March 2021
While still undergraduate students, nutrition and dietetics majors Teal Walters ’20 (Eagan, Minn.) and Katie Lilja ’21 (Lino Lakes, Minn.) landed the chance to conduct some important nutrition research with two St. Catherine University faculty members. Last year, together with assistant professors of nutrition and dietetics Ambria Crusan and Megan Baumler, Walters and Lilja developed and tested a new nutrition assessment tool to use with patients at St. Mary’s Health Clinics.
St. Mary’s has seven outpatient clinic sites, one of which is located right on the St. Catherine University campus. That particular clinic treats mostly Latinx patients, Crusan said, yet the available nutrition assessment tools the St. Kate’s foursome could find were heavily focused on white people who were staying in hospitals. “We thought, these questions about swallowing problems and unintentionally losing weight don’t make sense or fit with our patient population,” Crusan said. “Existing assessments didn’t identify barriers for good nutrition or risks for common chronic health conditions.”
Added Baumler, “We needed a guide or a tool to use when conducting nutritional assessments in a community setting, where we are seeing lots of food insecurity and chronic diseases like diabetes.” After searching in vain for just such a tool, Baumler and Crusan decided to develop it themselves, conducting the research and developing and trying out the assessment tool along with future dietitians Lilja and Walters.
When using their more sensitive measurement tool, the researchers found that 100 percent of their patients required at least one nutrition intervention. This compares to just 13 percent who were shown to need intervention when they used the traditional assessment tool.
Just as their research was really gaining traction, COVID hit, briefly “bringing things to a screeching halt,” as Crusan puts it. Fortunately, they were able to quickly work with clinic staff to substitute in-person visits for telehealth appointments, which in the end turned out to be a blessing, she says. “Instead of seeing four to six patients every two weeks in the clinic, we were able to see four to six patients each week. It took more coordination, but it was a really great experience for us.”
The telehealth experience also was often a superior one for patients as well, adds Crusan, because it eliminated their need to arrange childcare, time off work, and transportation to the clinic. Because of a lack of reliable internet access among their patients, the St. Kate’s nutritionists limited their appointments to telephone only.
The telehealth nutrition sessions — and the research they did surrounding it — benefited them both greatly as well, Lilja and Walters said. The students did everything from reviewing the literature to meeting with patients (their professors on standby, in case they needed help) to writing up the results, which will be presented at several academic conferences later this year. “It was great hands-on experience,” Lilja said. “Our professors really let us lead the nutrition appointments; they didn’t take over in any way.” The faculty members reported the positive impact as well, with Crusan noting how this kind of real-world work enriched the students’ understanding of material covered in the classroom.
Although the appointments were complicated by a language barrier—most of their patients were middle-aged Latinx women who spoke mainly Spanish—the need to use a translator was another good learning opportunity for Lilja and Walters, they said.
The clinic’s patient population also allowed the students to familiarize themselves with Latinx eating, exercise, and other cultural traditions, says Walters. “It was an honor to work with the Latinx community and offer these individuals health care they would not otherwise have access to.”
What they found, Lilja said, was a group of people more at risk for developing diabetes and cardiovascular problems, many of whom also suffered from food insecurity and a lack of reliable access to healthy produce and proteins. Most of their patients also had previously encountered roadblocks to accessing good preventive health care because they lacked health insurance.
Seeing these patients and their challenges inspired the students to develop more than 100 Spanish language nutritional handouts, which they then mailed, emailed or handed out to patients, depending on their preference. “They did so much work!” Crusan said.
Lilja was so taken by her clinical experience that she decided to focus her job hunt on community health positions. After she graduates from St. Kate’s in May, she and her husband are headed to Huntsville, Alabama, where he will be stationed with the U.S. Army. “I definitely feel more strongly about finding a job in which I can affect more people,” she said. She also plans to someday pursue a master’s degree in public health nutrition.
As for Walters, who graduated last December, she said she is thankful for the opportunity to complete research as an undergraduate: “It makes me stand out when competing for a job or an internship.” The internships required for becoming a registered dietitian are notoriously competitive, with just about half of applicants getting placed in any given year. Lilja said, “I was so grateful to be able to add research work to my resume — it’s a big boost.” She will be seeking a hospital dietitian job, preferably in a traumatic gastrointestinal unit.
Although neither student will find out the results of her internship search until the national organization announces its internship matches in April, both women are confident that the research experience they gained at St. Catherine’s will help them compete successfully with their peers.
And then there’s this. “Research is a big part of the nutrition field,” Lilja said. “Getting the chance to dive in and really see how it’s done allowed me to build my skills.”