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By Kelly Glynn, RD
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Year RD/DTR Started: Terese started working at Vital Bridges in 1998, ten years after the facility opened. Shira began working for the agency about three years ago as the client load and number of service locations increased. Jennifer began working at Vital Bridges two years ago.
Number of Days/Hours on Site: The three dietitians rotate around to the different pantries (each of which have their own service hours) as well as partnering with three medical clinics and one alternative-care clinic in the city. Almost any time a pantry is open for service, there is a dietitian available to assist clients with nutrition needs or questions. The RD's schedule is based on a 40 hour work week. They work Monday through Friday or Tuesday through Saturday.
Funding Source: Seventy-percent of the funding for Vital Bridges is derived from public sources while the other 30% comes from private sources such as individual donations.
Is someone involved in program operation also actively involved with your local HIV/AIDS Health Services Planning Council? No
Patient Referral Source: Referrals are made by contacting the main office for eligibility requirements.
Number of Clients and Specific Population Served: The client base at Vital Bridges is nearly 100% adult, however they do have some clients who are children. About 65% of the clients are male while 35% are female. Approximately 83% of the clients are members of ethnic and racial minorities, primarily African Americans and Hispanics. Vital Bridges also serves a few Africans, Asians, Eastern Europeans, and other people from diverse backgrounds.
When are patients seen? The RDs attempt to respond to the needs of Vital Bridges clients by seeing them as needed and at times that are convenient for the clients. Two of the pantries serve clients on Saturdays; all have some evening hours to best accommodate clients’ needs.
Are all patients screened for nutritional risk? Yes, all clients are screened for nutritional risk during the intake procedure.
How often do you provide nutritional assessments and follow-ups? Assessments are done within the first three months of starting service with Vital Bridges. Follow-ups are conducted based on individual client need. Generally if a client is doing well without any clinical issues and has a satisfactory Bioelectrical Impedance Analysis (BIA), they try to see that client every six months. Nutritional reassessments are done as needed based on the client's state of health.
What other nutritional services does the program provide? In addition to the above services, Vital Bridges offers BIA, Workshops, Home Visitation, and In-house Nutrition Education. Vital Bridges is working on a goal of providing in-house cooking classes as well.
What kind of patient education materials do you incorporate in your program? RDs use a variety of patient nutrition education materials. Donated materials that they solicit from various groups such as the National Cancer Institute and the Midwest Dairy Council are often distributed to clients. The RDs at Vital Bridges also have many materials that they have developed and some that are garnered from on-line resources or through the HRSA materials. Topics include: Basic Nutrition, Food Safety, Symptom Management, Therapeutic Diets, etc.
What was the most difficult issue you had to deal with when you started? Learning about the prescribed medication regimens that most HIV-positive people take.
Who is your best ally? The RDs at Vital Bridges rely on the Internet and different groups such as the HIV/AIDS Dietetic Practice Group (DPG #29) of the American Dietetic Association (ADA). DPG #29 and the general ADA electronic list-serves are useful for gaining clinical information and for getting answers to timely questions. Also, the RD’s work well together as a team within the organization and support one another.
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Are there any differences in clinical care within your population group? Vital Bridges clients all have different practitioners whom they see for care, so there are huge discrepancies among them in the care that is provided. What differences exist between your current clientele and that of the HIV-positive person in the early 1980s? The clients at Vital Bridges greatly reflect the changing face of AIDS. Many of them are older, whether they have lived with the disease for longer, or have simply been diagnosed at older ages. "We also see many women, who have challenges such as desiring to raise families despite their status, and caring for existing partners and family members. Finally, the co-morbidity's that come from years of highly active antiretroviral therapy (HAART) have changed our clients. As wasting syndrome and Kaposi’s Sarcoma may have been the most common issue in the early days of the epidemic, now we face hypertension, lipodystrophy, heart disease and a need for weight loss." Do you participate regularly in HIV/AIDS networking groups? Yes, DPG #29. Heather notes, "Also, we are thinking of starting a HIV practice group for Chicago." What have you found
to be most useful in helping to keep up with the current research on nutrition
and HIV? Heather notes, "Electronic lists such as the one that DPG
#29 offers and web-based newsletters such as The
Body are extremely useful. Also, TPAN is located near our north side
pantry and puts out great publications such as the annual drug guide in
Positively Aware."
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