Date of Award:

2005

Document Type:

Dissertation

Degree Name:

Doctor of Philosophy (PhD)

Department:

Nutrition, Dietetics, and Food Sciences

Advisor/Chair:

Nedra K. Christensen

Abstract

Suboptimal growth and nutritional status are problematic for children with cystic fibrosis (CF). Optimal nutrition predicts better lung function and longevity. Daily nutrition therapy for children with CF requires adequate food resources, knowledge of appropriate nutrition and behavior management skills, and confidence in one's ability to correctly apply the necessary skills. The Mountain West Cystic Fibrosis Consortium Questionnaire (MWCFC-Q) was designed as an educational needs assessment for parents of children with CF. The goal was to identify areas of concern that could be targeted for educational intervention to ultimately improve children's growth and nutritional status.

Data analyzed from 305 returned surveys included household food security, use of food assistance programs, knowledge of nutrition and general CF therapy, and self-confidence in ability to manage CF care. Questions regarding food security and knowledge of CF nutrition and general therapies were multiple choice. A ten point Likert-type scale was employed for determining confidence around management of CF related issues.

Respondents' median accuracy for questions regarding nutrient content of commonly used foods was 71.4% and 57.9% for CF nutrition therapy, respectively. Although overall confidence in CF management was high, scores for confidence in nutrition and behavioral management were significantly lower than for confidence in CF respiratory/medical management and CF Center recommendations.

In the second phase of this project, a pilot study using the chronic care model was developed for enhancement of nutrition and behavior management skills of parents of children with CF. Participants attended a series of four classes, each with a short didactic presentation, group activity, and discussion. Important features of this evidence-based educational program included nutrition and behavior management, self-efficacy, problem solving skills, and peer mentoring. A pre-, post-, follow-up, follow-up format was used to evaluate changes in participants' knowledge and self-confidence regarding nutrition and behavioral management. Comparisons were made with responses to the mailed survey using the same questionnaire. Secondary outcomes were changes in the rate of weight gain and growth for participants' children with CF. Participants showed statistically significant improvement in knowledge of nutrition therapy for CF at post-intervention compared with respondents to the mailed survey.

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