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. Casey Colin

Department Chair

Dr. Andrea Arikawa

College Dean

Dr. Curt Lox


The Covid-19 pandemic advanced telephonic (TP) and tele-video (TV) visits for medical nutrition therapy (MNT). This study explored the health outcomes and patient’s viewpoints of MNT by modalities in a community health center (CHC). Participants ranged in age from 1-18 years, diagnosed with overweight/obesity, and received MNT from a registered dietitian nutritionist (RDN) from January 1, 2019 to August 31, 2021. Health outcomes measured were health goal achievement, BMI percentile, pre/post lipid panel, and A1C%. Show/no-show rates and demographic characteristics of gender, age, race, insurance, county, language, and ethnicity were also compared by the visit modality. Ten interviews in the qualitative analysis assessed patients’ viewpoints regarding the modality of visit. Results indicated no difference in health goal achievement, BMI percentile, lipid panels, A1C%, and show or no-show rates based on the modality of visit. The demographic characteristics of gender, race, county, language, and ethnicity had no significant association based on the modality of visit. However, there was a significant association of age (p = 0.008) and insurance status (p = 0.024) by modality. Themes from the interviews included benefits, barriers, preferences, and effectiveness. Benefits cited were interactivity, visualization, and lack of travel. The barriers identified were transportation and connectivity. Interviewees reported the most preferred and effective modality was the IP visit followed by the TV. Although, patients were willing to do any type of visit. TP and TV offer benefits to help increase access to care for patients in rural areas. Future studies should investigate these findings through several CHCs.