Date of Award:

8-2022

Document Type:

Dissertation

Degree Name:

Doctor of Philosophy (PhD)

Department:

Nutrition, Dietetics, and Food Sciences

Committee Chair(s)

Heidi J. Wengreen

Committee

Heidi J. Wengreen

Committee

Gretchen G. Peacock

Committee

Mateja Savoie-Roskos

Committee

Maryellen McClain-Verdoes

Committee

Katie Brown

Abstract

Many factors influence health; two such factors that warrant additional research include interdisciplinary healthcare teams and food insecurity. These factors may be particularly important among vulnerable populations such as individuals with special healthcare needs, lower income populations, and individuals with disabilities.

Interdisciplinary teamwork promotes improved, and more efficient patient care through the collaboration of healthcare providers in various professional disciplines. Registered Dietitian Nutritionists (RDNs) are experts in the science and application of nutrition, which plays an important role in various disease states. Despite the established need for RDNs on interdisciplinary teams, there is limited research in the interdisciplinary scholarship targeting this profession. As a first step in determining the quality of RDN integration in healthcare teams, interdisciplinary attitudes of RDNs and students studying to become RDNs across the United States (U.S.) were analyzed. Results revealed that the specific area of specialty of the RDN (clinical RDNs), feeling more valued by other team members, more frequent participation in teams, and gender (females) were associated with more favorable attitudes of interdisciplinary healthcare teams. More time with the RDN credential was associated with slightly less favorable attitudes.

In 2017, the accreditation parameters for dietetic programs in the U.S. required that all programs include interprofessional-related education (IPE) to support students in their future readiness to participate effectively in interdisciplinary teams. As a step to determining IPE effectiveness in dietetic students, this dissertation explored various aspects of IPE, including specific IPE approaches alongside student and program director perspectives, as well as how directors determine whether students meet the IPE-related learning objectives. Main findings indicated that multiple approaches to meet IPE standards were related to higher student satisfaction of IPE. Additionally, few programs seem to be utilizing validated tools to evaluate whether students are meeting IPE-related learning objectives, which makes the broad assessment of readiness for interdisciplinary teamwork challenging.

Food insecurity occurs when the quality or quantity of available food is insufficient. Lower income individuals and persons who have a disability experience food insecurity at higher rates. This dissertation investigated the impact of the COVID-19 pandemic on food access and food insecurity in lower-income Utahns four to six months following the onset of COVID-19 (March 2020). Frequent difficulties with physical access to food in combination with children in the home were related to food insecurity severity, as were employment changes during the pandemic, and older age. This emphasizes the need for additional support and preventative efforts for lower-income families in reducing food access challenges during times of crisis, such as a pandemic.

This dissertation also examined the relationship between disability and self-reported health status, and whether food insecurity among persons with disabilities contributed to disparities in self-reported health. Results suggested that food insecurity may play a role in poorer self-reported health in individuals with disabilities compared to individuals without disabilities. This finding is important, as it proposes that reducing food insecurity among persons with disabilities may impact health outcomes.

In conclusion, this dissertation substantially adds to existing work by investigating RDN and dietetic student attitudes of interdisciplinary teams and aspects of IPE in dietetic programs; a profession that is generally understudied in the interdisciplinary healthcare research. Moreover, this research explored food access, food insecurity, and health in vulnerable populations—lower income individuals and persons with disabilities. The exploration of food access/food insecurity among lower-income Utahns may help to reduce health burden in this population. Lastly, reducing food insecurity in persons with disabilities may impact self-reported health. Though the interdisciplinary teams-related research in RDNs and students did not directly correspond to health outcomes in the studies conducted herein, perhaps they set the stage for future research in the area.

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