(P24-34-26) Feasibility of Adding A Registered Dietitian to Rural Community Healthy Behavior Support Services for Management of Type 2 Diabetes

Objectives: Rural communities experience health care shortages of diabetes services provided by a registered dietitian (RD). This pilot study tested the feasibility of using rural community health screenings to recruit adults with Type 2 Diabetes (T2D) to receive Medical Nutrition Therapy (MNT) via telehealth and to test its impact on health, diet, and physical activity.

Methods: Adults aged ≥18 yr with BMI ≥25 kg/m² and a diagnosis of T2D, who attended health screenings, were recruited to receive MNT. Health markers (BMI, waist circumference, blood pressure, glucose, lipids) were collected at an initial and follow-up (6-9 mo) screening. Participants received MNT (initial, 1- and 3-mos) with the RD. Diet (24-hr) and physical activity (7-day) recalls were collected at each MNT visit. Paired t-tests and linear mixed models assessed mean differences between timepoints. Data is presented as mean (SD or SE). Feasibility was measured via rates of recruitment, retention, and adherence.

Results: Among the 305 adults screened, 72 had T2D (24%), and 14 were recruited to receive MNT (19%). Two participants decided not to continue. The remaining 12 participants completed the MNT visits and the follow-up health screening (100% adherence). Participants’ age was 69.8(9)yr, 75% were female, and 100% were White. Non-significant decreases occurred in BMI [0.75(2.29)kg/m2], blood glucose [23.83(93.17)mg/dl], and HbA1c [0.83(3.22)%]. Significant decreases (p < 0.05) occurred in sucrose [9.97(3.89)g/d] and added sugar intake [16.46(4.11)g/d], while significant increases occurred in fruit intake [0.51(0.16) serving/d] Significant increases (p < 0.05) occurred in moderate yardwork and housework activity [0.67(0.22); 0.63(0.23)hr/d].

Conclusions: This pilot study demonstrates the feasibility of using rural community health screenings to recruit individuals with T2D for telehealth delivery of MNT which improved some markers of diabetes, diet, and physical activity. Further testing in a randomized controlled trial is warranted to expand access to diabetes services in rural communities.

Funding Sources: Indiana Clinical and Translational Sciences Institute