Paper Type

Doctoral Dissertation


Brooks College of Health

Degree Name

Doctor of Clinical Nutrition (DCN)


Nutrition & Dietetics

NACO controlled Corporate Body

University of North Florida. Department of Nutrition & Dietetics

First Advisor

Dr. Lauri Wright

Second Advisor

Dr. Andrea Arikawa

Third Advisor

Dr. Freda Intiful

Department Chair

Dr. Lauri Wright

College Dean

Dr. Curt Lox


Micronutrients are key components of various physiological processes. Therefore, in the setting of deficiency, poor health outcomes ensue. In Ghana, micronutrient deficiencies are common and medical resources are limited. The Ghanaian dietetics profession is growing, and this growth is propitiously timed to address micronutrient deficiencies. Biochemical markers of nutrition status are considered the gold standard to detect micronutrient deficiencies, but are costly and require specialized medical equipment. In the absence of available biochemical markers of nutrition status, the micronutrient-directed nutrition-focused physical exam is a viable tool. Nutrition professionals such as Registered Dietitians are qualified to conduct this exam, but feel relatively ill-equipped to do so. This mixed-methods research was conducted to determine whether a two-day virtual workshop for Ghanaian nutrition professionals (n=131) improved perceptions that using the micronutrient-directed nutrition-focused physical exam is an innovative strategy to assess patients/clients for micronutrient deficiencies, and to assess whether the workshop significantly improved feelings of self-efficacy in regards to conducting this exam. Quantitative data was collected via a virtual pretest (immediately prior to the workshop) and a virtual posttest (immediately following the workshop). Qualitative data was gathered via focus groups, which were conducted in virtual breakout rooms on the second day of the workshop. Total posttest scores were significantly higher (M=70.15, SE= .703), t(130)= -7.357, p=<.001 than total pretest scores (M= 64.85, SE= .165), t(130)= -7.357, p= <.001. The qualitative data mirrored and complemented the quantitative data. Specifically, participants stated that micronutrient deficiencies are common in their workplace, that cost and/or insufficient medical infrastructure are often barriers to assessing micronutrient status, and for these reasons the physical exam is an incredibly useful tool in their workplaces. Participants improved their feelings of self-efficacy in performing a complex clinical skill; a clinical skill that they perceive to be an advantageous and useful method of treating their patient population. Virtual platforms offer a safe and effective method by which to deliver nutrition-focused physical exam training during a global pandemic.