Date of Award

Spring 2025

Project Type

Clinical Doctorate

College or School

CHHS

Department

Nursing

Program or Major

DNP

First Advisor

Dr. Cathleen Colleran

Second Advisor

Dr. Courtney Coffey

Abstract

Background: Celiac disease (CD) is projected to be the most common genetic autoimmune disease in the world with 1% or 3 million people effected in the United States. It is estimated that as many as 70% of those effected are not aware. Diagnosis routinely takes 10-12 years from the initial onset of symptoms, exposing patients and the healthcare system to significant cost and stress through excess testing and misdiagnosis. One area that is often referenced in barriers around celiac disease is the lack of awareness and education specifically with patients, healthcare providers, and the community at large.

Methods: In this study, a Central European study, evaluating health care provider awareness of CD, was replicated with primary care providers in a community hospital, furthermore, test ordering patterns were evaluated. Data collection was followed by an educational intervention and ordering practices were reevaluated in the months to follow. To address patient education and awareness and access to resources, a care navigation program was piloted. Patients were provided with virtual interactions as well as personalized resources to address areas of need. Maslow’s Hierarchy of Needs was used to assess patients’ development and provide appropriate guidance. Follow up was completed with patients. Data was collected comparing pre and post attendance in a common well-developed resource to determine if increased awareness resulted in increased utilization.

Results: Overall, education of providers did result in increased awareness and screening for celiac disease. Patients were receptive to the idea of care navigation of celiac disease and data did show increased utilization of the resources with increased awareness. Limited timeframe, small populations, and organizational limitations limit the overall impact of this project. However, it does show promising evidence of the importance of increasing education and awareness in the community. Conclusions: Specifically, this project was intended to address education and awareness in small communities not served by the larger tertiary celiac centers. With this in mind, it lends evidence to the consideration of expanding the reach of tertiary clinics through small outreach clinics to improve care to those currently underserved patients. More research over greater time frames with a larger population is needed to determine if a clinic of this nature could be expanded to improve diagnosis and management of celiac disease.

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