Abstract
Objectives
1. To describe the development of a dietary assessment tool (Rapid Eating and Activity
Assessment for Patients [REAP]) that quickly assesses a patient’s diet and physical
activity and facilitates brief counselling by a primary care provider, and 2. To describe
the evaluation of the REAP in terms of its reliability, validity, and ease of use
by primary care providers.
Design, Setting and Participants
The evaluation of REAP included: 1) an implementation feasibility study conducted
with 61 medical students and practicing physicians in practice settings at various
medical schools; 2) a calibration study with 44 Brown University Medical School students;
3) cognitive assessment testing with 31 consumers in Rhode Island; and 4) a reliability
and calibration study of the revised tool with 94 consumers in Rhode Island and Massachusetts.
Results
The feasibility study revealed moderately high rankings on usefulness, ease, practicality,
and helpfulness. The calibration studies demonstrated that REAP has excellent test-retest
reliability (r = 0.86, P < .0001), is correlated with the Healthy Eating Index score (r = 0.49, P = .0007), and is significantly associated with intake of most nutrients studied.
Conclusions and Implications
REAP has adequate reliability and validity to be used in primary care practices for
nutrition assessment and counselling, and is also user-friendly for providers.
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References
- The disease burden associated with overweight and obesity.JAMA. 1999; 282: 1523-1529
- AHA Dietary Guidelines Revision 2000: a statement for healthcare professionals from the Nutrition Committee of the American Heart Association.Circ. 2000; 102: 2284-2289
- American Diabetes Association position statement: evidence-based nutrition principles and recommendations for the treatment and prevention of diabetes and related complications.J Am Diet Assoc. 2002; 102: 109-118
- Nutrition and your health: dietary guidelines for Americans. 6th ed. Government Printing Office, Washington DC2005 (Available at: http://www.health.gov/dietaryguidelines/dga2005/document/ Accessed November 29, 2005)
Healthy People Year 2010 (Stock No. 017-001-00547-9). US Government Printing Office, Superintendent of Documents, PO Box 371954, Pittsburgh, PA 15250-7954. Available at: http://www.health.gov/healthypeople/Document/tableofcontents.htm. Accessed November 30, 2005.
- American Cancer Society guidelines on nutrition and physical activity for cancer prevention: reducing the risk of cancer with healthy food choices and physical activity.CA-Cancer J Clin. 2002; 52: 92-119
- Clinical and cost outcomes of medical nutrition therapy for hypercholesterolemia: a controlled trial.J Am Diet Assoc. 2001; 101: 1012-1023
- The evidence for the effectiveness of medical nutrition therapy in diabetes management.Diabetes Care. 2002; 25: 608-613
- The estimated costs and savings of medical nutrition therapy: the Medicare population.J Am Diet Assoc. 1999; 99: 428-435
- The effectiveness of nutrition education and implications for nutrition education policy, programs, and research: a review of research.J Nutr Educ. 1995; 27: 277-418
Agency for Healthcare Research and Quality: Efficacy of Interventions To Modify Dietary Behavior Related to Cancer Risk. Summary, Evidence Report/Technology Assessment: Number 25. AHRQ Publication No. 01-E028, November 2000. Agency for Healthcare Research and Quality, Rockville, MD. Available at: http://www.ahrq.gov/clinic/epcsums/dietsumm.htm. Accessed November 29, 2005.
- Clinician’s Handbook for Preventive Services. 2nd edition. US Public Health Service, International Medical Publishing, Inc, Washington, DC1998
- Roadmaps for Clinical Practice: Case Studies in Disease Prevention and Health Promotion—Assessment and Management of Adult Obesity: A Primer for Physicians. American Medical Association, Chicago, IL2003 (Available at: http://www.ama-assn.org/ama/pub/category/10931.html. Accessed December 7, 2005)
- Eat Smart: efficacy of a multifaceted prevention in clinical practice.Prev Med. 2001; 33: 91-98
- A dietary intervention in primary care practice: The Eating Patterns Study.Am J Public Health. 1997; 87: 610-616
- Preliminary evaluation of a multicomponent program for nutrition and physical activity change in primary care: PACE+ for adults.Prev Med. 2002; 34: 153-161
- How does physician advice influence patient behavior? Evidence for a priming effect.Arch Fam Med. 2000; 9: 426-433
- Provision of Nutrition Advice in Primary Care Practice. University of Wisconsin Madison, Madison, Wis2002 ([doctoral dissertation])
- The escalating pandemics of obesity and sedentary lifestyle.Arch Intern Med. 2004; 164: 249-258
- Diet and physical activity counseling during ambulatory care visits in the United States.Prev Med. 2004; 39: 815-822
- Direct observation of nutrition counseling in community family practice.Am J Prev Med. 2002; 23: 174-179
- Direct observation of physician counseling on dietary habits and exercise: patient, physician, and office correlates.Prev Med. 2004; 38: 198-202
- Nutrition guidance by primary-care physicians: perceived barriers and low involvement.Eur J Clin Nutr. 1995; 49: 842-851
- Potentials and pitfalls for nutrition counselling in general practice.Eur J Clin Nutr. 2005; 59 (discussion S129): S122-S128
- Physicians’ attitudes towards prevention: importance of intervention-specific barriers and physicians’ health habits.Fam Pract. 2000; 17: 535-540
- Developments and challenges in family practice nutrition education for residents and practicing physicians: an overview of the North American experience.Eur J Clin Nutr. 1999; 53: S89-S96
- Validation for MEDFICTS, a dietary assessment instrument for evaluating adherence to total and saturated fat recommendations of the National Cholesterol Education Program Step 1 and Step 2 diets.J Am Diet Assoc. 2001; 101: 81-86
- The Northwest Lipid Research Clinic Fat Intake Scale: Validation and utility.Am J Public Health. 1997; 87: 181-185
- Rate Your Plate: An eating pattern assessment and educational tool for blood cholesterol control.Nutr Clin Care. 2000; 3 (177–178): 163-169
- Practical nutrition assessment in primary care settings: a review.Am J Prev Med. 2000; 18: 289-299
- Translation of nutritional sciences into medical education: the Nutrition Academic Award Program.Am J Clin Nutr. 2001; 74: 164-170
- The Healthy Eating Index: design and applications.J Am Diet Assoc. 1995; 95: 1103-1108
- Healthy Eating Index and obesity.Eur J Clin Nutr. 2004; 58: 1580-1586
- Healthy Eating Index scores are associated with blood nutrient concentrations in the third National Health and Nutrition Examination Survey.J Am Diet Assoc. 2004; 104: 576-584
- Validation of the Healthy Eating Index with use of plasma biomarkers in a clinical sample of women.Am J Clin Nutr. 2001; 74: 479-486
- Hess M.A. Portion Photos of Popular Foods. Am Diet Assoc. and Center for Nutr Educ, University of Wisconsin – Stout, 1997
- Associations of race/ethnicity, education, and dietary intervention with the validity and reliability of a food frequency questionnaire: the Women’s Health Initiative Feasibility Study in Minority Populations.Am J Epidemiol. 1997; 146: 856-869
- Measurement characteristics of the WHI food frequency questionnaire.Ann Epidemiol. 1999; 9: 178-187
- Nutritional Epidemiology: Second Edition. Oxford University Press, New York1998
USDA Resources page. U.S. Department of Health and Human Services Web site. Dietary Guidelines for Americans 2005. Available at: http://www.health.gov/dietaryguidelines/dga2005/document/.
- REAP and WAVE: new tools to rapidly assess/discuss nutrition with patients.J Nutr. 2003; 133: 556S-562S
- WAVE: A Pocket Guide for a Brief Nutrition Dialogue in Primary Care.Diabetes Educ. 2001; 27: 352-362
- Physician-delivered nutrition counseling: Why and how?.Med Health RI. 2000; 83: 351-355
- Teaching nutrition skills to primary care practitioners.J Nutr. 2003; 133: 563S-566S
- Physician’s guide to the new 2005 dietary guidelines: How best to counsel patients.Cleve Clin J Med. 2005; 72 (Accessible at: http://www.ccjm.org/PDFFILES/Blackburn7_05.pdf): 609-618
- Validation of a short dietary assessment questionnaire: The Rapid Eating Assessment for Participants (Short Version): REAP-S.Diabetes Educator. 2004; 30 (776, 778): 774
Article info
Footnotes
Continuing Education Questionnaire available at www.sne.org/Meets Learning Need Codes for RDs and DTRs 3010, 5090, and 6020.
This study was supported in part by Grant No. NIH-HL-03948 Linking Resources for Brown Medical Nutrition Education.
Identification
Copyright
© 2006 SOCIETY FOR NUTRITION EDUCATION. Published by Elsevier Inc. All rights reserved.
