INTEREST J. K. Abram, and C. Papoutsakis are employees of the Academy of Nutrition and Dietetics which has a financial interest in the ANDHII platform and the NCPT described here.
FUNDING/SUPPORT Financial and material support for the development of ANDHII has been provided by the Academy of Nutrition and Dietetics, and the Commission on Dietetic Registration. Funding for this study was provided by the Diabetes Dietetic Practice Group (DDPG).
AUTHOR CONTRIBUTIONS W. J. Murphy, R. K. Hand, and C. Papoutsakis wrote different components of the initial draft of the article. W. J. Murphy analyzed the data. W. J. Murphy and C. Papoutsakis interpreted data and conducted critical revision of the paper. W. J. Murphy, R. K. Hand, and J. K. Abram contributed to collection of the data. All authors reviewed and commented on subsequent drafts of the manuscript. All authors read and approved the final manuscript.
Identification
Copyright
© 2021 by the Academy of Nutrition and Dietetics.
