Dietary Micronutrient Levels in Allied Health and Nursing Students PDF
Preview Dietary Micronutrient Levels in Allied Health and Nursing Students
Walden University ScholarWorks Walden Dissertations and Doctoral Studies Walden Dissertations and Doctoral Studies Collection 2015 A Cross-Sectional Study: Dietary Micronutrient Levels in Allied Health and Nursing Students Grisseel A. Cruz-Espaillat Walden University Follow this and additional works at:https://scholarworks.waldenu.edu/dissertations Part of theEpidemiology Commons, and theHuman and Clinical Nutrition Commons This Dissertation is brought to you for free and open access by the Walden Dissertations and Doctoral Studies Collection at ScholarWorks. It has been accepted for inclusion in Walden Dissertations and Doctoral Studies by an authorized administrator of ScholarWorks. For more information, please [email protected]. Walden University College of Health Sciences This is to certify that the doctoral dissertation by Grisseel Cruz-Espaillat has been found to be complete and satisfactory in all respects, and that any and all revisions required by the review committee have been made. Review Committee Dr. Cassius Lockett, Committee Chairperson, Public Health Faculty Dr. Aaron Mendelsohn, Committee Member, Public Health Faculty Dr. German Gonzalez, University Reviewer, Public Health Faculty Chief Academic Officer Eric Riedel, Ph.D. Walden University 2015 Abstract A Cross-Sectional Study: Dietary Micronutrient Levels in Allied Health and Nursing Students by Grisseel Cruz-Espaillat MPH, Florida International University, 2000 MD, Universidad Central Del Este, 1986 AA, Miami Dade Community College, 1982 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Public Health Epidemiology Walden University March 2015 Abstract The adequate intake of micronutrients is important to maintain optimal health and prevent nutritional disorders and chronic disease. Studies have shown that medical students often reduce self-care behaviors and lack adequate dietary intake, leading to nutritional deficiencies. In this quantitative cross-sectional study, measurements of micronutrient levels in a sample of allied health and nursing students were compared to Recommended Daily Allowance (RDA) values. NutritionQuest Data-on-Demand System was used to analyze nutrients and food group intake. The postpositivist paradigm was used to examine how the independent and dependent variables relate to each other. Using a one- sample t test, a comparison of average micronutrient intake among study participants with RDA values for those micronutrients showed that average micronutrient intake in the study population was higher than recommended values. Two sample t-test results showed no significant difference in average intake of micronutrients among participants with high and low income levels, or with high and low stress levels. As the normality assumption was not satisfied by the outcome variables, nonparametric tests were used to evaluate hypotheses. While this finding does not support the original hypothesis, it could have implications for the role of allied health and nursing practitioners in the care of both their patients and members of their medical team. Conversely, an assumption of this study was that a high level of similarity between the traditional medical student population and the allied health and nursing population in terms of nutritional habits may have led to a flaw in the overall research hypothesis. The detection of micronutrient deficiencies in students can bring awareness to improve nutritional intake and initiate a change in how public health officials advocate healthy and balanced diets. A Cross-Sectional Study: Dietary Micronutrient Levels in Allied Health and Nursing Students by Grisseel Cruz-Espaillat MPH, Florida International University, 2000 MD, Universidad Central Del Este, 1986 AA, Miami Dade Community College, 1982 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Public Health Epidemiology Walden University March 2015 Dedication I dedicate this dissertation to my mother, Julia Esther Cruz Sanchez, my sons, Eliseo de Jesus Espaillat, Jr. and Julyan Elishah Espaillat, and my sister, Martizael Lanza. Thank you for the support, encouragement, and constant love that have sustained me throughout my life. I also thank my husband, Dr. Eliseo de Jesus Espaillat, for his support. Acknowledgments I would like to thank my committee members, Dr. Cassius Lockett, Dr. Aaron Mendelsohn, and Dr. German Gonzalez for your assistance and suggestions throughout my dissertation process. I would like to express my sincere gratitude to my supervisors, Dr. Gary Markowitz and Dr. Cristy Sibila for their academic, emotional, and psychological support. I would like to give my deepest appreciation to the faculty, staff, and students of Keiser University in the Miami campus for allowing me to access data collection and completion of my study. I cannot forget to acknowledge those who have crossed my path in the course of this journey to critique my work and provide encouragement, such as Dr. Tammi L. Fleming-White, Andrea Bowers, Dr. John Orisasona, Dr. Michelle Witherspoon, Belkis Cabrera, Cyndi White, Eliseo de Jesus Espaillat, Jr., and Ivette Enriquez. Table of Contents List of Tables .......................................................................................................................v List of Figures ................................................................................................................... vii Chapter 1: Introduction to the Study ....................................................................................1 Introduction ....................................................................................................................1 Background ....................................................................................................................4 Statement of the Problem ...............................................................................................8 Purpose of the Study ....................................................................................................13 Research Question and Hypotheses .............................................................................15 Theoretical Framework ................................................................................................17 Nature of the Study ......................................................................................................18 Definitions....................................................................................................................19 Assumptions .................................................................................................................20 Scope and Delimitations ..............................................................................................20 Limitations ...................................................................................................................22 Significance of the Study .............................................................................................23 Summary ......................................................................................................................25 Chapter 2: Literature Review .............................................................................................29 Introduction ..................................................................................................................29 Literature Search Strategy............................................................................................29 Micronutrient Background ...........................................................................................30 Micronutrients ........................................................................................................34 Trace Elements.......................................................................................................38 i Micronutrient Deficiency .............................................................................................39 Epidemiology ...............................................................................................................51 Incidence and Prevalence of Micronutrients..........................................................51 Theoretical Framework ................................................................................................54 Comparative Studies on Micronutrient Deficiency .....................................................55 Micronutrient Sustainment Roles ..........................................................................59 Trace Elements Sustainment Roles ........................................................................67 Risk Factors .................................................................................................................68 Modes of Administration .......................................................................................70 Summary of Research ..................................................................................................73 Chapter 3: Research Methodology.....................................................................................75 Introduction ..................................................................................................................75 Research Design and Rationale ...................................................................................76 Research Hypotheses ...................................................................................................77 Setting and Sample ......................................................................................................81 Sampling and Sampling Procedures ......................................................................82 Procedures for Recruitment, Participation, and Data Collection ...........................84 Data Collection ......................................................................................................87 Study Eligibility .....................................................................................................89 Instrumentation and Materials .....................................................................................90 Block Rapid Food Screeners Questionnaire ..........................................................90 The Perceived Stress Scale ....................................................................................92 Reliability Analysis ................................................................................................93 ii Income Interpretation .............................................................................................93 Data Analysis ...............................................................................................................94 Threats to Validity .................................................................................................97 Ethical Consideration ...................................................................................................98 Protection of Participants’ Rights ..............................................................................100 Summary ....................................................................................................................101 Chapter 4: Results ............................................................................................................102 Introduction ................................................................................................................102 Data Collection ..........................................................................................................104 Subject Recruitment .............................................................................................104 Prescreening Data/Phase I ....................................................................................105 Phase II Screening................................................................................................106 Results ........................................................................................................................107 Demographic Data ...............................................................................................107 Descriptive Analyses ...........................................................................................110 Mann-Whitney U Analyses..................................................................................119 Perceived Stress Scale..........................................................................................122 Multiple Linear Regression..................................................................................127 Summary ....................................................................................................................134 Chapter 5: Discussion, Conclusions, and Recommendations ..........................................137 Introduction ................................................................................................................137 Interpretation of Findings ..........................................................................................138 Independent Variable (Income) ...........................................................................139 iii
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