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Browsing by Author "Bukhari, Asma Sultana, author"

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    Assessment of nutrition education strategies to reduce cardiovascular disease in U.S. Army hospitals
    (Colorado State University. Libraries, 2007) Bukhari, Asma Sultana, author; Jennifer Anderson, advisor; Kaminski, Karen, committee member; Gould, Susan, committee member
    Cardiovascular disease (CVD) continues to be the leading cause of death in the United States with an estimated 79,400,000 adults diagnosed with this disease in 2004 and costs of $431.8 billion projected this year. As a result there is an increased emphasis on early detection and treatment of risk factors. Military personnel are vulnerable to this killer disease due to indulgence in unhealthy behaviors such as cigarette smoking, physical inactivity, poor nutrition, and increased stress. These behaviors can have a profound impact on the military readiness and mission accomplishment. The purpose of this study was to identify strategies to enhance nutrition education provided to the military personnel at US Anny hospitals to manage CVD. The results will be used to identify weaknesses and gaps in an existing program and facilitate improvement of CVD nutrition education. It was hypothesized that nutrition education can be enhanced by aligning the existing CVD management programs with evidenced based guidelines that will provide program consistency. The target audience for this study was Registered Dietitians in clinical leadership positions at U.S Anny hospitals and outpatient clinics. The study was approved by the Colorado State University Human Research Committee and the U.S Anny Medical Research and Material Command Human Research Protection Office. Survey validity was established by obtaining information from a review of literature and feedback from expert Army dietitians and CSU faculty. Survey reliability was established by a test and re-test during a pilot test on a subset of Army dietitians. The responses were analyzed using computer software and reported as mean, standard deviations and frequencies. The survey response rate was 70% (n=21). The primary educators of CVD risk reduction were dietitian. Sixty-two percent of the hospitals provided nutrition education based on current guidelines. The current program was rated either "very good" or "good" by 67% of the dietitians. Eighty-one percent of dietitians experienced variation in the program at their hospitals. Only 24% of the dietitians indicated a mechanism to reach deployed soldiers with hypercholesterolemia. A web-based resource center was selected by 43% of the dietitians followed by 23% who suggested development of a self-paced web-based education program for deployed or remotely located soldiers. Caution is advised while interpreting the results because the findings are based on dietitians' knowledge and opinions and may not have captured all the services offered to the patients. The survey provided insight into current program and suggestions for future program improvements. Cost effectiveness and improved patient satisfaction of medical nutrition therapy by Registered Dietitians is already established. Army dietitians need to take the lead in designing and implementing programs to reduce the CVD risks among military personnel. Such interventions will improve the quality of life of soldiers by providing long term health benefits; and that, in tum, will save resources from reduction in mortality and morbidity associated with CVD events. It is important to explore various communication media for information dissemination.
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    ItemOpen Access
    Effectiveness of a Web-based nutrition education program to reduce cardiovascular disease risk among U.S. Army personnel and their families ("Defend your heart" study)
    (Colorado State University. Libraries, 2009) Bukhari, Asma Sultana, author; Jennifer Anderson, advisor; Kaminski, Karen, committee member; Harris, Mary, committee member; Gould, Susa Martin, committee member
    Cardiovascular disease (CVD) continues to be the leading cause of mortality and morbidity in the United States. Military personnel are also vulnerable to this killer disease due to indulgence in unhealthy behaviors such as cigarette smoking, physical inactivity, poor nutrition, and high stress. Formative assessment identified a need for web-based resources for the Army registered dietitians (RDs) and for deployed or remotely located military beneficiaries. The purpose of the current study was to create and assess the effectiveness of a web-site "Defend Your Heart". This web-site was targeted to two audiences: RDs and a self care program for the military beneficiaries. This self care program was created using the framework of Rosenstock's Expanded Health Belief Model (EHBM). The effectiveness of a web-based self care program was evaluated using a randomized 4-month study with participants either in the web-based group (n=17) or the usual care (n=13) at a U.S. Army hospital. Data were collected at baseline, two months and four months. Variables measured were anthropometric, blood pressure, lipid profile, fasting glucose, C-reactive protein, nutrient intake, physical activity, and EHBM constructs. Data were analyzed using analysis of covariance and using baseline means to adjust the two and four month data. Results indicated a significant reduction of total blood cholesterol, LDL-cholesterol, predicted body fat percent, and estimated body mass index (P<0.05) in the web-based group. The usual group demonstrated a significant increase in self-efficacy score at month four (p<0.05). Significant within group changes for both groups were demonstrated for the reduction in waist circumference and serum triglycerides (p<0.05). Due to a smaller sample size caution is required while interpreting the results. The results of the web-site usability showed that a majority of the RDs (n=34) and web-based participants (n=8) were satisfied with the content and ease of navigation. RDs and web-based groups suggested enhancing web-site eye appeal, interactivity, and printing capability. Web-based programs may serve as an effective alternate mechanism of delivering CVD risk reduction education. The U.S Army needs to invest in further research to launch an effective web-based program for military beneficiaries to reduce CVD risk factors.