A systematic review and meta-analysis of the literatures was conducted to evaluate the effectiveness of nutrition intervention by dietitian. The 31 studies that were all randomized controlled trials, were identified from computerized search of published researches on MEDLINE, Embase database until January, 2003 and review of reference lists. The main search terms were the combination “dietitian”, “dietary intervention”, “nutrition intervention” or “nutritional intervention” and “effectiveness”. The subgroup analysis was performed by the publication year, quality score, type of disease, content of intervention, intervention provider, type of intervention (nutritional counseling and education/nutrilion counseling and education + diet modification), method of intervention (individual/group/individual + group) and follow-up period. Two reviewers independently selected trials for inclusion, assessed the quality and extracted the data. The meta-analysis of 31 studies based on the random effect model showed that the medical nutrition therapy was significantly effective in treating the diseases (effect size 0.1715 : 95% confidence interval 0.0938-0.2491). This study showed the clear evidence of the effectiveness of nutrition intervention through the meta-analysis. So the nutrition intervention by dietitian should be recommended and recognized as the effective therapy of treating the diseases. Also the nutrition intervention should be conducted regularly to maintain the effectiveness of the nutrition intervention. The nutrition intervention was significantly effective in treating the diseases on the random effect model (effect size 0.1715 : 95% confidence interval 0.0938-0.2491).
Objectives: A meta-analysis of the literatures was conducted to evaluate the cost-effectiveness of medical nutrition therapy by dietitians. Methods : The 30 studies were identified from a computerized search of published research on MEDLINE, Science-Direct and the PQD database until May, 2002 and a review of reference lists. The main search terms were“dietitian”,“dietary intervention”,“nutrition intervention”, “cost”,“cost-effectiveness”and“cost-benefit analysis”. The subgroup analysis was performed by publication year, study design, intervention provider, type of patient (in/out-patient) and type of cost (total cost/direct cost). Two reviewers independently selected trials for inclusion, assessed the quality and extracted the data. Results : The 30 studies were identified using the electric database search and bibliographies. The 17 trials were eligible for inclusion criteria, then the systematic review and a meta-analysis were conducted on effectiveness and cost-effectiveness of medical nutrition therapy. The quality of the studies was evaluated using the quality assessment tool for observational studies. The quality score was 0.515 $\pm$ 0.121 (range : 0.279-0.711, median : 0.466). The meta-analysis of 17 studies based on the random effect model showed that medical nutrition therapy was highly effective in treating the diseases (effect size 0.3092 : 95% confidence interval 0.2282-0.3303). The vote-counting method, one of meta-analysis methods, was applied to evaluate the cost-effectiveness of medical nutrition therapy conducted by dietitians. Two criteria (method 1, method 2) for voting were used. The calculated p-values for method 1 (more conservative method) and method 2 (less conservative method) were 0.1250 and 0.0106, respectively. Medical nutrition therapy by dietitians was significantly cost-effective in the method 2. Conclusion. This meta-analysis showed that the effectiveness of medical nutrition therapy was statistically significant in treating disease (effect size 0.3092), and that the cost-effectiveness of medical nutrition therapy was statistically significant in the method 2 (less conservative method) of vote counting. (Korean J Nutrition 36(5): 515~527, 2003)
An, Sumin;Ahn, Hyejin;Woo, Jeonghyeon;Yun, Young;Park, Yoo Kyoung
Journal of Nutrition and Health
/
v.54
no.5
/
pp.515-533
/
2021
Purpose: A systematic review and meta-analysis of nutrition educational intervention studies was performed to assess the association between nutrition education intervention and fruit & vegetable (F&V) preferences and nutrition knowledge in preschool children. Methods: The relevant studies of nutrition education intervention and F&V preferences and nutrition knowledge published from January 2000 to June 2020 were located using PubMed, Web of Science, Cochrane Library, Research Information Sharing Service, Korean Studies Information Service System databases, and lists of references. A random-effects meta-analysis was conducted to estimate the standardized mean difference with a 95% confidence interval (CI). Subgroup analyses were performed to identify the association between nutrition education and F&V preferences and nutrition knowledge. Results: The results show that the effect sizes (ES) of F&V preferences and nutrition knowledge of preschool children were 0.31(95% CI, 0.23, 0.39), and 1.69(95% CI, 1.27, 2.12), respectively. The result of subgroup analysis, nutrition education focused on F&V (F&V preferences, ES: 0.32; nutrition knowledge, ES: 2.09) presented a slightly larger effect than general nutrition education (F&V preferences, ES: 0.26; nutrition knowledge, ES: 1.62). As for the type of exposure to F&V, direct exposure education (F&V preferences, ES: 0.40) had a greater effect than indirect exposure (F&V preferences, ES: 0.26). This meta-analysis showed that nutrition education intervention had positive effects on the F&V preferences and nutrition knowledge in preschool children. Conclusion: In conclusion, from the meta-analysis and subsequent subgroup analysis, we found that varied types of nutrition education intervention had varying effects on F&V preferences and nutrition knowledge in preschool children.
Constructs with seven latent evaluation indicators and 18 observable survey questions were developed by food and nutrition experts to calculate a food safety recognition and practice index for children. The purpose of this study was to suggest statistical approaches to test construction validity on the constructs, obtain weights of the evaluation indicators, and develop questionnaires to calculate a children's food recognition and practice index. Survey data of 2,400 elementary fifth grade students were used as empirical results. Test validity was evaluated by exploratory factor analysis and confirmed to be highly significant by confirmatory factor analysis [i.e., linear structural relations (LISREL) analysis]. Standardized path coefficients of the LISREL analysis were suggested based on weights, and the weights were compared using the AHP and Delphi methods.
This study is an analysis on how current elementary teachers think about nutrition education, how they are teaching it, and problems that have occurred. The main purpose of this analysis was to deal with future problems in nutrition education by analyzing the present situation . The survey was done on 544 currently working elementary school teachers. from the 9 education departments within Seoul, 2 schools were chosen from each department by stratified random sampling. The survey used a questionnaire that was passed out personally to teachers from September 1, 1997 to the 19th. The 544 usable questionnaires were analyzed by using the teachers had nutrition education training and the average score of nutrition knowledge was 13.30 $\pm$2.73 out of 20. Nutrition education was being taught as apart of other subjects in 87.9% of the schools, and mainly by lecture. Audio visuals aids were used by 53.7% of the teachers and the most common was the VTR. Nutrition education was taught as a part of physical education and 41.5% were using teacher guides to help them. 91.9% of the teachers supported the idea of nutrition education in elementary schools. Nutrition education was supported by 80. 0% of teachers to begin when children are in kindergarten, proving that early nutrition education is supported. The analysis showed that nutrition education should be taught by parents(29.4%) , teachers(29.2%), and nutritionists(25.9%) relating that family , education, and school lunch programs should tie in with each other. 96.7% of the teachers responded that they would teach nutrition education. However, 41.0% disagreed with having a separate course for nutrition education . Proper eating habits, nutrition and its diseases, and growth with nutrition were the main categories within nutrition education and the most effect method was thought to have audio visuals, guides for teachers , and to link the subject matter with school lunch programs. The teachers main responses to problems with children were that they are too much instant food, did not eat in a variety , and had no manners in eating. Ironically, the believed that malnutrition, fainting and growth stunt were not important nutrition problems.
The purpose of this study was to understand barrier factors affecting nutrition education jobs and determining priorities according to frequency of occurrence of obstacles. Focus group interview (FGI) was conducted on 11 nutrition teachers, and the result are summarized by the phenomenological analysis method. The barriers of nutrition education consisted of three categories, seven themes, and 10 sub-themes. The three categories were divided into work burden, recognition of nutrition education, and limitations of the nutrition education environment. Recognition of nutrition education was further divided into internal recognition from nutrition teachers and individual and external recognition from students and staff. The results showed that the most frequent barrier experienced by nutrition teachers in the work burden category was heavy work loads of foodservice management, followed by irrational working environment. In addition, limitations of the nutrition education environment consisted of absence of standard curriculum and textbooks, inadequate education infrastructure, and inadequate class time. To improve this, it is necessary to reduce nutrition teacher's food service management and develop standard curriculum and educational materials for nutrition education.
The objective of this study was to examine job performance and importance, and job satisfaction of school foodservice dietitians nutrition teacher in Jeonnam and Gwangju area according to the school types (elementary school, middle school, high school). A total of 646 questionnaires were distributed, 244 questionnaires were analyzed using SPSS 12.0 for a descriptive analysis, t-test and ANOVA. There were significant differences between the school dietitians' nutrition teachers' job performance and importance in all areas of the job analysis for all school types. In the foodservice management/evaluation and nutrition education area, elementary and middle school foodservice dietitian nutrition teacher showed a significantly higher performance, compared to that of high school dietitian nutrition teacher. Nutrition education was recognized by elementary and middle school dietitian nutrition teacher to be more significantly important than that of high school dietitian nutrition teacher. Elementary school foodservice dietitian nutrition teacher was most satisfied with their job condition. Dietitian working in middle school was least satisfied with the salary and compensation. These results suggest that appropriate curriculum should be structured according to foodservice dietitian nutrition teacher of the school type for improving the work efficiency. In order to increase the job satisfaction, the employment status of school dietitian should be guaranteed by the government and school officials, especially in the middle and high schools.
The purpose of this study was to develop a standardized job description for dietitians working in the public health nutrition area. Work-oriented job analysis methodology was employed for the study purpose. Subjects of 38 dietitians currently working at health centers in 2002 were recruited. Based on the focus group interview with 7 public health nutritionists and 7 professors, information about task elements was collected. Questionnaires measuring work performance and self-perception of importance of the selected task elements were administered. Reliability and validity of this instrument were tested by Chronbach's alpha and factor analysis. SAS PC package program was used for the statistical analysis. The final developed job description for public health nutritionists included 5 duties, 20 tasks and 93 task elements. The results of this study can be summarized as follows; 1) 5 duty areas are A. plan and evaluation of public health nutrition services, B. developing nutrition education materials, C. implementing nutrition services, D. networking community, and E. self development. 2) Each duty area from A to E was composed with 6, 2, 6, 4, 2 tasks, respectively. 3) Each duty area from A to E was composed with 24, 8, 38, 14, 9, and 2 task elements, respectively.
This study was conducted to develop the NutriSonic Web Expert System for Meal Management and Nutrition Counseling with Analysis of User's Nutritive Changes of selected days and food exchange information with easy data transition. This program manipulates a food, menu and meal and search database that has been developed. Also, the system provides a function to check the user's nutritive change of selected days. Users can select a recommended general and therapeutic menu using this system. NutriSonic can analyze nutrients and e-food exchange ("e" means the food exchange data base calculated by a computer program) in menus and meals. The expert can insert and store a meal database and generate the synthetic information of age, sex and therapeutic purpose of disease. With investigation and analysis of the user's needs, the meal planning program on the internet has been continuously developed. Users are able to follow up their nutritive changes with nutrient information and ratio of 3 major energy nutrients. Also, users can download another data format like Excel files (.xls) for analysis and verify their nutrient time-series analysis. The results of analysis are presented quickly and accurately. Therefore it can be used by not only usual people, but also by dietitians and nutritionists who take charge of making a menu and experts in the field of food and nutrition. It is expected that the NutriSonic Web Expert System can be useful for nutrition education, nutrition counseling and expert meal management.
The purpose of this study was to analyze the importance-performance of clinical nutrition management in convalescent hospitals. The research was carried out based on questionnaires administered from March to April, 2015 to 73 dietitians at 40 convalescent hospitals in the Gyeongnam area. There was a statistically significant difference between the mean scores for importance (4.01/5.00) and performance (2.95/5.00) of clinical nutrition management. The importance and performance grid analysis showed that participation in a nutritional management committee, administration of patients using a cooperation program among hospital departments, cooperation with a medical team on patient's nutrition status, nutrition initial assessment, nutrition care process for patients showing malnutrition, nutrition care process for tube feeding patients, management of a therapeutic diet, meal management using dietary slip instructions including a therapeutic diet, and explication of a therapeutic diet for patients scored high regarding importance and performance (doing great area). Medical records on patient's nutrition management, and nutrition counseling for requested patient scored low regarding the importance and high regarding performance (overdone area). Participation in medical rounds, personal nutrition education for patients, group nutrition education for patients, nutrition education for medical teams, development of a menu for therapeutic diet and standardized recipes, and provision of information on diet therapy for patients after discharge scored low regarding importance and performance (low priority area). Accreditation of convalescent hospitals and interest of medical professionals in clinical nutrition management were effective variables for the importance-performance gap of clinical nutrition management. In conclusion, the accreditation process and positive awareness of medical professionals with regard to clinical nutrition management had positive effects on reduction of the importance-performance gap in clinical nutrition management at convalescent hospitals. The strength of clinical nutrition management in the accreditation and development of an education program for increasing medical team or administrator interest in clinical nutrition management could lead to improvement of clinical nutrition management for elderly patients in convalescent hospitals.
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