Canadian Foundation for Dietetic Research.

Chair, 2007 Poster Presentations Abstracts Page 1 Canadian Foundation for Dietetic Research Dietetic Research Event – JUNE 69, 2007 These abstracts represent research projects of dietitians that were accepted through a peer-review process for presentation. *Indicates the presenter [R] = Research abstract [E] = Experience-sharing abstract POSTER RESEARCH PRESENTATION ABSTRACTS – SERIES A THURSDAY JUNE 7, 2007 Community-based Nutritional Care Addressing nutrition risk in community dwelling seniors through a nutrition screening program using SCREENTM at a downtown Calgary seniors’ centre K Boyd*, S Graham, and L Slauenwhite. Calgary Health Region, Calgary, Alberta [E] Purpose: The Nutrition Screening Initiative was implemented to identify and address nutrition risk among seniors attending programs at the Kerby Centre with the goal of increasing the participants’ capacity to make healthy choices and access nutrition resources prior to the development of serious negative outcomes. Process: The coordinated efforts of senior-serving agencies in Calgary interested in ensuring the nutritional health of seniors resulted in the implementation of a program to connect at-risk seniors to existing community-based services. Nutrition risk of participating seniors was assessed by trained volunteers using the validated SCREENTM tool. Volunteers offered participants referrals to appropriate services for their risk and specific nutrition-related concerns. Services included provision of printed nutrition education materials and referral to community-based services or registered dietitian. Communitybased services for seniors included transportation, grocery shopping, meal delivery and meal preparation services. All participants referred to services were followed-up via telephone to ensure access to and appropriateness of the service to which the seniors’ was referred. An evaluation was conducted with participating seniors, volunteers and service providers. Project Summary: 6.5% of participants were found to have no risk, 85% indicated moderate risk and 8.5% had high risk. 36% of participants questioned indicated that nutrition screening helped them to identify problems with their eating and nutrition. A majority of participants questioned reported improved eating habits since participating in nutrition screening. 12% of participants were referred to a community-based service. Recommendations & Conclusions: Further expansion of this program to a broader population of seniors will promote wellness, independence and a vital, active lifestyle through nutrition education before illness and disability occur. The need for a program of home-based nutrition services in British Columbia C Morley*, Consultant, West Vancouver, BC; J Macdonald, Dietitians of Canada, Vancouver, BC; D Cunningham, Consultant, Victoria, British Columbia [R] Objectives: The objectives of this project were to provide evidence on the importance of home-based nutrition services, to ascertain the current state of affairs regarding client needs for home-based nutrition services in British Columbia and the availability of these services, and to propose solutions to address any identified gaps. Methods: The number of dietitian full time equivalents (FTE) providing home-based nutrition services in Home and Community Care (HCC), Health Services for Community Living (HSCL), and other programs was compared to the need for these services (estimated by applying the percent of these populations at nutritional risk to the numbers of clients receiving HCC services in the health regions, and the number of children living with disabilities registered with Ministry of Children and Family Development programs). Results: Home-based nutrition services are wholly inadequate in BC to Poster Presentations Abstracts Page 1 address the care gap of clients living at home at nutritional risk. The nutritional risk of HCC clients in BC ranges from 53 to 78% in contrast to international reports of 43 to 51%. An estimated 40,000 adults and 9,000 children are at nutritional risk in BC with only 15 dietitian FTEs providing home-based nutrition services compared to the more than 250 FTEs estimated to meet recommended staffing levels. Implications & Conclusions: An evidence paper based on these findings and outlining the benefits of province-wide, coordinated, and readily accessible home-base nutrition services to address the care gap, to prevent malnutrition, and to minimize the fiscal and social costs associated with malnutrition will support advocacy efforts. Chronic disease management in primary health care: the Hamilton Family Health Team Nutrition Program W Gamblen*, Hamilton Family Health Team Nutrition Program, Hamilton, Ontario [E] Purpose: The Chronic Care Model (CCM) is comprised of six interrelated components which promote a high quality of health care to people living with chronic illnesses. This presentation describes how the Hamilton Family Health Team has moved toward integrating this model of care into its Nutrition Program. Description: The Hamilton Family Health Team Nutrition Program integrates 18 registered dietitians into 150 family physicians practices throughout Hamilton, a city of 500,000 people in southern Ontario. Project Summary: Integrating registered dietitians into the primary care setting increases the accessibility of service delivery and enhances care for patients living with chronic illnesses. Dietitians are located directly within the physicians’ offices to provide services and include activities that empower and promote patients to manage their own care and include regular follow-up. They work collaboratively with the physicians, nurse practitioners, mental health counselors, several community based organizations and other members of the health care team. Care management decisions made by the dietitians and other team members are based on clinical practice guidelines and patient preferences. Dietitians help to educate the physicians and other team members, thus increasing their confidence, skill level, and efficacy in managing chronic illness. Dietitians chart directly in the physician notes, so everyone has access to the same care plan. Data from every patient referred and seen is collected and stored electronically. This data is then used to monitor performance of the care system and track individual patients or populations as necessary. Conclusion: Adopting the CCM of disease management into the primary care setting enables registered dietitians to become prepared, proactive members of the health care team and help patients living with chronic illnesses to cope more effectively. Dental Nutrition Services in Vancouver Community Health B Crocker*, Infant, Child and Youth Program; P Glassby, T Wyman, Dental Program, Vancouver Coastal Health; and C Morley, Consultant/Researcher, Vancouver, British Columbia [E] Purpose: The purpose of this project was to assess the needs for a nutrition service to support the Vancouver Community Dental Health Program (prevention and early intervention of early childhood dental caries). Dental caries in extreme cases leads to general anesthetic for some children costing over 10 million dollars annually at BC’s Children’s Hospital. Early childhood caries is 100% preventable when parents have the knowledge and supports to deal with nutrition, feeding, oral hygiene, and parenting issues. Description of Process: Project components included a literature review, pilot of dietitian-client consultations and record keeping at the dental clinic, chart audit, key informant interviews, and business case development. Project Summary: The dental team and community nutritionists collaborated to develop a dental nutrition program model. As a follow up, limited nutrition services have been offered. A waitlist of 67 children resulted, demonstrating the need for nutrition services to management. Presentation of the business case to managers and directors resulted in funding for short-term dietitian and interpreter positions. Advocacy for a funded dental nutrition program for individualized nutritional care and health promotion services continues. Conclusions: Addressing the complex issues of preventing dental caries and promoting healthy eating and hygiene practices with a targeted at risk early childhood population requires a focused team approach with nutrition and dental health professionals working Poster Presentations – Abstracts Page 2 together. This is an exciting new collaboration for dietitians in community health services. Our experience of systematically documenting the needs of this vulnerable population has lead to short-term funding of nutrition services and discussions for the expansion of the program to all service delivery areas in Vancouver Coastal Health.