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Dana Louise Craven
School of Health and Sport Sciences, University of the Sunshine Coast, Maroochydore, QSL 4558, Australia

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Journal article
Published: 30 March 2021 in International Journal of Environmental Research and Public Health
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Samoan food systems have undergone a dramatic nutrition transition, with dietary patterns changing concurrently with increased rates of obesity and non-communicable disease. Whilst policy action and environmental interventions play an important role in improving access to and consumption of healthy food, the success of these relies on a greater understanding of individuals’ food knowledge and behaviours. This study aimed to explore these behaviours using the construct of food literacy in an adult Samoan population. A cross-sectional interviewer-administered questionnaire of a convenience sample of 150 adult Samoans (≥20 years) assessed the four domains of food literacy: plan/manage, select, prepare, and eat. Participants generally plan to include healthy food (87%) and budget money for food (87%). The majority know where to find nutrition labels (68%), of which 43% always use them to inform their food choices. Participants were mostly confident with cooking skills, although food storage practices require further investigation. Over 90% agreed or strongly agreed that food impacts health, although understanding of the Pacific Guidelines for Healthy Living was lacking. Understanding the ability of Samoans to plan/manage, select, prepare, and eat food is an important consideration for future interventions aiming to assist this population in navigating the modern-day food system.

ACS Style

Grace Kammholz; Dana Craven; Ramona Boodoosingh; Safua Akeli Amaama; Jyothi Abraham; Sarah Burkhart. Exploring Food Literacy Domains in an Adult Samoan Population. International Journal of Environmental Research and Public Health 2021, 18, 3587 .

AMA Style

Grace Kammholz, Dana Craven, Ramona Boodoosingh, Safua Akeli Amaama, Jyothi Abraham, Sarah Burkhart. Exploring Food Literacy Domains in an Adult Samoan Population. International Journal of Environmental Research and Public Health. 2021; 18 (7):3587.

Chicago/Turabian Style

Grace Kammholz; Dana Craven; Ramona Boodoosingh; Safua Akeli Amaama; Jyothi Abraham; Sarah Burkhart. 2021. "Exploring Food Literacy Domains in an Adult Samoan Population." International Journal of Environmental Research and Public Health 18, no. 7: 3587.

Review
Published: 03 September 2020 in Journal of Interprofessional Care
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In Australia, a national approach to accreditation of programs and regulation of health professions was adopted a decade ago. Accreditation standards and regulatory frameworks can drive change and provide support for interprofessional education and collaborative practice. There is a commonly held belief among Australian academics involved in health professional education, that accreditation and practice standards provide system-level support for interprofessional education and interprofessional collaborative practice. Using a purpose-designed analysis framework and scoring scheme, we analyzed standards of accreditation and practice for 29 regulated, self-regulated and member health professions in Australia to determine the extent and accountability of statements related to interprofessional education and interprofessional collaborative practice. Currently, in Australia, there is a fragmented and inconsistent approach to interprofessional education and interprofessional collaboration evident in accreditation and practice standards and, in general, there are more explicit requirements in standards of the regulated health professions. However, overall the concepts of interprofessional education and interprofessional practice are ill-defined and statements lack accountability and/or outcome measures. Our analysis provides a foundation for reform of Australian standards and an approach for analysis of accreditation and practice standards which may be useful in other jurisdictions.

ACS Style

Fiona Bogossian; Dana Craven. A review of the requirements for interprofessional education and interprofessional collaboration in accreditation and practice standards for health professionals in Australia. Journal of Interprofessional Care 2020, 35, 691 -700.

AMA Style

Fiona Bogossian, Dana Craven. A review of the requirements for interprofessional education and interprofessional collaboration in accreditation and practice standards for health professionals in Australia. Journal of Interprofessional Care. 2020; 35 (5):691-700.

Chicago/Turabian Style

Fiona Bogossian; Dana Craven. 2020. "A review of the requirements for interprofessional education and interprofessional collaboration in accreditation and practice standards for health professionals in Australia." Journal of Interprofessional Care 35, no. 5: 691-700.

Journal article
Published: 16 January 2020 in Education Sciences
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Nutrition and dietetic (N&D) education is traditionally taught didactically; however, the flipped classroom approach (FCA) is an emerging pedagogical approach in this discipline. Technological tools providing cognitive support enhance learning, particularly when students are engaged. In N&D education, students have reported the FCA as engaging; however, evidence for how best to integrate technologies into the FCA is limited. The aim of this research is to explore undergraduate nutrition and dietetic students’ self-reported perceptions of the use of a digital workbook in nutrition courses designed and delivered using an FCA. A cross-sectional self-administered online survey was utilised to investigate Australian undergraduate student (N = 39) satisfaction, frequency of use, engagement with, and usefulness of a digital workbook. Most students (87%) were satisfied/very satisfied with the digital workbook as a tool for learning, applying and consolidating/revising course content. Most students (95%) agreed the digital workbook was engaging, providing comments related to workbook design, encouraged participation and novelty. Most useful aspects reported were workbook structure, development of a learning artefact, self-directed aspects and convenience, whereas, least useful aspects included technological issues. The use of a digital workbook in N&D education was well received and is an innovative approach to delivering courses taught with an FCA.

ACS Style

Sarah Burkhart; Dana Craven. Digital Workbooks in Flipped Nutrition Education: Student Perspectives’. Education Sciences 2020, 10, 22 .

AMA Style

Sarah Burkhart, Dana Craven. Digital Workbooks in Flipped Nutrition Education: Student Perspectives’. Education Sciences. 2020; 10 (1):22.

Chicago/Turabian Style

Sarah Burkhart; Dana Craven. 2020. "Digital Workbooks in Flipped Nutrition Education: Student Perspectives’." Education Sciences 10, no. 1: 22.

Review
Published: 01 December 2018 in Clinical Nutrition
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Malnutrition is a significant barrier to healthy and independent ageing in older adults who live in their own homes, and accurate diagnosis is a key step in managing the condition. However, there has not been sufficient systematic review or pooling of existing data regarding malnutrition diagnosis in the geriatric community setting. The current paper was conducted as part of the MACRo (Malnutrition in the Ageing Community Review) Study and seeks to determine the criterion (concurrent and predictive) validity and reliability of nutrition assessment tools in making a diagnosis of protein-energy malnutrition in the general older adult community.A systematic literature review was undertaken using six electronic databases in September 2016. Studies in any language were included which measured malnutrition via a nutrition assessment tool in adults ≥65 years living in their own homes. Data relating to the predictive validity of tools were analysed via meta-analyses. GRADE was used to evaluate the body of evidence.There were 6412 records identified, of which 104 potentially eligible records were screened via full text. Eight papers were included; two which evaluated the concurrent validity of the Mini Nutritional Assessment (MNA) and Subjective Global Assessment (SGA) and six which evaluated the predictive validity of the MNA. The quality of the body of evidence for the concurrent validity of both the MNA and SGA was very low. The quality of the body of evidence for the predictive validity of the MNA in detecting risk of death was moderate (RR: 1.92 [95% CI: 1.55-2.39]; P < 0.00001; n = 2013 participants; n = 4 studies; I(2): 0%). The quality of the body of evidence for the predictive validity of the MNA in detecting risk of poor physical function was very low (SMD: 1.02 [95%CI: 0.24-1.80]; P = 0.01; n = 4046 participants; n = 3 studies; I(2):89%).Due to the small number of studies identified and no evaluation of the predictive validity of tools other than the MNA, there is insufficient evidence to recommend a particular nutrition assessment tool for diagnosing PEM in older adults in the community. High quality diagnostic accuracy studies are needed for all nutrition assessment tools used in older community samples, including measuring of health outcomes subsequent to nutrition assessment by the SGA and PG-SGA.

ACS Style

Skye Marshall; Dana Craven; Jaimon Kelly; Elizabeth Isenring. A systematic review and meta-analysis of the criterion validity of nutrition assessment tools for diagnosing protein-energy malnutrition in the older community setting (the MACRo study). Clinical Nutrition 2018, 37, 1902 -1912.

AMA Style

Skye Marshall, Dana Craven, Jaimon Kelly, Elizabeth Isenring. A systematic review and meta-analysis of the criterion validity of nutrition assessment tools for diagnosing protein-energy malnutrition in the older community setting (the MACRo study). Clinical Nutrition. 2018; 37 (6):1902-1912.

Chicago/Turabian Style

Skye Marshall; Dana Craven; Jaimon Kelly; Elizabeth Isenring. 2018. "A systematic review and meta-analysis of the criterion validity of nutrition assessment tools for diagnosing protein-energy malnutrition in the older community setting (the MACRo study)." Clinical Nutrition 37, no. 6: 1902-1912.

Review
Published: 05 September 2018 in Age and Ageing
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Protein-energy malnutrition is a major health concern in home-dwelling older adults, particularly in the context of an ageing population. Therefore, a systematic review and meta-analysis was undertaken to determine the prevalence of malnutrition among older adults living independently in the community according to geographical region, sampling frame, rurality and sex. six electronic databases were searched until September 2016. Original research studies which used the Mini Nutritional Assessment, Patient-Generated Subjective Global Assessment or Subjective Global Assessment to determine nutrition status in community samples with a mean age of ≥65 years were critically appraised and pooled using meta-analysis. Meta-regression was used to explore predictors of malnutrition prevalence in pooled statistics with high heterogeneity. 111 studies from 38 countries (n = 69,702 participants) were included. The pooled prevalence of malnutrition in the older community setting ranged from 0.8% (95% CI: 0.2-1.7%) in Northern Europe to 24.6% (95% CI: 0.0-67.9%) in South-East Asia. Of all sampling frames, participants receiving homecare services had the highest prevalence at 14.6% (95% CI: 9.9-20.0%). Malnutrition prevalence in rural communities (9.9%; 95% CI: 4.5-16.8%) was double that in urban communities (5.7%; 95% CI: 4.2-7.3%) and higher among females than males (odds ratio = 1.45 [95% CI: 1.27-1.66]; P < 0.00001). the results of this review provide strategic insight to develop public and community health priorities for preventing malnutrition and associated poor health outcomes.

ACS Style

Megan Crichton; Dana Craven; Hannah Mackay; Wolfgang Marx; Marian De Van Der Schueren; Skye Marshall. A systematic review, meta-analysis and meta-regression of the prevalence of protein-energy malnutrition: associations with geographical region and sex. Age and Ageing 2018, 48, 38 -48.

AMA Style

Megan Crichton, Dana Craven, Hannah Mackay, Wolfgang Marx, Marian De Van Der Schueren, Skye Marshall. A systematic review, meta-analysis and meta-regression of the prevalence of protein-energy malnutrition: associations with geographical region and sex. Age and Ageing. 2018; 48 (1):38-48.

Chicago/Turabian Style

Megan Crichton; Dana Craven; Hannah Mackay; Wolfgang Marx; Marian De Van Der Schueren; Skye Marshall. 2018. "A systematic review, meta-analysis and meta-regression of the prevalence of protein-energy malnutrition: associations with geographical region and sex." Age and Ageing 48, no. 1: 38-48.

Articles
Published: 28 June 2018 in Journal of Nutrition in Gerontology and Geriatrics
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Many community-living older adults experience the condition of malnutrition and the causes are complex and multi-factorial. This study examined nutrition risk in a sample of community-living older Australians (n = 77, age ≥65 years) using an online, self-administered survey consisting of two validated questionnaires (SCREEN II and SF-12). We found a significant relationship between health status and nutrition risk; those with higher self-rated health status had lower nutrition risk. Forty percent of the participants were categorized at high nutritional risk, 26% at moderate nutritional risk and 34% not at nutritional risk. The most common nutrition risk factors were: (i) weight perception (perceiving weight to be more than it should); (ii) food avoidance; (iii) low intake of milk, milk products and alternatives; and (iv) finding meal preparation a chore. Many nutrition-risk factors were consistent with population survey data highlighting the need for greater awareness of nutritional requirements for healthy ageing.

ACS Style

Dana L. Craven; Fiona E. Pelly; Geoff P. Lovell; Elizabeth Isenring. Nutrition Risk Measured Online in Community-Living Older Australians. Journal of Nutrition in Gerontology and Geriatrics 2018, 37, 241 -254.

AMA Style

Dana L. Craven, Fiona E. Pelly, Geoff P. Lovell, Elizabeth Isenring. Nutrition Risk Measured Online in Community-Living Older Australians. Journal of Nutrition in Gerontology and Geriatrics. 2018; 37 (3-4):241-254.

Chicago/Turabian Style

Dana L. Craven; Fiona E. Pelly; Geoff P. Lovell; Elizabeth Isenring. 2018. "Nutrition Risk Measured Online in Community-Living Older Australians." Journal of Nutrition in Gerontology and Geriatrics 37, no. 3-4: 241-254.

Review
Published: 19 February 2018 in Maturitas
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Telehealth offers a feasible method to provide nutrition support to malnourished older adults. This systematic review and meta-analysis aims to determine the efficacy of telehealth methods in delivering malnutrition-related interventions to community-dwelling older adults. Studies in any language were searched in five electronic databases from inception to 2nd November 2017. Quality of the evidence was assessed using the Cochrane Risk of Bias tool and the GRADE approach. Nine studies were identified, with results published across 13 included publications, which had mostly low to unclear risk of bias. There were two interventions delivered to disease-specific groups, one with kidney disease and one with cancer; the remaining seven interventions were delivered to patients with mixed morbidities following discharge from an inpatient facility. Seven studies delivered telehealth via telephone consultations and two used internet-enabled telemedicine devices. Ten meta-analyses were performed. Malnutrition-focused telehealth interventions were found to improve protein intake in older adults by 0.13 g/kg body weight per day ([95%CI: 0.01–0.25]; P = 0.03; n = 2 studies; n = 200 participants; I2 = 41%; GRADE level: low) and to improve quality of life (standardised mean difference: 0.55 [95%CI: 0.11–0.99]; P = 0.01; n = 4 studies with n = 9 quality-of-life tools; n = 248 participants; I2 = 84%: GRADE level: very low). There were also trends towards improved nutrition status, physical function, energy intake, hospital readmission rates and mortality in the intervention groups. Overall, this review found telehealth is an effective method to deliver malnutrition-related interventions to older adults living at home, and is likely to result in clinical improvements compared with usual care or no intervention. However, further research with larger samples and stronger study designs are required to strengthen the body of evidence.

ACS Style

Wolfgang Marx; Jaimon T. Kelly; Megan Crichton; Dana Craven; Jorja Collins; Hannah Mackay; Elizabeth Isenring; Skye Marshall. Is telehealth effective in managing malnutrition in community-dwelling older adults? A systematic review and meta-analysis. Maturitas 2018, 111, 31 -46.

AMA Style

Wolfgang Marx, Jaimon T. Kelly, Megan Crichton, Dana Craven, Jorja Collins, Hannah Mackay, Elizabeth Isenring, Skye Marshall. Is telehealth effective in managing malnutrition in community-dwelling older adults? A systematic review and meta-analysis. Maturitas. 2018; 111 ():31-46.

Chicago/Turabian Style

Wolfgang Marx; Jaimon T. Kelly; Megan Crichton; Dana Craven; Jorja Collins; Hannah Mackay; Elizabeth Isenring; Skye Marshall. 2018. "Is telehealth effective in managing malnutrition in community-dwelling older adults? A systematic review and meta-analysis." Maturitas 111, no. : 31-46.

Article
Published: 20 June 2017 in The journal of nutrition, health & aging
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Community-living older adults may be susceptible to malnutrition (undernutrition) due to both physiological and non-physiological causes. The condition develops over time and the early signs and symptoms may not be obvious. Therefore awareness and early identification of nutrition risk factors may prevent, or at least slow, the progression of malnutrition. To describe community-living older adults’ understanding of the signs of malnutrition, where they would seek malnutrition information and their selfperception of body weight. Older adults (aged ≥ 65 years) living in the community setting completed an online or paper based questionnaire between May and August 2016. The questionnaire contained a mix of closed and open questions which related to weight perception, weight changes, perceived signs of malnutrition and sources of malnutrition information. Body mass index (BMI) from self-reported data was classified using BMI reference ranges for older adults and compared to self-perceived weight status. Textual data regarding the signs of malnutrition were analysed and reviewed by two authors using content analysis. Descriptive statistics were used to describe participant characteristics. A total of 344 responses were received, the majority (90%) completed online. Mean participant age was 73 years and 57% of participants were female. Most (92%) reported their health to be good/very good. Body weight was perceived to be just right or more than it should be by 87% of underweight women and 97% of underweight men. Although 71% of the participants indicated their body weight had remained stable in the past six months, 37% reported they had been trying to change their weight. Signs of malnutrition resulted in four key categories of (i) psychological, (ii) physical appearance, (ii) bodily function and (iv) weight change. Very few reported the need to locate malnutrition information and indicated the top three sources for information would be (i) general practitioner, (ii) dietitian or (iii) internet. This paper has presented useful data about malnutrition from the perspective of the community-living older adult. We found there may be uncertainty about the best weight, for older age. As many indicated they had been trying to change their weight, awareness needs to be raised regarding the impact of weight changes on health outcomes in this population. In this study, the internet appeared to be a key provider of nutrition information. Healthcare professionals need to consider how this can be used in an informative manner among community living older adults as a tool for raising awareness about nutrition risk and malnutrition.

ACS Style

Dana L. Craven; G. P. Lovell; F. E. Pelly; E. Isenring. Community-Living Older Adults’ Perceptions of Body Weight, Signs of Malnutrition and Sources of Information: a Descriptive Analysis of Survey Data. The journal of nutrition, health & aging 2017, 22, 393 -399.

AMA Style

Dana L. Craven, G. P. Lovell, F. E. Pelly, E. Isenring. Community-Living Older Adults’ Perceptions of Body Weight, Signs of Malnutrition and Sources of Information: a Descriptive Analysis of Survey Data. The journal of nutrition, health & aging. 2017; 22 (3):393-399.

Chicago/Turabian Style

Dana L. Craven; G. P. Lovell; F. E. Pelly; E. Isenring. 2017. "Community-Living Older Adults’ Perceptions of Body Weight, Signs of Malnutrition and Sources of Information: a Descriptive Analysis of Survey Data." The journal of nutrition, health & aging 22, no. 3: 393-399.

Journal article
Published: 01 January 2017 in Australian Journal of Primary Health
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Many older adults living in their own homes are at nutrition risk which, left untreated, can lead to the state of malnutrition. To reduce the prevalence of malnutrition among community-living older adults (CLOAs), risk factors should be identified and addressed early via malnutrition screening. The aim of this study was to identify barriers and enablers to malnutrition screening of CLOAs from the perspective of dietitians. Ninety-two dietitians working for government, not-for-profit and private organisations in Australia provided written comments to open-ended survey questions. Textual data were analysed using content analysis, resulting in four key categories of organisational, staff, screening and CLOA factors. Insufficient time to screen and lack of knowledge by non-dietetic staff and CLOAs about malnutrition were identified as the strongest barriers. Organisational factors of screening policy and procedures and the provision of education and training emerged as the strongest enablers. The findings from this study can provide guidance to organisations and healthcare practitioners considering the implementation of routine malnutrition screening of CLOAs. Increased awareness about malnutrition and the associated outcomes may help to reduce nutrition risk among CLOAs.

ACS Style

Dana L. Craven; Fiona E. Pelly; Elisabeth Isenring; Geoff P. Lovell. Barriers and enablers to malnutrition screening of community-living older adults: a content analysis of survey data by Australian dietitians. Australian Journal of Primary Health 2017, 23, 196 .

AMA Style

Dana L. Craven, Fiona E. Pelly, Elisabeth Isenring, Geoff P. Lovell. Barriers and enablers to malnutrition screening of community-living older adults: a content analysis of survey data by Australian dietitians. Australian Journal of Primary Health. 2017; 23 (2):196.

Chicago/Turabian Style

Dana L. Craven; Fiona E. Pelly; Elisabeth Isenring; Geoff P. Lovell. 2017. "Barriers and enablers to malnutrition screening of community-living older adults: a content analysis of survey data by Australian dietitians." Australian Journal of Primary Health 23, no. 2: 196.

Journal article
Published: 01 March 2016 in Nutrition & Dietetics
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AimTo explore malnutrition screening practices by dietitians working with community dwelling older adults in Australia.MethodsA descriptive cross-sectional online survey of dietitians providing dietetic care to older adults (aged ≥65 years) was conducted in November to December 2014 using a three-part 25-item questionnaire with scaled, closed and open-ended questions.ResultsOne hundred and thirty-three community dietitians participated in the survey. Seventy-seven percent of them reported malnutrition screening was conducted in the workplace and this was highest in government organisations. The majority of dietitians (75%) reported a screening tool was used and the Malnutrition Screening Tool was most commonly used. Independent of level of experience, the majority of dietitians considered malnutrition screening important and agreed with the need for routine screening. Sixty-six percent of dietitians reported that clients screened and found to be at risk of malnutrition frequently refused nutrition assessment.ConclusionReported malnutrition screening practices varied considerably across all organisations and states. Although routine screening for malnutrition risk is recommended, refusal for nutritional assessment after positive screening is common and requires further investigation. It is not clear how the term ‘malnutrition’ is perceived by the elderly and further investigation into their perceptions would be useful, particularly as offer for nutrition care is frequently declined.

ACS Style

Dana L. Craven; Fiona E. Pelly; Geoff P. Lovell; Maree Ferguson; Elisabeth Isenring. Malnutrition screening of older adults in the community setting: Practices reported by Australian dietitians. Nutrition & Dietetics 2016, 73, 383 -388.

AMA Style

Dana L. Craven, Fiona E. Pelly, Geoff P. Lovell, Maree Ferguson, Elisabeth Isenring. Malnutrition screening of older adults in the community setting: Practices reported by Australian dietitians. Nutrition & Dietetics. 2016; 73 (4):383-388.

Chicago/Turabian Style

Dana L. Craven; Fiona E. Pelly; Geoff P. Lovell; Maree Ferguson; Elisabeth Isenring. 2016. "Malnutrition screening of older adults in the community setting: Practices reported by Australian dietitians." Nutrition & Dietetics 73, no. 4: 383-388.

Journal article
Published: 01 March 2014 in JBI Database of Systematic Reviews and Implementation Reports
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ACS Style

Dana Craven; Zachary Munn; Clint Moloney; Melissa Taylor. Malnutrition screening among elderly people in a community setting: a best practice implementation project. JBI Database of Systematic Reviews and Implementation Reports 2014, 12, 433 -448.

AMA Style

Dana Craven, Zachary Munn, Clint Moloney, Melissa Taylor. Malnutrition screening among elderly people in a community setting: a best practice implementation project. JBI Database of Systematic Reviews and Implementation Reports. 2014; 12 (3):433-448.

Chicago/Turabian Style

Dana Craven; Zachary Munn; Clint Moloney; Melissa Taylor. 2014. "Malnutrition screening among elderly people in a community setting: a best practice implementation project." JBI Database of Systematic Reviews and Implementation Reports 12, no. 3: 433-448.