Transforming the nutrition care model for infants with cystic fibrosis: A qualitative study of clinicians' perspectives

Author:

Ong Thida12ORCID,Bell Sarah2,Britto Maria T.3,Gamel Breck4,McNamara Sharon2,Ramsey Bonnie12,Barton Krysta S.5

Affiliation:

1. Department of Pediatrics, Division of Pulmonary and Sleep Medicine University of Washington Seattle Washington USA

2. Cystic Fibrosis Center Seattle Children's Hospital Seattle Washington USA

3. James M. Anderson Center for Health Systems Excellence Cincinnati Children's Hospital Medical Center Cincinnati Ohio USA

4. Pediatric Cystic Fibrosis Center Children's Health, University of Texas‐Southwestern Dallas Texas USA

5. Biostatistics Epidemiology and Analytics for Research (BEAR) Core Seattle Children's Research Institute Seattle Washington USA

Abstract

AbstractClinician perspectives may inform health service strategies to meet optimal nutrition needs for infants with cystic fibrosis (CF). We conducted a qualitative study with CF‐specialized dietitians (registered dietitians [RDs]) and physicians between July to December 2020 to characterize the current state of infant nutrition care delivery and organize input into a conceptual model to inform CF care program strategies. Among 42 participants, 36 completed survey responses and 6 completed interviews; 93% were RDs. Three global themes emerged in the current care model: nutrition management, family centered connections, and collaborative care delivery. Within nutrition management, clinicians emphasized providing education, setting goals, and maintaining adequate follow‐up with families. Under family centered connections, clinicians expressed the need to foster relationships with families and link families to resources for assistance to social stressors such as food insecurity. Collaborative care delivery for clinicians interviewed was defined by sharing expertise from across the interdisciplinary team. Based on the timing of this study, clinicians reported compelling examples for various modes of telehealth and home weight monitoring to facilitate and support these domains of nutrition care, including potential advantages for education, supporting family needs, and communication. We integrate these themes to propose a conceptual model to organize complementary in‐person and telehealth activities and enhance quality infant CF nutrition care delivery. Future implementation can refine this model through testing of practical telehealth interventions to optimize nutrition outcomes for infants with CF.

Funder

Cystic Fibrosis Foundation

National Institutes of Health

Agency for Healthcare Research and Quality

Publisher

Wiley

Subject

Pulmonary and Respiratory Medicine,Pediatrics, Perinatology and Child Health

Reference40 articles.

1. The future of cystic fibrosis care: a global perspective

2. Cystic FibrosisFoundation.2019 patient registry annual data report. Accessed March 24 2021.https://www.cff.org/Research/Researcher-Resources/Patient-Registry/2019-Patient-Registry-Annual-Data-Report.pdf

3. Early Life Growth Trajectories in Cystic Fibrosis are Associated with Pulmonary Function at Age 6 Years

4. Cystic fibrosis foundation evidence‐based guidelines for management of infants with cystic fibrosis;Cystic Fibrosis F;J Pediatr,2009

5. Effects of Diagnosis by Newborn Screening for Cystic Fibrosis on Weight and Length in the First Year of Life

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