A successful physician training program in cholesterol screening and management

Jack, Brian W.; Gans, Kim M.; McQuade, William; Culpepper, Larry; Lasswell, Anita B.; Hume, Anne L.; Dowling, Patrick T.; Carleton, Richard A.

doi:10.1016/0091-7435(91)90035-3

Cited by 15 publications

(5 citation statements)

References 24 publications

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“…Educational interventions have resulted in significantly increased student and health care provider self-efficacy. The self-efficacy behaviors were diverse and included community-based family nursing, communication with cancer patients, pharmacology, cholesterol screening, and counseling (Ford-Gilboe, Laschinger, Laforet-Fliesser, Ward-Griffin, & Foran, 1997;Gans et al, 1993;Jack et al, 1991;Laschinger, McWilliam, & Weston, 1999;Murdock & Neafsey, 1995;Parle, Maguire, & Heaven, 1997;Pololi & Potter, 1996).…”

Section: Literature Review and Conceptual Frameworkmentioning

confidence: 99%

Labor Support: Nurses' Self-Efficacy and Views About Factors Influencing Implementation

Davies

Hodnett

2002

Journal of Obstetric, Gynecologic & Neonatal Nursing

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Section: Literature Review and Conceptual Frameworkmentioning

confidence: 99%

Labor Support: Nurses' Self-Efficacy and Views About Factors Influencing Implementation

Davies

Hodnett

2002

Journal of Obstetric, Gynecologic & Neonatal Nursing

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“…[4][5][6][7][8] Despite the clear need for physicians to advise their patients about nutrition, there is an equally well-documented lack of skills, knowledge, and confidence of physicians in their ability to effectively counsel patients to change eating patterns. [9][10][11][12] In addition to the education-related determinants of physicians' nutrition behavior, [13][14][15][16][17][18][19][20] several system factors affect nutrition behavior in the primary care setting, such as lack of supportive office systems and organization, perceived lack of time, and lack of payment and referral sources and materials. [21][22][23][24][25] JGIM To assist primary care physicians in improving their practice behaviors related to nutrition and cancer prevention, the National Cancer Institute (NCI) developed a manual on nutrition in primary care (referred to as "the manual" in this article).…”

mentioning

confidence: 99%

“… 4–8 Despite the clear need for physicians to advise their patients about nutrition, there is an equally well‐documented lack of skills, knowledge, and confidence of physicians in their ability to effectively counsel patients to change eating patterns. 9–12 In addition to the education‐related determinants of physicians' nutrition behavior, 13–20 several system factors affect nutrition behavior in the primary care setting, such as lack of supportive office systems and organization, perceived lack of time, and lack of payment and referral sources and materials. 21–25 …”

mentioning

confidence: 99%

Effect of training on adoption of cancer prevention nutrition-related activities by primary care practices: Results of a randomized, controlled study

Tziraki

Graubard

Manley³

et al. 2000

J Gen Intern Med

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OBJECTIVE:The National Cancer Institute (NCI) developed a manual to guide primary care practices in structuring their office environment and routine visits so as to enhance nutrition screening, advice/referral, and follow-up for cancer prevention. The adoption of the manual's recommendations by primary care practices was evaluated by examining two strategies: physician training on how to implement the manual's recommendations versus simple mailing of the manual. This article reports on the results of a randomized controlled trial to evaluate the effectiveness of these two strategies. DESIGN:A three-arm, randomized, controlled study. SETTING:Free-standing primary care physician practices in Pennsylvania and New Jersey. INTERVENTION:Each study practice was randomly assigned to one of three groups. The training group practices were invited to send one member from their practice of their choosing to a 3-hour "train-a-trainer" workshop, the manual-onlygroup practices were mailed the nutrition manual, and the control group practices received no intervention. For training group practices, training was provided in the four major components of the nutrition manual: how to organize the office environment to support cancer prevention nutrition-related activities; how to screen patient adherence to the NCI dietary guidelines; how to provide dietary advice/referral; and how to implement a patient follow-up system to support patients in making changes in their nutrition-related behaviors. MEASUREMENTS:The primary outcomes of the study were derived from two evaluation instruments. The observation instrument documented the tools and procedures recommended by the nutrition manual and adopted in patient charts and the office environment. The in-person structured interview evaluated the physician and staff's self-reported nutrition-related activities reflecting the nutrition manual's recommendations. Data from these two instruments were used to construct four adherence scores corresponding to the areas: office organization, nutrition screening, nutrition advice/referral, and patient follow-up. MAIN RESULTS:The adoption of the manual's recommendations was highest among the practices in the training group as reflected by their higher adherence scores. They organized their office ( P ‫؍‬ .005) and screened their patients regarding their eating habits ( P ‫؍‬ .046) significantly more closely to the recommendations of the nutrition manual than practices in the manual-only group. However, despite being the highest in compliance, the training group practices were only 54.9% adherent to the manual's recommendations regarding nutrition advice/referral, and 28.5% adherent to its recommendations on office organization, 23.5% adherent to its recommendations on nutrition screening, and 14.6% adherent to its patient follow-up recommendations. CONCLUSIONS:Primary care practices exposed to the nutrition manual in a training session adopted more of the manual's recommendations. Specifically, practices invited to training were more likely to perfor...

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“…It has been successfully used with individuals from a variety of demographic groups, including those with low literacy levels, ethnic minorities, blue collar workers, and older adults. 11–15 Versions of RYP have been used in other countries, and the tool has been translated into several languages. Rate Your Plate has also been effectively integrated into busy primary care practices and was used as part of a training program to improve family medicine residents' attitudes, knowledge, and practices regarding cholesterol management and to increase their self‐efficacy in providing nutrition counseling.…”

Section: Using Rate Your Plate With Patientsmentioning

confidence: 99%

“…Rate Your Plate has also been effectively integrated into busy primary care practices and was used as part of a training program to improve family medicine residents' attitudes, knowledge, and practices regarding cholesterol management and to increase their self‐efficacy in providing nutrition counseling. 14,15 Several physician offices and cardiac rehabilitation programs use RYP with patients on an ongoing basis. Others have recommended RYP as a quality eating pattern assessment/educational tool for blood cholesterol management.…”

Section: Using Rate Your Plate With Patientsmentioning

confidence: 99%

Rate Your Plate: A Dietary Assessment and Educational Tool for Blood Cholesterol Control

Gans

Hixson

Eaton

et al. 2000

Nutrition in Clinical Care

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Practitioners who wish to deliver targeted nutritional advice to their patients for the prevention and management of elevated serum cholesterol levels must first assess their patients' diets. Unfortunately, many primary care providers do not have sufficient training in nutrition to do this adequately. In this situation, dietary assessment instruments would be useful; however, standard dietary assessment methods such as 24‐h recalls, food records, and food‐frequency questionnaires are inappropriate for use in this clinical setting. Rate Your Plate (RYP), a simplified food‐frequency questionnaire consisting of questions focusing on foods contributing the most fat, saturated fat, and cholesterol to the American diet, was developed by the Pawtucket Heart Health Program (PHHP) in the late 1980s and has been updated several times to reflect changes in national dietary recommendations. This review discusses the development and clinical applications of RYP and provides advice for its use in a primary care setting. A copy of a portion of the instrument is provided in the “Clinical Tools” section of this issue of Nutrition in Clinical Care.

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A successful physician training program in cholesterol screening and management

Cited by 15 publications

References 24 publications

Labor Support: Nurses' Self-Efficacy and Views About Factors Influencing Implementation

Labor Support: Nurses' Self-Efficacy and Views About Factors Influencing Implementation

Effect of training on adoption of cancer prevention nutrition-related activities by primary care practices: Results of a randomized, controlled study

Rate Your Plate: A Dietary Assessment and Educational Tool for Blood Cholesterol Control

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