Publications by authors named "Enza Gucciardi"
Buildings contribute in crucial ways to how students experience learning spaces. Four schools within a faculty (nursing, nutrition, occupational and public health, and midwifery) moved into a new Health Sciences building Fall of 2019. This new building created a unique opportunity to explore the intersection between higher education and learning space design, informed by concepts of space and place, and students' profession specific and interprofessional learning experiences in a new Health Sciences building.
View Article and Find Full Text PDFObjective: In this study, we aim to review the current evidence of Food is Medicine interventions on diabetes outcomes among low-income or food-insecure individuals.
Methods: Seven databases were searched from January 1, 2000 to October 26, 2021 for full-text articles written in English. The studies included experimental studies of any duration and design which addressed the effect of Food is Medicine interventions on fruit and vegetable (F&V) intake and glycated hemoglobin (A1C) levels among low-income or food-insecure populations with prediabetes or diabetes of any age group.
Objectives: This study investigated the feasibility and acceptability of implementing a screening tool as a part of routine care and the subsequent screening experiences of patients and clinicians. Additionally, potential sources of diabetes distress (DD) were identified in this clinical population.
Methods: Our investigation was a cross-sectional, mixed-methods, convenience sample of 203 patients living with type 1 or type 2 diabetes from 2 Canadian tertiary hospital-based clinics.
Objectives: Our aim in this study was to assess the level of collaboration between a hospital-based outpatient diabetes education program (DEP) and emergency departments (EDs) for reducing number of ED revisits and hospital admissions by implementing intervention strategies to promote education services and streamlining referral and appointment intake processes.
Methods: Patients (≥18 years of age) with an ED visit for hyper- or hypoglycemia were analyzed in 2 cohorts based on their intervention exposure. We conducted a single-cohort analysis of the exposed cohort (exposure to the intervention strategies) and compared 2-year outcomes with those of the unexposed cohort.
Context: Consumption of lean fish and fish-derived proteins were effective for improving lipid profiles in published studies; however, evidence remains inconclusive.
Objective: To evaluate the effectiveness of lean fish or fish-derived protein on serum/plasma lipid and lipoprotein levels by conducting a systematic review of the literature and meta-analysis of available randomized controlled trials (RCTs).
Data Sources: Medline (Ovid), Scopus, CINAHL, and Food and Nutritional Sciences databases were searched from the start date of each database to September 2019 to identify RCTs determining the effect of lean fish on lipid profile.
Background: To evaluate the impact of integrating diabetes education teams in primary care on glycemic control, lipid, and blood-pressure management in type 2 diabetes patients.
Methods: A historical cohort design was used to assess the integration of teams comprising nurse and dietitian educators in 11 Ontario primary-care sites, which delivered individualized self-management education. Of the 771 adult patients with A1C ≥ 7% recruited, 487 patients attended appointments with the diabetes teams, while the remaining 284 patients did not.
Little is known about screening in clinical settings for food insecurity (FI) among households of children with diabetes. This study evaluated the acceptability and feasibility of an FI screening initiative in a pediatric diabetes clinic that was implemented to help diabetes dietitian educators tailor management plans for families of children with type 1 or type 2 diabetes facing FI. The initiative comprised three validated screening questions, a care algorithm, a community resource handout, and a poster.
View Article and Find Full Text PDFBackground: Food insecurity undermines a patient's ability to follow diabetes self-management recommendations. Care providers need strategies to direct their support of diabetes management among food insecure patients and families.
Objective: To identify what emerging practices health care providers can relay to patients or operationalize to best support diabetes self-management among food insecure adults and families.
Aims: To evaluate the impact of the integration of onsite diabetes education teams in primary care on processes of care indicators according to practice guidelines.
Methods: Teams of nurse and dietitian educators delivered individualized self-management education counseling in 11 Ontario primary care sites. Of the 771 adult patients with HbA1c ≥7% who were recruited in a prospective cohort study, 487 patients attended appointments with the education teams, while the remaining 284 patients did not (usual care group).
Objective: We explored the underlying mechanisms by which storytelling can promote disease self-management among people with type 2 diabetes.
Methods: Two, eight-session storytelling interventions were delivered to a total of eight adults with type 2 diabetes at a community health center in Toronto, Ontario. Each week, participants shared stories about diabetes self-management topics of their choice.
Objectives: This pilot project aimed to examine the acceptability and feasibility of a group storytelling intervention to support self-management among adults living with type 2 diabetes.
Methods: Two waves of a single-arm storytelling intervention, consisting of 8 sessions at a community health centre, were delivered to 8 adults with type 2 diabetes. Diabetes educators facilitated each session, in which patients shared stories about diabetes-self-management topics of their choice.
Objectives: Routine food insecurity screening is recommended in diabetes care to inform more tailored interventions that better support diabetes self-management among food-insecure patients. This pilot study explored the acceptability and feasibility of a food insecurity screening initiative within a diabetes care setting in Toronto.
Methods: A systematic literature review informed the development of a food insecurity screening initiative to help health-care providers tailor diabetes management plans and better support food-insecure patients with type 2 diabetes.
Objective: To examine provider- and patient-related factors associated with diabetes self-management among recent immigrants.
Design: Demographic and experiential data were collected using an international survey instrument and adapted to the Canadian context. The final questionnaire was pretested and translated into 4 languages: Mandarin, Tamil, Bengali, and Urdu.
Patients' experiences of diabetes education teams integrated into primary care.
Can Fam Physician
February 2017
Objective: To explore patients' perspectives on care received from diabetes education teams (a registered nurse and a registered dietitian) integrated into primary care.
Design: Qualitative study using semistructured, one-on-one interviews.
Setting: Three diabetes education programs operating in 11 primary care sites in one region of Ontario.
The aim of this cross-sectional study was to examine differences in health behaviours among ethnic minority and Caucasian women after a diagnosis of gestational diabetes mellitus (GDM). Data were derived from medical charts and a questionnaire among a multi-ethnic cohort of 898 Canadian pregnant women diagnosed with GDM attending prenatal diabetes clinics in Ontario, Canada. Health behaviours were compared between ethnic minority and Caucasian women, adjusting for relevant covariates.
View Article and Find Full Text PDFBackground: Little is known about how to develop and deliver storytelling as an intervention to support those managing chronic illnesses. This scoping review aims to describe the core elements of storytelling interventions in order to help facilitate its implementation.
Methods: A scoping review was conducted in seven databases for articles published up to May 2014 to identify interventions that describe in detail how storytelling was used to support people in disease self-management interventions.
Background: Specialised diabetes teams, specifically certified nurse and dietitian diabetes educator teams, are being integrated part-time into primary care to provide better care and support for Canadians living with diabetes. This practice model is being implemented throughout Canada in an effort to increase patient access to diabetes education, self-management training, and support. Interprofessional collaboration can have positive effects on both health processes and patient health outcomes, but few studies have explored how health professionals are introduced to and transition into this kind of interprofessional work.
View Article and Find Full Text PDFObjective. To explore how food insecurity affects individuals' ability to manage their diabetes, as narrated by participants living in a large, culturally diverse urban centre. Design.
View Article and Find Full Text PDFObjectives: This study explores the implementation processes of integrating specialized diabetes teams into primary care in southern Ontario, Canada.
Methods: In-depth qualitative interviews were conducted with 23 patients, 20 diabetes educators and 16 primary care physicians. In addition, group debriefing sessions were conducted and field notes were collected from diabetes educators and diabetes education program managers to further explore the day-to-day issues of implementation.
Access to sufficient, safe, and nutritious food not only affects the health of people who experience food insecurity, but also their ability to manage health conditions, such as diabetes. When people find it difficult to access sufficient food, tailoring their food selection to a diabetes regimen is even more difficult. Food insecurity in North America is consistently more prevalent among households with a person living with diabetes, and similarly, diabetes is also more prevalent in food-insecure households.
View Article and Find Full Text PDFObjective: The objective of this research was to explore self-management practices and the use of diabetes information and care among Black-Caribbean immigrants with type 2 diabetes.
Method: The study population included Black-Caribbean immigrants and Canadian-born participants between the ages of 35 to 64 years with type 2 diabetes. Study participants were recruited from community health centres (CHCs), diabetes education centres, hospital-based diabetes clinics, the Canadian Diabetes Association and immigrant-serving organizations.
Background: Over 2 million Canadians are known to have diabetes. In addition to the economic burden placed on the healthcare system, the human cost associated with diabetes poses a heavy burden on those living with diabetes. The literature shows that apparent differences exist in diabetes complications and diabetes management between men and women.
View Article and Find Full Text PDFBackground: To examine the views and current practice of SMBG among Black Caribbean and South Asian individuals with non-insulin treated Type 2 diabetes mellitus.
Methods: Twelve participants completed semi-structured interviews that were guided by the Health Belief Model and analyzed using thematic network analysis.
Results: The frequency of monitoring among participants varied from several times a day to once per week.
Objective: The purpose of this study was to examine the lived experiences of university students with type 1 diabetes mellitus.
Methods: University students participated in a 2-part focus group. Transcripts were analyzed thematically using an open-coding approach.