ABSTRACT
INTRODUCTION: Primary care providers have a role to play in supporting the development of healthy eating habits, particularly in a child's early years. This study examined the feasibility of implementing the NutriSTEP® screen-a 17-item nutrition risk screening tool validated for use with both toddler and preschooler populations-integrated with an electronic medical record (EMR) in primary care practices in Ontario, Canada, to inform primary care decision-making and public health surveillance. METHODS: Five primary care practices implemented the NutriSTEP screen as a standardized form into their EMRs. To understand practitioners' experiences with delivery and assess factors associated with successful implementation, we conducted semi-structured qualitative interviews with primary care providers who were most knowledgeable about NutriSTEP implementation at their site. We assessed the quality of the extracted patient EMR data by determining the number of fully completed NutriSTEP screens and documented growth measurements of children. RESULTS: Primary care practices implemented the NutriSTEP screen as part of a variety of routine clinical contacts; specific data collection processes varied by site. Valid NutriSTEP screen data were captured in the EMRs of 80% of primary care practices. Approximately 90% of records had valid NutriSTEP screen completions and 70% of records had both valid NutriSTEP screen completions and valid growth measurements. CONCLUSION: Integration of NutriSTEP as a standardized EMR form is feasible in primary care practices, although implementation varied in our study. The application of EMR-integrated NutriSTEP screening as part of a comprehensive childhood healthy weights surveillance system warrants further exploration.
Subject(s)
Electronic Health Records , Pediatric Obesity/prevention & control , Primary Health Care/methods , Surveys and Questionnaires , Attitude of Health Personnel , Body Height , Body Mass Index , Body Weight , Child , Child, Preschool , Clinical Decision-Making , Data Accuracy , Diet , Electronic Health Records/statistics & numerical data , Feasibility Studies , Feeding Behavior , Female , Humans , Infant , Interviews as Topic , Male , Parents , Primary Health Care/organization & administration , Program Development , Public Health Surveillance , Risk FactorsABSTRACT
PURPOSE: This study was conducted to determine consumer understanding and retention of nutrition information presented at grocery stores during the Paint Your Plate campaign via two approaches: interactive display events and brochure distribution. METHODS: Data were collected at 17 grocery stores in northern Ontario. Eleven stores held interactive display events with public health staff, a display, resources, and food samples. Six stores only distributed brochures. A total of 688 participants completed a baseline questionnaire, and 432 consented to a three-month follow-up telephone call. Of these, 201 were randomly selected to participate. RESULTS: Participants at interactive display events were six times more likely than participants receiving brochures to identify a serving size of fruit and vegetables (odds ratio [OR]=5.88; 95% confidence interval [CI]: 4.05, 8.54) and 23 times more likely to identify the recommended number of servings of fruit and vegetables (OR=22.67; 95% CI: 14.29, 35.98). However, at follow-up, there was no significant difference between type of event and the ability to answer correctly. CONCLUSIONS: Interactive displays increased immediate knowledge but failed to increase retention, a finding that suggests consistent presence of the message is needed to reinforce initial understanding and retention. More emphasis should be placed on directing funding toward increasing the frequency and duration of promotional efforts.
Subject(s)
Community Participation , Health Knowledge, Attitudes, Practice , Health Promotion/methods , Nutrition Policy , Social Marketing , Adolescent , Adult , Confidence Intervals , Diet , Female , Follow-Up Studies , Fruit , Health Promotion/organization & administration , Humans , Male , Middle Aged , Odds Ratio , Ontario , Surveys and Questionnaires , Time Factors , Vegetables , Young AdultABSTRACT
BACKGROUND: Epidemiological and experimental studies have suggested that high levels of dietary iron and hemeiron can lead to myocardial injury. Lean meat, a primary source of iron and hemeiron, is promoted because it is lower in fat and cholesterol. Does lean meat put us at risk for myocardial infarction, and should we reconsider its promotion? METHODS: We analyzed the importance of dietary iron and hemeiron as a risk for myocardial infarction among 2,198 Nova Scotians who participated in a nutrition survey and who were followed for eight years, using logistic regression. RESULTS: Acute myocardial infarction incidents occurred in 94 (4.3%) participants. We found no increased risk for myocardial infarction associated with high intake of iron and hemeiron. CONCLUSIONS: Based on Nova Scotian data showing no increased risk for myocardial infarction with high intake of iron and hemeiron, there is no need for immediate reconsideration of promotion of lean meat.
