Perceptions of and Barriers to Dietary Counseling among Adults with Type II Diabetes

Abstract

Problem: Type II diabetes (T2D) is a common occurrence in healthcare and found in nearly every part of the world. Epidemiological evidence suggests that, without effective prevention and control programs, the burden of diabetes will continue to increase globally. Programs involving dietary counseling have proven efficacious for improving a range of outcomes in T2D, including a decrease in the HbA1c by 0.5-2%, and have been shown to prevent or postpone associated comorbidities. Despite the endless benefits dietary counseling can provide, little is known about patient perceptions regarding dietary counseling. Furthermore, there is a lack of evidence on the various barriers patients face in adhering to the dietitian’s recommendations. Project Purpose: One of the Healthy People 2020 objectives is to reduce diabetes and its economic burden as well as improve the quality of life for all persons who have, or are at risk for, diabetes. Additionally, the Standards of Medical Care in Diabetes published by the American Diabetes Association in January 2017 recommends a dietary counseling program, preferably by a registered dietitian (RD), for all people with diabetes. In considering the influence dietitians have on promoting lifestyle interventions, the purpose of this quality improvement project was to determine patients’ perceptions of dietary counseling and the barriers faced in adhering to the dietitian’s recommendations. The project sample included adults age 18 and older who have T2D, are of either gender, and any race or ethnicity. Pender’s health promotion model was the applied theoretical framework for this project. Project Method: The project took place at the South Branch Library in Kansas City, Kansas. The sample was derived from patients who attend Silver City Health Clinic (SCHC), an underserved urban clinic in Kansas City, Kansas. Patients who met the inclusion criteria were encouraged by their providers to attend any or all of the eight dietary sessions that were free to attend and were conducted by a RD and RN employed by SCHC. A survey was administered at the end of the sessions to evaluate patients’ perceived benefits of the dietary counseling they received, along with the barriers they believed may impede adherence to the recommendations.