Document Type

Presentation

Publication Date

4-21-2020

Publication Title

the University of Providence 5th Annual Undergraduate Research Symposium

Abstract

Background: Gestational diabetes (GDM), a common pregnancy complication, increases the risk of dangerous birth outcomes, fetal anomalies, and sustained disease and comorbidity for mothers and infants throughout the lifespan. Insulin use is an independent predictor of anomalies. Our prenatal care did not include detailed nutrition assessments and modifications such as Mediterranean diet, a lifestyle associated with reduction in non-pregnant adult diabetes incidence, even reversal. Adding hands-on cooking to nutrition counseling has improved A1c outcomes. We hypothesized a comprehensive package of diet review, nutrition guidelines, and participation in an onsite cooking class initiated at the beginning of prenatal care (Green Pregnancy – GP) would reduce GDM incidence and insulin use.

Methods: Study conducted in two obstetric clinics, control period 2018, GP intervention 2019. Participation in GP was voluntary. We standardized GP, inviting all pregnant patients at their orientation to care visit. Participants attended a single culinary medicine group where families and nurses cooked together while exploring patient-selected topics woven in with cooking skills and GDM prevention principles.

Results: 2018 baseline: 146 pregnant patients developed GDM, 53 (36%) required insulin. 2019: 229 patients developed GDM, 48 (21%) required insulin; none of the 20 women who participated in GP developed GDM. There was no anemia in GP pregnancies, and there were no NICU admissions in their infants.

Conclusions of Prior Work and Problem Statement: Comprehensive culinary nutrition lifestyle modification with an onsite cooking class emphasizing Mediterranean diet is associated with a reduction in GDM, though moving into 2020, attendance was lower than projected. Nurses aimed to discover if adding RN in-person invitations vs. RN reminder calls alone would improve Green Pregnancy nutrition group attendance. Nurses imagined that when they placed a reminder phone call and invited patients to attend nutrition groups in-person, there would be an increased opportunity for enrollment and attendance. Based on the small change nurses implemented with adding in-person invitations to reminder calls, enrollment and attendance at the Women's Clinic Green Pregnancy nutrition group improved over a three-week period. Nurses reported the connection made during the patient-facing invitation impacts the conversation during the reminder call. Explore the same nurse who met the patient in-person being the nurse to place the reminder call to capitalize on that connection. Well-designed, systematic studies of specific methods of appointment invitations and reminders are needed to discover the link between the intervention and attendance rates.

Clinical Institute

Women & Children

Clinical Institute

Kidney & Diabetes

Department

Nursing

Department

Obstetrics & Gynecology

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