“it’s Changed the Way I Teach Students About Needing to Be Flexible....” Challenges Identified by Dietetic Preceptors During the COVID Pandemic
Journal of the Academy of Nutrition and Dietetics, Aug 31, 2023
Feeding Stressors and Resources used by Caregivers of Children with Down Syndrome: A Qualitative Analysis
Journal of the Academy of Nutrition and Dietetics, Jul 1, 2023
“We’re Better Together”: Registered Dietitians’ Preferences for Continuing Professional Education Opportunities on Providing Nutritional Care to Older Adults with Dementia
Journal of the Academy of Nutrition and Dietetics, Sep 1, 2020
Mealtime Support by Long-Term Care Staff and Impact on Meal Intake and Behaviors Among Adults with Dementia: A Systematic Review
Journal of the Academy of Nutrition and Dietetics, Oct 1, 2021
International Journal of Environmental Research and Public Health, Sep 17, 2022
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Nutrition-Related Challenges and Needs of Community-Dwelling Survivors of Traumatic Brain Injury: A Focus Group Study of the Perspectives of Caregivers
Journal of the Academy of Nutrition and Dietetics, Oct 1, 2021
Modified Mini-Mental State Examination(3MS) and chart diagnoses of dementia at hospital discharge... more Modified Mini-Mental State Examination(3MS) and chart diagnoses of dementia at hospital discharge on dementiarelated cause of death(DR-COD) in a cohort of hip fracture patients. Hospital charts, cognitive testing within 15 days of admission, and National Death Index reports from the Baltimore Hip Studies 7th cohort(2006-2011) were collected in 339(171 women,168 men) subjects. The 204 subjects that died before 2015 were analyzed using odds(OR) of DR-COD, which included codes of Alzheimer's disease or dementia as any primary or contributing cause of death. Predictors included dementia or delirium diagnosis in hospital chart, and age/education-corrected 3MS<78. Cognitive impairment was found in 13.7%(n=28) by both 3MS and chart; 13.7%(n=28) by 3MS alone, 12.8%(n=26) by chart alone (with 59.8% not impaired). DR-COD was found in 29.7% of deceased participants(n=47). Those with cognitive impairment by both 3MS and chart had greater DR-COD(OR=11.6, 95%CI:4.52-29.71, p=<.001) and shorter survival times (M=24.67 + 4.15) than those identified by neither (ref OR=1,M=64.91 + 2.3). Odds of DR-COD among those identified by 3MS alone were 5.1(95%CI:2.54-10.30); 4.3 by chart alone(95%CI:2.15-8.66). Survival times for 3MS or charts are largely the same (M=46.35 + 5.4 vs. M=45.83 + 5.7), surviving shorter than no impairment(p<.0001). 3MS alone detected impairment in 19.2% of patients who later died of DR-COD. The addition of measuring 3MS within 15 days of admission improves the prediction of DR-COD compared to chart diagnosis of dementia alone.
American journal of health education, Jun 22, 2016
Background-Effective childhood obesity prevention programs for preschool children are limited in ... more Background-Effective childhood obesity prevention programs for preschool children are limited in number and focus on changes in the child care environment rather than the home environment. Purpose-The purpose of this project was to develop and test the feasibility of a home environment obesity prevention program that incorporates mindful eating strategies and Social Cognitive Theory (SCT) constructs. Home Sweet Home is specifically designed for rural parents and grandparents of preschool-age children.
Journal of the Academy of Nutrition and Dietetics, 2020
Learning Outcome: Identify two correlates of lower weight bias among a nationally representative ... more Learning Outcome: Identify two correlates of lower weight bias among a nationally representative sample of practicing registered dietitians. Background: Weight bias among registered dietitians (RDs) can negatively impact patients. It is unclear if weight-inclusive approaches, including Health At Every SizeÒ (HAES) or receiving weight bias training, are correlated with weight bias. Exploratory secondary analyses were conducted on crosssectional data from a nationally representative sample of RDs to determine the associations of weight bias with HAES alignment, weight bias training and demographics. Methods: RDs were recruited from a random sample of 5,000 in the Commission on Dietetic Registration database. Sociodemographic data, explicit weight bias (Anti-Fat Attitudes Test, AFAT), implicit weight bias (Implicit Association Test, IAT), alignment with HAES and history of weight bias training were collected. Chi-squared test and two-way ANOVA were used for the analyses. Results: Of 246 participants, 34.1% were aligned with HAES. 34.6%, 13% and 18.3% were somewhat aligned, not aligned and did not know about HAES, respectively. 37% had prior weight bias training. HAES alignment did not correlate with demographics (p>0.05). There was no interaction between HAES alignment and weight bias training for any of the AFAT subscores (p>0.05). Blame and physical AFAT subscores were significantly lower in RDs aligned with HAES than other groups (p<0.05). AFAT-blame score (p<0.05) and IAT (p<0.05) were significantly lower in RDs with weight bias training than those without. Conclusion: Alignment with HAES and prior weight bias training are associated with lower weight bias in RDs. Future interventional research is warranted to confirm our findings.
OBJECTIVES/GOALS: Stress is amplified in parents of children with Down syndrome (DS). However, li... more OBJECTIVES/GOALS: Stress is amplified in parents of children with Down syndrome (DS). However, little is known about caregivers’use of coping strategies in relation to stress-related eating and their child with DS. The purpose of this study is to explore stressors and coping resources that increase or decrease stress-related eating among caregivers of children with DS. METHODS/STUDY POPULATION: This descriptive qualitative study sought to understand and describe the lived experiences of caregivers of children with DS. Fifteen caregivers of children, ages 2-6-years with DS, completed an online survey and individual interview. The Transactional Model of Stress and Coping was used to develop the interview guide and to assess related constructs using the Mindful Eating Questionnaire (MEQ), Perceived Stress Scale (PSS), Salzburg Stress Eating Scale (SSES), and a subscale of the Eating and Appraisal Due to Emotions and Stress Questionnaire (EADES). Interviews were audio-recorded, transcri...
Background and Objectives: In long-term care facilities in the United States, certified nursing a... more Background and Objectives: In long-term care facilities in the United States, certified nursing assistants (CNAs) provide mealtime assistance to residents with dementia, a task that substantially increases caregiver burden due to the time and attention required. The aim of this qualitative study was to explore the individual and interpersonal barriers and facilitators CNAs experience when providing mealtime assistance to residents with dementia. Research Design and Methods: Focus group questions were developed based on the corresponding levels of the Social Ecological Model. Using purposive sampling, 9 focus groups were conducted with 53 CNAs who had at least 1 year of experience as a CNA working with older adults. Focus groups were audio-recorded and transcribed verbatim. Data were analyzed using the directed content analysis approach. Results: CNAs reported individual skills, training, and personal characteristics that affected their ability to provide mealtime assistance. At the interpersonal level, CNAs identified their relationships with residents, residents' family members, and other health care professionals as factors that affect their ability to provide mealtime assistance. Discussion and Implications: These findings provide evidence for strategies that administrators can utilize to reduce caregiver burden by improving the mealtime experience. First, CNAs need adequate training, particularly to develop communication skills. Developing verbal communication skills may improve interpersonal relationships between CNAs and residents' family members and other coworkers. Developing nonverbal communication skills may foster an improved relationship between CNAs and their residents with dementia. Future research should evaluate interventions that seek to improve these skills to determine their impact on the mealtime experience.
Perceptions of and Preferences for Dementia Care Training among Registered Dietitian Nutritionists in Alabama: A Qualitative Focus Group Study
A Qualitative Analysis of Experiences With Food-Related Activities Among People Living With Parkinson Disease and Their Care-Partners
Journal of Applied Gerontology
Objectives: The purpose of this qualitative study was to explore factors associated with the abil... more Objectives: The purpose of this qualitative study was to explore factors associated with the ability of people with PD to perform food-related activities (FRAs). Methods: Eleven dyads, older adults with Parkinson disease (PD) and their care-partners ( n = 22), completed virtual semi-structured interviews guided by the Social Cognitive Theory (SCT) that were independently analyzed by two coders via directed content analysis. Results: The following themes were identified—(1) Personal: perception of a healthy diet, perception of how nutrition influences PD, confidence in following a healthy diet, and barriers to performing FRA; (2) Environmental: previous sources of nutrition information and willingness to changing their diet with a registered dietitian; and (3) Behavioral: modifications to FRA due to food-medication interactions, and skills necessary to maintain a healthy diet. Discussion: Findings from this study highlight the need for nutrition intervention research to inform eviden...
Food-Related Resources Available to Community-Dwelling Traumatic Brain Injury Survivors and their Caregivers: A Focus Group Study
Journal of the Academy of Nutrition and Dietetics, 2021
Objectives This study utilized the Healthy Eating Index (HEI) to assess dietary quality by the fr... more Objectives This study utilized the Healthy Eating Index (HEI) to assess dietary quality by the frequency of frozen meal consumption among community-dwelling older adults. Methods A sample of 2,730 participants, ≥60 years and not participating in meal programs through the Older Americans Act, was selected from the National Health and Nutrition Examination Survey (NHANES) 2015–2018. Frequency of frozen meal consumption was recoded into non-consumers, occasional consumers, and frequent consumers (0, 1–2, and 3+ times per month, respectively). The HEI 2015 was calculated using two days of dietary recalls. Linear regression analysis was used to assess the relationships between HEI and frozen meal consumption while adjusting for gender, race/ethnicity, marital status, education, and body mass index. Results The percentage of participants classified as non-consumers, occasional consumers, and regular consumers was 58.0%, 24.7%, and 17.3%, respectively. Mean HEI scores for non-consumers, oc...
Uploads
Papers by Joy Douglas