PRIMARY CARE DIETITIANS' ASSOCIATION

Abstract Submission # 1:

 

Title: Development of a Dietary Management Care Pathway for Cardiometabolic Risk Conditions  

 

Authors: Paula Brauer, PhD, RD, Dawna Royall, MSc, RD, Caroline Rhéaume, MD, PhD, Laurie Flood, Isabela Frias, Brittany Vaters 

 

Background and objectives:

Cardiometabolic risk conditions (CMR), including pre-diabetes, type 2 diabetes and metabolic syndrome are very prevalent in Canadian adults and increase the risk of developing cardiovascular diseases, some cancers and other conditions. The key challenges for diet therapy in CMR include the diversity of different named diets being promoted, the number of different professions involved and the challenges of health behaviour change. The objective of this work is to develop a care pathway for dietary management of CMR that incorporates new evidence, new technology and medications with insights from health care providers that will be feasible in Canada’s team-based primary care organizations. 

 

Approach/Intervention:

A multi-step process is being used to engage multiple providers in different types of primary care contexts across Canada.  An online survey (French and English) has been deployed to identity what lifestyle services are currently being offered in Canadian primary care organizations to clients at high CMR (e.g. prediabetes, type 2 diabetes, metabolic syndrome), including the size and organization of teams, and who does what on the team from screening to medical management. We are also conducting a literature review of the best available evidence (primarily from practice guidelines and high-quality systematic reviews) to identify effective dietary interventions and processes. These resources will inform an online multi-round Delphi consensus process in 2025-26 to assess the expected effectiveness and feasibility of diet counselling in Canadian primary care settings.  A interprofessional stakeholder group will guide the process.  

Results to Date: 

Recruitment for the health provider survey is currently underway. The literature review has targeted  intervention studies conducted within groups already at high CMR where more than one clinical indicator has been assessed (e.g. A1c, blood lipids, blood pressure) and/or a patient-important outcome has been reported (e.g. remission, morbidity, mortality). To date, a number of effective dietary interventions have been identified, including: alterations in macronutrients, dietary patterns, meal timing and composition.   Guidelines reviewed to date fail to describe detailed implementation strategies. Examination of effective implementation strategies in primary research studies (e.g. online groups, eating competence, mindfulness) is underway. 

 

Conclusion 

The proposed interprofessional care pathway for managing CMR will incorporate aspects of current practice, effective interventions and the perspectives of researchers, health care providers and expert patients, and include adaptations needed for different subgroups to address issues of equity, diversity and inclusion. The work is a critical step to provide better diet prevention services for Canadians at high CMR in team-based primary care organizations.   

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Abstract Submission # 2:

Title: Demystifying Type 2 Diabetes Mellitus through Digital Storytelling 

 

Author: Emily Andreiuk, MEd, RD 

 

Background and objectives: 

This project explored the use of digital storytelling to teach older adults about complex  health concepts, particularly type 2 diabetes mellitus pathophysiology. Digital storytelling  holds great potential as an educational tool for teaching health information. Available  evidence supports digital storytelling as an effective teaching tool, however more research is needed in this area. When designed with accessibility in mind, digital stories  engage auditory and visual senses, invoke emotions, and leverage the natural human  affinity for learning through stories.  

 

In my work as a registered dietitian, I taught older adults about chronic diseases like  type 2 diabetes mellitus (T2DM) and tried numerous approaches to explain T2DM  pathophysiology while meeting individual learning needs. Over time, I began using an  analogy-based story about diabetes. While I had anecdotal success with the story, I  recognized the importance of offering a more robust learning experience. I began to  search for additional resources to support my storytelling approach (e.g., images,  videos, posters).  

 

Unfortunately, I could not find resources that adequately explained T2DM  pathophysiology in a way that was accessible and appropriate for the older adult  learners I taught. When unable to find resources that fit my needs, I created my own.  

 

Approach/Intervention: 

I saw an opportunity to create a resource that would be useful and meaningful for  myself and other clinicians engaged in teaching diabetes. I became interested in using 

digital storytelling (DS) to educate and empower clients to manage their chronic  disease. I developed a DS educational intervention explaining one component of the  pathophysiology of T2DM, specifically, how carbohydrate intake impacts blood sugar. 

 

Results: 

The project includes a review of the literature around the use of digital storytelling as a  means of teaching adults, explores how theories of learning support the use of digital  storytelling, and outlines the design and development of a digital storytelling intervention  grounded in evidence and theory. While not formally evaluated, colleagues informally  reviewed the tool and felt it was a valuable resource, especially the inclusion of an  animated analogy.  

Additionally, a digital story toolbox for clinicians interested in incorporating DS into their  practice was developed. This toolbox offers suggested steps clinicians can take to  create and share materials. While digital resource development is becoming  increasingly popular, more work must be done to improve clinician knowledge around  adult education and adoption of digital resource development in everyday clinical  practice. 

 

Conclusion:

Digital stories are a valuable educational tool, yet their development requires an  

investment in time and effort from clinicians. With that in mind, the digital story, user  guide, and DS toolbox are available to share with clinicians.

 

Abstract Submission # 3:

Title: Nutrition through the Lifecyle

 

Author: Dufferin Area Family Health Team – ‘Latch & Learn’ Clinic

 

Background and objectives: 

Breastfeeding is essential for the healthy growth, development, and immunity of infants with Health Canada, the Canadian Pediatric Society, Dietitians of Canada, and the Breastfeeding Committee of Canada recommending exclusive breastfeeding for the first six months of life and up to two years or longer (Canada Food Guide). Despite these recommendations, breastfeeding rates in Canada have been steadily declining. According to the StatsCAN 2022 report, while 80% of Canadian mothers exclusively breastfed for at least one week postpartum, only 56% continue at four months and 35% at six months (Statistics Canada, 2022).

 

An environmental scan of the Dufferin Community revealed a notable gap in accessible, free, group lactation support, exacerbated by the dissolution of the public health unit breastfeeding clinics during COVID-19. Current local supports are limited to one-on-one, referral and fee-based consultations, with no community-driven group services available. To address this need, the Dufferin Area Family Health Team (DAFHT) created the ‘Latch and Learn’ drop-in clinic. This free clinic offers infant feeding support to families facing challenges with breastfeeding, bottle feeding, or formula, aiming to address concerns, boost parental confidence, and improve breastfeeding duration.

 

Approach/Intervention: 

‘Latch and Learn’, launched in April 2024, provides breast, chest and bottle-feeding support from Lactation Consultants (IBCLC), Registered Nurses and Dietitians. Initially the clinic was open twice weekly (4 hours a week) for families rostered with the DAFHT physicians. By October 2024, the clinics expanded to the public and as of February 2025 DAFHT created a partnership with Headwaters Health Care centre allowing for a third clinic to meet the growing demand. Health care providers facilitating the clinics address various medical related breast-feeding concerns such as latching difficulties, damaged nipples, inadequate or low milk supply, breast inflammation, and inadequate infant weight gain.Data collection involves an anonymous survey assessing parents’ confidence, knowledge, and comfortability in breastfeeding, as well as their ability to prevent and solve common feeding challenges. A follow up survey is sent to families when the child is four months of age to track breastfeeding duration.

 

Results: 

From April 2024 to December 31st, 97 families (63 rostered and 34 non-rostered) visited a ‘Latch and Learn’ clinic. Feedback from rostered families showed that 98% felt more confident in their knowledge and abilities, 96% felt more equipped to prevent or solve common feeding challenges, and 96% felt more comfortable feeding their baby. Most notably, 100% of families felt their feeding issues were addressed.

 

One participant shared, “Loved the atmosphere and so thankful for clear and encouraging support. This clinic seems to be an amazing resource and definitely filled a need for us.”

Results from a four-month survey, with 26 responses, revealed that 69.23% of respondents were exclusively breastfeeding at four months. 23.08% were combination feeding, and 7.69% were exclusively formula feeding. Notably, 44% of respondents stated they planned to breastfeed longer as a result of their experience at the clinic.

 

Conclusion:

The ‘Latch and Learn’ drop-in clinics are providing valuable infant feeding support by improving parental confidence and knowledge and addressing parental feeding issues. Early results suggest it has positively influenced breastfeeding duration, highlighting the importance of accessible, community-drive lactation services in enhancing breastfeeding rates.