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Integrating a diet quality screener into a cardiology practice: assessment of nutrition counseling, cardiometabolic risk factors and patient/provider satisfaction
  1. Jeannette Beasley1,
  2. Paloma Sardina1,
  3. Emily Johnston2,
  4. Lisa Ganguzza3,
  5. Jane Padikkala3,
  6. Ashley Bagheri3,
  7. Simon Jones3 and
  8. Eugenia Gianos1
  1. 1Department of Medicine, NYU Langone Health, New York City, New York, USA
  2. 2Department of Nutritional Sciences, Pennsylvania State University, University Park, Pennsylvania, USA
  3. 3Department of Population Health, NYU Langone Health, New York City, New York, USA
  1. Correspondence to Dr Jeannette Beasley, NYU Langone Health, New York City, NY 10016, USA; jeannette.beasley{at}


Objective We assessed factors related to the integration of an office-based diet quality screener: nutrition counselling, cardiometabolic risk factors and patient/physician satisfaction.

Methods We evaluated the impact of a 10-item diet quality measure (self-rated diet quality question and a 9-item Mediterranean Diet Score (MDS)) prior to the cardiology visit on assessment of nutrition counselling, cardiometabolic risk factors and patient/provider satisfaction. Study staff trained the nine participating physicians on the purpose and use of the screener. To assess physician uptake of the diet quality screener, we reviewed all charts having a documented dietitian referral or visit and a 20% random sample of remaining participants that completed the screener at least once to determine the proportion of notes that referenced the diet quality screener and documented specific counselling based on the screener.

Results Between December 2017 and August 2018, 865 patients completed the diet quality screener. Mean age was 59 (SD 16) years, 54% were male and mean body mass index was 27.4 (SD 6.0) kg/m2. Almost one-fifth (18.5%) of participants rated their diet as fair or poor, and mean MDS (range 0–9) was moderate (mean 5.6±1.8 SD). Physicians referred 22 patients (2.5%) to a dietitian.

Conclusion Integrating the screener into the electronic health record did not increase dietitian referrals, and improvements in screener scores were modest among the subset of patients completing multiple screeners. Future work could develop best practices for physicians in using diet quality screeners to allow for some degree of standardisation of nutrition referral and counselling received by the patients.

  • nutrition assessment
  • preventive counselling

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  • Contributors JB, EG and EJ planned the study and obtained funding. JB analysed the data and drafted the manuscript. PS, LG, JP, AB and SJ assisted with data collection, management and analysis. All authors provided feedback on the manuscript draft.

  • Funding This work was funded by the Center for Healthcare Innovation and Delivery Sciences at NYU Langone Health.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request.

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