NutritionasMedicine1

JeremyONeal&CaitlynDempsey WrittenProjectProposal 4November2013

NutritionasMedicine:AnInterdisciplinaryStudentInterestGroupthatFocusesonNutrition forPreventionofChronicDiseases

Goal: ThisstudentinterestgroupwillfosterinterprofessionalparticipationandrelationshipsbetweenOHSU studentsandtheprofessionalmedicalcommunitythathighlightsnutritionaspreventativemedicine. Objectives: 1. 90%ofmemberswillbeabletoidentifyhownutritionisrelevanttotheirspecificpractice throughouteachactivity. 2. 90%ofmemberswillbeabletostatehownutritionpreventschronicdiseaseaftereachactivity. 3. 50%ofeventattendeeswillbeinterestedinattendingfutureevents. LiteratureReview: Theliteraturereflectstheimportanceofnutritioneducationforstudentsinfuturehealthcare careers,howeverthecurriculuminmanyschoolsleavesmuchtobedesired.Amedicalprofessional studentwillnotobtainAmericanSocietyforNutrition(ASCN)srecommendationof37to44hoursof nutritioneducation.1Mostmedicalprofessionalsonlyreceiveabout15to20hoursofnutritioneducation throughouttheiracademiccareer,missinghalfoftheASCNsrecommendedhours.2Despitemore

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recentdata,only38%ofmedicalschoolsrequiredtheminimum25hoursintheirgeneralcurriculum basedona1985surveybytheNationalAcademyofSciences.3Thereisanobviousneedfornutrition educationwithinamedicalprofessionalstraining. Withanevergrowingbodyofliteraturehighlightingnutritionsrelationshipwithdisease,itis sensiblenutritioneducationisimplementedinamedicalprofessionalscurriculumpertheASCNs recommendation.Asobesitywithallagegroupsisbecominganevermoreprevalentissueinthepast decadeandasaboutonethirdofthecurrentadultpopulationisobese,thechancesofamedical professionalencounteringapatientwithobesityishigh.4Evenwithalackofformalnutritioneducation inaclassroom,astudentinamedicalprofessioncanbetaughtnutritionthroughanontraditional method,suchasastudentinterestgroup.Themorenutritioneducationapersonhas,themore knowledgethatindividualwillhaveabouttheimportanceofchangingahealthbehaviorfordisease prevention.Anutritionstudentinterestgroupwillnotonlyassisteachstudentsfuturepatients,butthe studenthimorherself.Agoodexampleincludescollegeeducatedsmokersbeingabletoquitfivetimes fasterthantheirlessereducatedcounterparts.5Ifthisstudentinterestgroupcaninformitsparticipants aboutnutritionanditsroleindiseaseprevention,thegroupcanpotentiallyalteritsstudentsdiet behaviors.Themorehealthbehaviorknowledgeapersonhas,themorelikelyheorsheistotranslate healthinformationintoaction.Aneducatedindividualcanpersonalizehealthbehaviorknowledgeintoa formthatappliestohisorhercurrentlifestyleandwillbemorelikelytoimplementchange.5 Thisnutritionfocused,interdisciplinarystudentinterestgroupatOregonHealthandScience University(OHSU)willeducatemedicalprofessionalstudentsthroughopendemonstrationsand discussions.BasedontheNutrientRichFoodsConsumerEducationProgram,instructingabout nutrientdensefoodsgivesparticipantstheknowledgetomakefoodchoicesbasedonfactsandlesson

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cravings.Educatingabouthealthfulfoodchoiceshasbeenshowntoincreaseconsumptionofbothfresh fruitandgreenleafyvegetables.6Thisstudentinterestgroupwillhostmultiplenutritioneducationevents withthehopeofbehaviorchange. Significance: Propernutritionandhealthpromotionisessentialinordertoimproveasocietysufferingfroman increasedprevalenceofchronicdiseases.Doctorsandnurseshistoricallydonothaveasignificant amountofeducationandtraininginnutritionthereforeitisimportanttoaddressthatknowledgedeficit withinthestudentscurricula.1Ourstudentinterestgroupisonewaytoprovidenutritioneducationto upcomingmedicalprofessionals.Wewillhighlightnutritionsimpactinpreventingtheonsetand progressionofvariousdiseasestates.Thisgroupwillalsoserveasanintroductionforfuturehealthcare professionalstounderstandthescopeofnutritionandtheimportanceworkingwithinaninterdisciplinary team. MethodsandDesign: ThroughaboothsetupattheOHSUNewStudentInformationFairwereachedoutto interestedstudentsalongsideNAMspastmentorSonjaConnor,MS,RD.Duringthistimewe explainedNAMsmission,futureevents,andmembershipbenefits.InordertocontactNAMs members,weposteventsandgroupupdatestoourFacebookgroupURL: https://www.facebook.com/groups/nutrasmed/.Inordertoorganizeevents,weareusingaGoogle calendarthatisshareabletoeveryonewithinternetaccess.Thiscalendarcanemailparticipantsin advancebasedonoursettimepreferences.NAMseventsallincludeanutritioncomponentandare opentoOHSUstudentsforasmallfeeornofee.AstrongexamplewillincludepromotingNUTN505

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bookclubreadingsinwinterthatarefreeandopentoeveryone.NAMpostsotherexperientiallearning opportunitiesforstudentsthatareapplicabletonutritionsroleindifferentdiseasestatesontheirgroup calendartopromoteinterdisciplinaryconnections. AllNAMseventsrelatetothegroupsmissionstatementof"TheNutritionasMedicine interestgroupexploresnutritionasapreventativemeasureagainstchronicillnessesthroughvarious communitybased,philanthropic,andeducationalevents.Thisgroupwillfosterinterprofessional participationandrelationshipsbetweenOHSUstudentsandthecommunity."Inotherwordsourgroup willprovideauniqueoutletforstudentstoexperiencenutritionandhealthpromotionandhowitapplies totheirfuturecareerseveniftheyarenotdirectlyinthedieteticprofession. 1.TargetAudience: StudentswhowererecruitedthroughtheNewStudentInformationFairheldonOctober4, 2013makeupthetargetaudience,aswellasanyotherstudentinterestedinattendingevents.Sincethe fairwassetupfornewstudents,wehavetorelyonpromotionalflyersandemailssentoutthrough differentschoolsinOHSUtoreachthestudentsnotintheirfirstyear.Thegroupalsowelcomesfaculty andstafftojoinevents. 2.ImplementationDetails: Usingthesignupsheetfromthestudentfair,wecontactedthestudentsviaemail,theFacebook group,andtheGooglecalendaraboutNAMsupcomingevents.Ourfirsteventwillincludea presentationandpotluckdiscussionwithDr.JosephQuinnaboutantioxidantsvariousrolesin preventingtheonsetandprogressionofAlzheimersdisease.ForthiswehavereachedouttoPortland AcademyofNutritionandDietetics,aswellasOregonAcademyofNutritionandDieteticsforhelp

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promotingtheeventthatwilltakeplaceDecember2,2013at4:00pm.Withintwoweeksoftheevent, NAMspresidentswillsendaneventreminderemailtoparticipantsandpostflyersinhighlytrafficked studentareasatOHSU.Additionally,wehopetocontinuetheWeightoftheNationfilmscreeningsfor eachepisode.Thesefilmscreeningshighlightcurrentnutritionissuesandalsocelebratenutrition firsthandwiththepotlucksnacks.Theseeventswillallowparticipantstounderstandcurrentnutrition relatedissueswithintheirpracticesandhowpropernutritioncouldpreventdisease.Theseevents implementationhoweverwilldependonthecopyrightfeeamount.NAMwilladjusteventsasfinancially capable. 3.Theory: TheTheoryofPlannedBehaviorwillbemostusefulinourcommunityoutreachprojectasit statesonesbehaviorisdeterminedbytheintentiontoperformthebehaviorthatstemsfromthe individualsattitude.NutritionasMedicinewillseektochangeorimproveuponattitudesofthe multidisciplinarystudentsinregardstotheirbeliefsofnutritionanditsvitalroleinpreventativemedicine anddiseasestates. 4.Evaluation: Successofthegroupwillbemeasuredbyattendanceofparticipantsattheplannedeventsand generalinterestinthematerialsbeingpresented.TherewillbeasurveypostedonSurveyMonkeythat willbesentoutinthegroupemail,aswellaspostedonFacebook.Thesurveyandmemberattendance willenableustoseeiftheobjectiveshavebeenmet.ThereisasamplesurveypostedonAppendixA, althoughitmaybesubjecttochangeastheyearprogresses. 5.FacilitiesandPersonnel:

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JulieMcGuire,MS,RD,isourmentorforthiscommunityoutreachproject.SonjaConnor, MS,RD,hasbeenthegroupsmentorinthepast,andisstillactivelyinvolvedwithNAM.Karen Seresun,MBA,MPE/AssistantViceProvostforStudentLife,assistswitheventplanningandreserving roomsatOHSU.NathanRisley,thepresidentoftheAllHillStudentCouncil,assistsNAMwithstudent interestgroupfunding.ForNAMsfirstevent,Dr.JosephQuinn,MD,hasagreedtospeakinthemedia roomofOHSUsStudentCenterregardingantioxidantsandAlzheimersdisease.Ms.CaitScherrhas assistedoureffortsschedulingDr.Quinn,MD.Dr.DianeStadler,PhD,RD,hasassistedthegroupin providinginformationaboutschedulingatourofBobsRedMillandotherevents.Thestudentmembers arethemostimportantpartofourprojectastheyarethetargetaudience. OHSUsStudentCenterwillbethesiteforfuturelecturesandfilmscreeningeventsasitis locatedcentrallyonthecampusandfreetoreserveforstudentinterestgroups.Duringthespringterm, localfarmsandorchardswillhostNAMsfruitlooptour. 6.Budget: AsanOHSUstudentinterestgroupwehaveaccesstofundsthroughOHSUsAllHillStudent Council.ItisimportanttonotethattheAllHillstudentcouncilhaslimitedfundingandwetrytoplan eventsthatarefreeorinexpensivetoimplement.Fundingisalsoneededtocovercopyrightfeesfor futuredocumentaryscreenings.Fortunately,thestudentcenterisfreetouseforstudentsandwilllikely bethesiteforothereventstobehostedinthefuture.Dr.Quinnhasalsoagreedtopresenttoforgroup freeofcharge,andmembersattendingtheeventareencouragedtobringahealthydishtoshare,thus eliminatingfoodcosts.TheinitialbeveragecostsarenotcoveredbytheAllHillStudentCouncilandwill befundedbyNAMscopresidentsJeremyandCaitlyn.InAppendixB,thebudgethasbeenbroken

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downfurtherbasedontheevent.

ImplementationSummary: 1.ChangesfromOriginalProposal Theintroductoryeventinthefallquarter,Dr.Quinnspresentation,wasverysuccessfulandhad highnumberofparticipants.Ourhopewastoincreaseawarenessofthegroupsowewouldhavea successfulwinterquarterevent,andprovideauniqueeducationalopportunity.Initially,wehadhopedto organizeabehindtheglasstourofBobsRedMillwithafollowupdiscussionoftheMooreInstitute forthemainwinterevent.However,thisprovedtobedifficultduetoschedulingwithourinternship hoursandtheavailabilityofthetourscheduling.Wearestillhopingtohavetheeventinthefuture, althoughschedulingwilllikelybeanissue. WedecidedtoshowTheWeightoftheNation,Part1:ConsequencesonFebruary25inthe OHSUStudentCenterasthegroupsmaineventforthewinterquarter.Togenerateinterestaboutthe eventwepromoteditonFacebook,andsentoutanemailtogroupmembers.HeatherEnnis,Assistant DirectorofStudentCenter&StudentActivities,notpreviouslymentionedintheproposal,hasbeen instrumentalinorganizingeventsatthestudentcenter.Inanefforttogetthewordoutaboutourevent, HeatheremailedourflyertothedifferentschoolprogramsatOHSU.Itisbecauseofthisemailthatwas senttotheSchoolofNursingthatwehadthreepeopleshowuptotheevent.Sincethesestudentswere notintheirfirstyearofstudy,theydidnotshowuptotheNewStudentOrientationFairheldinthe beginningoftheschoolyear,andwereunawareofthegroup.Uponfindingoutaboutthegroup,the eventattendeessigneduptomembersofNutritionasMedicine.

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Thefutureeventsweareplanningtohoststillincludeafieldtriptolocalorchards,althoughthat eventwoulddependoninterestandavailabilityoffruitsandvegetablesatthattime.Weaskedthe attendeesoftheWeightoftheNationscreeningiftheywouldbeinterestedviewingtheremainingparts ofthedocumentaryseriestowhichtheyrepliedtheywereveryinterestedinseeing.Tomakesurethey wouldbeabletoattendfutureevents,wealsoaskedwhatdaysandtimeswouldbebestforthem,to whichtheyrepliedany.Keepingtheiranswersinmind,wewillbeshowingtheremainingpartsofthe documentaryafterspringbreakinthesamepotluckstyleatthestudentcenter. 2.EvaluationResults NutritionasMedicinehostedtwoeventsandevaluatedoneinordertoincreasethegroups participatoryrateforthesecondevent.ThefirsteventwasapotluckdiscussionwithDr.JosephQuinn andthesecondeventwasapotluckfilmscreeningofWeightoftheNation.Thesecondeventwas evaluatedinordertounderstandthesuccesswithcompletingourobjectives.Toclarify,ourprimary implementationduringthewinterwastheWeightoftheNationfilmscreening. Duetouncertaintyofattendanceforthefilmscreening,onlythefirstepisodePartI: Consequenceshasbeenscreened.However,duetothestronginterestfortheconsecutiveepisodes, weplantocontinuethescreenings.Asthiswasapotluckstyleevent,attendeesbroughthealthysnacks toshareamongeveryone.Thepotluckisimportantasitallowsparticipantstohaveafirsthandexample ofnutritionwhilelearningaboutitthroughtheevents. Threenursingstudentsarrivedtoparticipateinthemainevent.Beforethefilmscreening,we askedeachparticipanthowtheydiscoveredtheeventandtheirmotivationtoparticipate.Allofthe participantsexplainedourmaingroupemailwasforwardedtothemfromtheSchoolofNursingdean

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whoalsowouldapprovethemforcontinuingeducationcreditsiftheyattended.Beforethescreening, weexplainedthefilmscreeningisourcommunityoutreachprojectandexplainedourevaluationplan. Inordertodetermineifachangeofknowledgeoccurredamongparticipants,wedistributeda preeventevaluation.Forquestion#1onthisevaluationtool,theparticipantsexpressedvariousways nutritionisinvolvedintheirinterestsand/orprogramsofstudy.Everyparticipantstatedtheyare responsibleforprovidingeducationandcounselinggoodnutritionandhealthylifestyles.Additionally, everyparticipantagreedthatnutritioncanpreventchronicdiseasesbasedontheirrepliestoquestion #2.Theirexplanationindicatedthatnutritionisabigpartofpreventingchronicdiseases.Forquestion #3,Whosresponsibilityisittomanagepublichealth,i.e.government,personal,orhealthcare?Their responsesstatedeveryoneisresponsiblemanagingpublichealth.However,wewouldappreciate acquiringotherstudentsanswersespeciallythosewhoarenottrainedinhealthsciences. Afterthecompletionofourfilmscreening,participantscompletedthepostevaluation.Question #1determinedifanyopinionschangedafterviewingthedocumentary.Noneoftheanswersdiffered fromthepreevaluationamongstthethreeparticipants.TheLikertscalequestionsanalyzingtheevents hadslightlydifferentresponsesbetweentheeventattendees.Seetable1forthedistributionsamong participants.Allrespondedthattheystronglyagreeourgroupprovidedauniqueopportunitytoincrease theirknowledgeofnutrition.Thereweremixedresultsregardingtheiropinionsonwhethertheirprogram ofstudyhadastrongemphasisofnutrition.Onepersonselectedstronglyagree,anotherselected agreeandtheotherselecteddisagree.Wefoundthistobeveryinterestingsincetheyareallinthe SchoolofNursingandyethadvaryinganswers.Twooftheparticipantsselectedstronglyagreewhen askedifnutritionwouldbeamajorpartintheirfuturecareer.Surprisingly,oneoftheparticipants disagreedwiththatsentimentleadingustosuspectwestillhavemoreworktodopromotingproper

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nutritionformultidisciplinarystudents.Mainly,weplantokeepthisgroupoperatingthesame,butwill expandouremaillistfurthertoincludeeveryOHSUschool,notjustHumanNutritionandNursing.
Table 1: Averages (rounded down) from the Completed Likert Scale This group provided unique opportunities for you to increase your knowledge of nutrition. There is a strong emphasis of evidence based nutrition in my program of study. Proper nutrition will be a major part of my career regarding patient care. Nutrition has a huge role in prevention and management of chronic diseases. The events hosted and promoted by this group really highlighted the importance of nutrition. I am interested in pursuing more nutrition education as a result of this group. 3 4 3 3 4 4

References 1.WeinsierRL,BokerJR,BrooksCM,etal.Prioritiesfornutritioncontentinamedicalschool curriculum:anationalconsensusofmedicaleducators.AmJClinNutr.198950(4):707712.

2.DaghighF,VettoriD,HarrisJ.Nutritioninmedicaleducation:history,currentstatus,andresources. TopicsInClinicalNutrition.April201126(2):147157.

3.AdamsKM,LindellKC,KohlmeierM,ZeiselSH.Statusofnutritioneducationinmedicalschools. AmJClinNutr.200683(suppl4):941S944S.

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4.WardSmithP.ObesityAmerica'sHealthCrisis.UrologicNursing[serialonline].July 201030(4):242245.

5.MargolisR.EducationalDifferencesinHealthyBehaviorChangesandAdherenceAmong MiddleagedAmericans.JournalOfHealth&SocialBehavior.September201354(3):353368.

6.GlanzK,HerseyJ,ZariphehS,etal.EffectofaNutrientRichFoodsConsumerEducationProgram: ResultsfromtheNutritionAdviceStudy.JournalOfTheAcademyOfNutrition&Dietetics.January 2012112(1):5663.

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AppendixB:PostEventEvaluation

Nutrition as Medicine
Event Post-Evaluation
**Thank you for taking the time to complete this evaluation. Simply, 1-2 phrases is acceptable and all evaluations are anonymous.

1. Have any of your previous answer changed since viewing the film? Whether you work within a nutrition-related field or not, how does nutrition affect your specific occupation? Do you believe nutrition can prevent chronic disease? Why or why not? Whos responsibility is it to manage public health, i.e. government, personal, healthcare? If so, please explain.

2. Nutrition as Medicine Survey: Please circle the answers that most accurately correspond to
your thoughts on the statements listed below. Likert Scale: 1= Strongly Disagree, 2=Disagree, 3=Agree, 4=Strongly Agree This group provided unique opportunities for you to increase your knowledge of nutrition. There is a strong emphasis of evidence based nutrition in my program of study. Proper nutrition will be a major part of my career regarding patient care. Nutrition has a huge role in prevention and management of chronic diseases. The events hosted and promoted by this group really highlighted the importance of nutrition. I am interested in pursuing more nutrition education as a result of this group. 1 1 1 1 1 1 2 2 2 2 2 2 3 3 3 3 3 3 4 4 4 4 4 4

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**More questions on back** 3. Open-Ended Comments: Please detail your thoughts and area of improvement for this event. What are some ways we can improve this group in the future?

Please feel free to write any other comments.

Nutrition as Medicine would like to thank you for attending! If there are any events you would like to see in the future, feel free to let either Caitlyn or Jeremy know.

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AppendixC:ProposedEventBudget AcademicYearof20132014sBudget Event All(Beverages) Dr.JosephQuinn Bob'sRedMill PotluckDocumentaries "FruitLoop" EstimatedCosts $100.00 $150(RoomandPresenter Fee) $0 ActualCost $50 $0 $0

$150permovie(Copyright$0(IfGroupLicensedDVD Fees) isavailable) $100(Fortransportation) $0(Carpool)

GrandTotal

$500 OHSUcampussavings

$50 $450