Evaluating the MyPlate Teaching Tool in an Obese Rural Population at Risk for Type 2 Diabetes

The rural population of Appalachia is plagued by enormous health disparities due to extensive poverty, lack of education, and minimal access to health care providers. Type 2 diabetes and obesity (a pre-cursor to type 2 diabetes) have become regional epidemics. There is accumulating evidence that diabetes prevention is cost-effective and that diabetes prevention interventions are beneficial from both the health system and a societal perspective. Because there are limited health care providers and many barriers to accessing treatment within the Appalachian population, the Remote Area Medical (RAM) clinic has been an important initiative in addressing the regional health needs. The purpose of this project was to evaluate the effectiveness of a teaching intervention, the MyPlate Healthy Eating Guide, used at the 2012 RAM events in Wise and Grundy, Virginia. In 2012, five nurse educators partnered with student nurses to implement a nutrition education project using the MyPlate educational tools targeting clients at risk for developing or who have type 2 diabetes. This tool offered simple, easy to understand, graphic information that significantly reduced nutrition instruction time and increased client comprehension, evaluated by response from 87 clients who completed a survey immediately following instruction. A follow-up survey was mailed to 70 clients who participated in the initial survey and agreed to be contacted for follow-up to evaluate the effectiveness of the tool on self-reported behavior change and body weight. Results demonstrate that the one-time education session using the MyPlate tool lead to weight loss in this vulnerable population, albeit not statistically significant. Barriers to following the MyPlate included food cost and change in eating habits. Participants who saw their MyPlate tool each day trended towards more weight loss than those who did not see their tool daily. Women were more likely to lose weight than men. Providing this population with education that includes healthy, affordable, and culturally sensitive nutrition choices can lead to greater awareness about healthy nutrition and its impact on body weight and diabetes. Health care providers, nursing students, and lay health workers, who work with at-risk populations may benefit from using this simple, clear, nutrition intervention.