Education Sessions Research Articles

The Effect of Implementation of Skin Care Guidelines on Nurses’ Knowledge Regarding Skin Care and Incidence of Skin Injuries Among Neonates at a Private Tertiary Care Hospital

Background: Skin care of sick newborns is important because skin acts as a barrier to prevent neonates from infections which may lead to neonatal morbidity and mortality. The highly technological environment of the neonatal intensive care unit (NICU) makes them vulnerable to loss of skin integrity. In acute care setting maintenance of skin integrity is considered as an established quality indicator representing nursing care. Aim of Study: The study aimed to determine the effect of skin care guidelines on nurses’ knowledge related to skincare and the incidence of skin injuries among neonates. Methodology: Pre-post quasi-experimental study was conducted in the NICU of a private tertiary care hospital. A consecutive sampling technique was used. The intervention comprised educational sessions and demonstrations of skin care practices from AWHONN skin care guidelines. The data on the nurses’ knowledge were collected through self-developed and self-administered questionnaires. Skin injuries were recorded on a checklist through observation for 1 month before and after the intervention. A paired sample t-test was used for comparing knowledge and continuous demographical variables. While the incidence density ratio was calculated for skin injuries. Results: There was a statistically significant improvement in the nurses’ knowledge of skin care from pre (mean 15.06 ± 5.16) to post (mean19.40 ± 5.17) measurement P-value .001. Incidence density rate of skin injuries reduced from 19% to 3% after the implementation of skin care guidelines. Conclusion: Through the implementation guidelines nurses’ knowledge and practices regarding skin care improved while skin injuries among neonates were reduced.

The impact of a multi-faceted intervention on non-prescription dispensing of antibiotics by urban community pharmacies in Indonesia: a mixed methods evaluation

IntroductionNon-prescription antibiotic dispensing is prevalent among community pharmacies in several low- and middle-income countries. We evaluated the impact of a multi-faceted intervention to address this challenge in urban community pharmacies...

Transformative impacts of explicit morphological instruction on irregular inflectional acquisition in Saudi EFL learners

The study aimed to investigate the transformative effect of overt instruction on the acquisition of irregular inflectional morphemes by Saudi EFL learners. A mixed-method approach consisting of quantitative data and complemented with a qualitative descriptive analysis was adopted for this study to measure the transformative effect of explicit instruction through pretest and posttest procedures. Input Processing Theory and Processability Theory were used in this study to see the transformative effect of overt instruction between the control and experimental groups. The study employed visual aids and metalinguistic discussion instructional techniques to treat the experimental group with a one-hour session once a week, other than the normal classroom instruction sessions. In total, it continued for seven consecutive weeks. The results demonstrated that a p-value less than 0.001 for all three hypotheses developed in the study posited in favour of the alternative hypothesis and rejected the null hypothesis. Hence, the two groups significantly differed in their vocabulary knowledge: morpheme recognition and morpheme use in writing. The results support the hypotheses developed initially in this study that overt instruction of inflectional irregular morphological knowledge transfers to the EFL learners’ writing skills and facilitates L2 acquisition. The study has significant implications for foreign language learners, L2 teachers, and researchers.

Posyandu Cadres' Contributions to Elderly Health Improvement

Background: This study investigates the role of community health workers in promoting elderly health through integrated health posts. Specific Background: A qualitative descriptive approach is used to examine the significance of these workers in ensuring regular attendance of the elderly at health services. Knowledge Gap: While previous studies have focused on health post activities, they often overlook the specific strategies employed by community health workers. Aims: The study aims to clarify the contributions of community health workers in facilitating elderly health programs. Results: Findings indicate that these workers adapt activities, such as health consultations and educational sessions, to enhance elderly participation and health outcomes. Novelty: The research provides new insights into innovative service delivery by community health workers amid logistical challenges. Implications: The results highlight the need for ongoing support and training for community health workers, advocating for structured programs to enhance elderly engagement and well-being, with potential applications in similar contexts to improve elderly healthcare. Highlights : Community health workers play a crucial role in facilitating elderly health services. Adaptation of activities enhances elderly engagement and health outcomes. Continuous support and training for health workers are essential for effective program implementation. Keywords: community health workers, elderly health, qualitative study, health post, participation

Reducing unnecessary outpatient group and screen testing at a regional cancer center.

Unnecessary group and screens (G&S) can lead to unnecessary antibody investigations, use of technologist time, and laboratory resources. A baseline audit at our institution identified that 25% of G&S from the cancer center were unnecessary. We aimed to reduce the ratio of monthly G&S to CBC samples processed from the cancer center by 10% (from 0.034 to 0.031) by January 2024. This represents an interrupted time series design from November 2022 to January 2024. Using Plan Do Study Act (PDSA) cycles, we aimed to increase the use of an existing reflex testing system, termed "do not test." When this option is selected, the blood bank will only process the G&S sample if specific CBC criteria are met (e.g., hemoglobin <9.0 g/dL). Educational sessions increased awareness of this feature and sought feedback from end-users on its usability. With feedback, the design was updated to include a modifiable hemoglobin threshold for G&S testing, automatic re-selection of the "do not test" feature for future G&S orders, and aesthetic changes to make the feature more visible. The percentage of samples with "do not test" selected increased from 7.2% to 63.0% (p < .0001) and the ratio of G&S to CBC specimens improved from 0.034 to 0.028, exceeding the target of 0.031. We noted an improvement in the appropriateness of G&S orders from 75% at baseline (n = 20) to 97.5% (n = 80) post intervention (p = .003). We describe an effective strategy to improve G&S utilization at our institution's cancer center using a reflex testing system.

A Multimodal Intervention to Improve Guideline-Based Screening for Alpha-1 Antitrypsin Deficiency in a Community Health Setting.

Evidence-based guidelines recommend screening all individuals with chronic obstructive pulmonary disease (COPD) for the genetic disorder alpha-1 antitrypsin deficiency (AATD). However, it is estimated that only 5% of people with COPD have been tested for AATD, and a large fraction of the estimated 70,000 to 100,000 Americans with AATD have not yet been diagnosed. Low familiarity with AATD and limited knowledge about diagnostic tests and available treatments contribute to suboptimal screening rates. To address barriers to and improve rates of guideline-based AATD diagnostic testing among racially and ethnically diverse patients with COPD at a large community health center. A quality improvement initiative consisting of educational sessions and electronic health record (EHR) system interventions was implemented to improve the adoption of guideline-based screening for AATD in patients with COPD. An analysis of EHR data demonstrated that of patients with a COPD diagnosis (N = 1,030), 22.2% (n = 229) were screened for AATD in the 12 months following the start of the quality improvement initiative compared with 1.3% (n = 13) of patients with a COPD diagnosis (N = 972) seen in the 12 months prior to the start of the quality improvement initiative (P < 0.001). A quality improvement initiative consisting of educational sessions and EHR system modifications was successful in increasing clinicians' knowledge and diagnostic screening rates for AATD in patients with COPD at a large community health center.

Pembangunan permainan papan untuk pengajaran dan pembelajaran kewarganegaraan digital [The development of a board game for teaching and learning digital citizenship

This study aims to examine the need for using board games in teaching and learning (PdP) sessions related to the theme of digital citizenship. This study employed a qualitative approach using the Design and Development Research (DDR) methodology. Data was collected through interviews involving five Moral Education trainee teachers who had taught topics related to Digital Citizenship. The data was analyzed by adapting the three phases in the DDR Design and Development Model, where the first phase is needs analysis, the second phase is development, and the third phase is evaluation. The study results showed that the study participants had a high awareness of providing early exposure to the elements of citizenship. A teaching aid, namely a board game that incorporates three elements of digital citizenship, is needed. In the usability testing phase, the board game produced is attractive, capable of achieving three moral dimensions, namely moral reasoning, moral emotion, and moral behavior; the board game can also strengthen the relationship between students and teachers. The study's implications provide exposure to teachers to create a game-based teaching for the topic of moral and citizenship education, which can increase students' interest.

Implementing a Care-Based Nursing Workforce Model: Implications for Missed Care, Teamwork, and Satisfaction.

Nursing care delivery models may serve as a significant factor contributing to nurse satisfaction, frequency of missed care, and patient outcomes. The nursing leadership team at our institution sought to determine if an adaptation of our primary registered nurse (RN) nursing model would enhance satisfaction of bedside nurses and care of patients. An improvement study introducing a care-based delivery model was implemented between January 2023 and January 2024 on a medical-surgical neurology/spinal unit at our organization. Adoption of a care-based nursing model was supported with the delivery of brief education sessions utilizing in situ simulations for development of competencies in teamwork and delegation. During the pilot period, overall satisfaction with job role improved 23%. Six missed nursing care elements and 7 teamwork elements significantly improved. A care-based nursing model may improve staff satisfaction and quality of nursing care.

The Status of Food and Nutrition Literacy and its determinants among Elementary School students in Egypt: community nursing-led design

AimTo assess food and nutrition literacy status and its determinants among elementary school students in El-Beheira Governorate, Egypt.BackgroundDeveloping strategies to enhance food and nutrition literacy necessitates a deeper understanding of the food and nutrition literacy situation among elementary school students and associated factors.DesignA cross-sectional descriptive research design was adopted.MethodsA final sample of 400 primary school students (aged 6–12 years) at Itay El Barud public elementary schools in El-Beheira Governorate were administered (1) a socio-demographic characteristics and anthropometric measurements questionnaire developed by the researchers, and (2) the Food and Nutrition Literacy Scale. The derived data were analyzed using descriptive and non-parametric tests.ResultsThe majority (61%) of students had low food and nutrition literacy scores. The results have shown that overall socio-demographic variables were significant in predicting understanding food and nutrition information, nutritional health knowledge, interactive functional and nutritional literacy, critical food and nutritional literacy, and food labeling.ConclusionThe study reveals that elementary school students in Egypt have poor knowledge and skills in food and nutrition literacy, largely due to a lack of nutrition education and family awareness. Factors like residential location, income, and education level also contribute to this disparity.Implications for the professionTo improve nutrition literacy among students, a nursing approach involving community stakeholders and school nurses is recommended. This includes integrating nutrition-related topics into the school curriculum, organizing workshops, and conducting age-appropriate health education sessions. Active engagement between community health and school nurses is crucial for raising awareness about healthy nutritional choices.ImpactThese findings hold an important impact on the education system and those designing curricula, emphasizing the need for significant incorporation of knowledge and skills related to food and nutrition within schools.Reporting methodCompliance with the STROBE checklist for cross-sectional studies was maintained throughout the research.Patient or public contributionNo Patient or Public Contribution.

Empowering Mothers: Self-efficacy Strategies and Fluoride Varnish Therapy Behavior in Preschool Children

Background: Oral health poses significant challenges, particularly among preschool children, emphasizing the critical role of mothers in preventive care. Self-efficacy, as a determinant of behavior, holds promise in shaping oral health practices. Objectives: The present study was conducted to determine the effect of Bandura's self-efficacy strategies on the fluoride varnish therapy behavior of mothers of preschool children. Methods: This intervention study, conducted from 2021 to 2023, involved 88 mothers with children aged 3 to 6 years. Participants were randomly divided into intervention and control groups. Data collection included a demographic questionnaire, a researcher-developed self-efficacy assessment tool, and an observational checklist of mothers' fluoride varnish therapy behavior. The intervention comprised educational sessions focusing on self-efficacy strategies. Data were analyzed with descriptive and inferential statistics in SPSS software version 20. Results: Before the intervention, there were no significant differences in self-efficacy scores between the intervention and control groups (Cohen's d = 0.18). Similarly, there were no significant differences between the two groups in the varnish therapy behavior score of the mother before the intervention (Cohen's d = 0.05). However, two months later, significant improvements were observed in both self-efficacy scores (Cohen's d = 2.28) and fluoride varnish therapy behavior (Cohen's d = 3/32) among mothers in the intervention group compared to controls. Conclusions: This study underscores the pivotal role of self-efficacy strategies in empowering mothers to effectively engage in fluoride varnish therapy behavior, and highlights the significant improvements observed in both self-efficacy and varnish therapy behavior that emphasize the educational interventions aimed at enhancing mothers' self-efficacy, ultimately contributing to improved oral health outcomes for children.

Comparison of the effects of nursing and peer education on quality of life and resilience in patients with multiple sclerosis: A randomized clinical trial

BackgroundMultiple sclerosis (MS) is a prevalent disease of the central nervous system that often leads to diminished resilience and quality of life in affected individuals. This study aims to compare the effects of nursing and peer education on improving the quality of life and resilience in patients with multiple sclerosis. Materials and methodsThis three-group clinical trial study was conducted before and after interventions at the MS Society in Hamedan, Iran. In this study, 120 patients with MS were randomly selected and assigned to three groups: nurse education, peer education, and control. Quality of life and resilience questionnaires were self-reported before and two months after the completion of the intervention. The educational sessions were conducted over five meetings, each lasting between 45 and 60 min, held every two days. Group one received education led by nurses, while group two participated in peer-led education sessions. ResultsThe results indicated that before the intervention, there were no significant statistical differences in demographic variables, resilience, and quality of life among the three groups (p > 0.05). However, after the intervention, both the peer and nurse groups showed a significant increase in quality of life and resilience compared to the control group (p < 0.05). Nevertheless, no differences were observed between the nurse and peer groups regarding these variables (p > 0.05). ConclusionsBoth nursing and peer education methods had an equal impact on enhancing the resilience and quality of life of patients with MS. It is recommended that peer support be utilized to empower MS patients, especially in contexts where there is a shortage of nurses.

Improving the quality of psychiatric residency training in Isfahan University of Medical Sciences by learning teams and changing curriculum implementation: An action research study

BACKGROUND: The deficiencies in the training of psychiatric residents in Isfahan, including the segregation of residency programs by year, the confinement of training to hospital departments, and the residents’ limited exposure to the perspectives of other faculty members, had not been given significant attention. However, the inevitable alterations in the Department of Psychiatry and the impact of the coronavirus disease 2019 pandemic have brought these issues to the forefront, highlighting the need for program modifications. The objective of this study is to enhance the quality of psychiatric residency training by changing the implementation of the curriculum. METHODS AND MATERIALS: This proactive action research was conducted in six steps. In the first step, the expectations of a new action were identified. In the second step, the new action – creating learning teams – was designed and implemented; thus, eight learning teams comprising experienced professors, novice professors, and residents from various academic levels were created, who collectively engaged in patient visits, psychotherapy, counseling, and educational sessions. Additionally, the portfolio was used in the training and evaluation of the residents. Steps 3 to 6 involved evaluation using a researcher-made questionnaire, analysis and interpretation of results, and reflection and making decisions for future actions. RESULTS: Step 1 resulted in preparing a list of department expectations from new action. The second step yielded the design of a new action. The survey results showed that more than 60% of respondents agreed that the program had a positive impact on 12 out of 15 items in the questionnaire, particularly in enhancing teamwork skills, facilitating discussions about patients, and fostering residents’ accountability. However, in items related to portfolio, this percentage ranged from 40% to 53%. CONCLUSION: The implementation of learning teams as the main action in the current study has yielded positive outcomes; however, the portfolio intervention requires some adjustments. Hence, it is advisable to employ learning teams in comparable circumstances. The research team anticipates that these outcomes will enhance the quality of psychiatric residency training, positioning the country among the leading and influential nations in the region.

Design of a Health Education Program to Manage Chronic Neck Pain: Protocol for a Development Study.

Chronic neck pain (CNP) needs attention to its physical, cognitive, and social dimensions. We aimed to design a health education program (HEP) with a biopsychosocial approach for patients with CNP. A literature search on CNP, health education, and biopsychosocial models was carried out. Seven physiotherapists with expertise in HEPs and chronic pain participated in three teams that evaluated the literature and prepared a synthesis document in relation to the three target topics. Experts compiled the information obtained and prepared a proposal for an HEP with a biopsychosocial approach aimed at patients with CNP. This proposal was tested in the physiotherapy units of primary care health centers belonging to the East Assistance Directorate of Madrid, and suggestions were included in the final program. The HEP for CNP with a biopsychosocial approach consists of 5 educational sessions lasting between 90 and 120 minutes, carried out every other day. Cognitive, emotional, and physical dimensions were addressed in all sessions, with particular attention to the psychosocial factors associated with people who have CNP. The proposed HEP with a biopsychosocial approach emphasizes emotional management, especially stress, without neglecting the importance of physical and recreational exercises for the individual's return to social activities. The objective of this program was to achieve a clinically relevant reduction in perceived pain intensity and functional disability as well as an improvement in quality of life in the short and medium term. ClinicalTrials.gov NCT02703506; https://clinicaltrials.gov/study/NCT02703506. DERR1-10.2196/56632.

Have interventions aimed at assisting general practitioners in facilitating earlier diagnosis of type 1 diabetes in children been successful in preventing acute complications? A systematic review

BackgroundDiabetic ketoacidosis (DKA) is a life-threatening emergency that can result from delayed diagnosis of type 1 diabetes mellitus (T1DM). Three-quarters of Australian children with a new diagnosis of T1DM visit...

A reflection on using an online polling and Q&amp;A platform as a method of engagement in undergraduate psychology lectures

Engaging a large cohort of students with teaching content is a difficult task for any educator working in higher education. When students are not receiving feedback about their participation efforts, this can lead to decreased engagement. Polling activities, such as hands up responses, can be used to address this but students cannot respond anonymously. However, there is now a plethora of online polling platforms (e.g. Vevox, Mentimeter) that can be used anonymously on mobile devices, to overcome these issues. Drawing upon the experiences of two educators within psychology, this paper specifically reflects upon how one of these platforms, Vevox, was implemented within first- and second-year psychology undergraduate modules. Reflections demonstrated that students found the use of Vevox to be a very positive experience; students appreciated the use of different Vevox activities and found that the anonymity afforded by the platform was beneficial in increasing engagement with the activities during teaching sessions. From these reflections, we offer guidance regarding the implementation of online and offline polling platforms.

A Picture Paints a Thousand Words: Perspectives of the Use of Images and Videos of Physical Findings in Virtual OSCE Teaching Sessions.

The COVID-19 pandemic has resulted in medical students' education being disrupted and a new direction of learning towards the online classroom, with students frequently learning to identify clinical signs via online conferencing platforms. Given this shift in student study techniques in the pandemic and post-pandemic era, we set out to analyse the confidence levels of students recognizing clinical signs in patients and the opinions and patterns of resources students would use to build up the knowledge and confidence for their future clinical practice. OSCEazy, a student-led medical education organisation, delivered an online teaching session and disseminated a questionnaire containing ten-point Likert scales, multiple-choice questions and free text options. The majority (over 75%) of respondents reported using digital resources to learn physical examinations. Most respondents were somewhat confident with recognising clinical signs during physical examinations (Median 7, IQR 6-8). Kruskal-Wallis H-test on students' impression of the quality of current OSCE materials showed a statistically significant difference between cohorts (X2(2) = 14.209, p = 0.014). A large proportion of students (98.41%) agreed that an online resources bank would be beneficial for their learning. Wilcoxon rank test showed a statistically significant preference for learning physical examinations using clinical images rather than videos (p = 0.014). A 29% of respondents mentioned the use of physical textbooks as a resource, while online platforms such as OSCE revision websites, YouTube and Google Images had become the mainstream platforms. The findings reported here suggest that there needs to be a greater emphasis on providing online image-based resources to support medical students in learning clinical signs. A resource containing these clinical signs would prove to be of benefit for students to access high-quality self-directed learning to identify and verify clinical signs.

Implementing a multisite shared haemodialysis care programme.

Adults receiving centre-based haemodialysis (HD) have low levels of patient activation which are associated with poorer outcomes. Shared haemodialysis care (SHC) describes an intervention whereby individuals are supported to undertake elements of their treatment to improve their activation levels and promote better self-care. This project aimed to increase the proportion of those performing SHC in seven HD centres within the Oxford Kidney Unit's catchment area. Sequential Plan-Do-Study-Act (PDSA) cycles effected change first in two central HD centres, in cycles 1 and 2, before rolling out to five satellite HD centres, in cycles 3 and 4. Cycle 1 explored and transformed staff perceptions regarding SHC using a questionnaire and teaching sessions while in cycle 2, staff partnered with patients to develop leaflets and noticeboards to improve awareness and participation. These interventions were then rolled out to the remaining HD centres in PDSA cycles 3 and 4. Other interventions included: Enrolling staff and patients in virtual training courses; designating SHC 'Champions'; engagement with a national SHC forum; and changes to the electronic patient record to enable the monitoring of patient SHC opportunity and to promote sustainable change. Outcome measurement data on the number of patients performing SHC and the number at different defined stages of SHC competency were captured monthly. In April 2022, only 4% (19/483) of those receiving centre-based HD performed any aspect of SHC. By the end of the project in December 2023, this had increased to 43% (220/511). There was a significant and sustained growth in the stage of patient SHC competency as well as the number of patients performing SHC in each HD centre. The project demonstrated that it is possible to implement, scale-up and maintain a multisite SHC programme even with little baseline staff and patient SHC experience.

PAPERLESS ASSIGNMENTS AND CHALLENGES INVOLVED: VOICE OF DISTANCE LEARNERS

The study was planned to explore the challenges faced by distance learners during paperless assignment process. This initiative was introduced a couple of years ago at a distance learning university in Pakistan. Target population comprised on distance learners of M. Phil Education and MBA (col) sessions 2017 to 2019 programs running online through Learning Management System (LMS). Total Population Sampling (TPS) technique was followed and all distance learners of both programs were engaged. It was mixed-method research comprising both structured and open-ended information. The instruments employed were two questionnaires: one on Likert Scale and the other was open-ended. The reliability coefficient was 0.71, and the open-ended questionnaire was validated through six subject experts. The structured questionnaire was sent to all 563 students and in response 132 students filled out the online questionnaire. Quantitative data was analyzed through descriptive statistics while qualitative data was analyzed through NVivo software. The main problems highlighted were study material relevance and late delivery, understanding and processing of paperless assignments, access and skills of ICT, financial constraints, evaluation of paperless assignments, and instructors’ feedback. Students suggested that textbooks should be revised and delivered in time, connectivity issues should be resolved, free internet packages should be introduced, LMS training should be conducted, in time feedback in descriptive form by instructors must be provided to the distance learners.

Athletic Trainer Emergency Management Skill Assessment via Low Fidelity Simulation Authors

Introduction: Athletic training education requires the inclusion of emergency management (EM) best practices, however the Board of Certification (BOC) does not mandate any continuing education (CE) past Emergency Cardiac Care (ECC). With EM best practices continuing to change there is potential for a large knowledge gap to develop in practicing athletic trainers (ATs) who do not chose to engage in EM CE. The purpose of this study was to identify knowledge gaps in practicing ATs’ EM skills via low fidelity simulation. Methods: A cross-sectional study was conducted in an educational laboratory setting involving twenty-two ATs (age 36.7±10.8 years; 13 males, 9 females, years of experience 13 + 11) attending a simulation-based CE event. A convenience sample of participants who attended the CE event voluntarily participated in data collection. Upon the completion of an educational review session, participants completed four low fidelity simulations (elbow dislocation, femur fracture, heat stroke and external hemorrhage) based on the 2020 Commission on Accreditation of Athletic Training Education (CAATE) standards. Checklists (completed/not completed) were utilized to grade participants simulation specific skill application. Mean overall, critical action, SAMPLE and vital scores were analyzed. Scores were calculated as percentages in order to compare the low fidelity simulation outcomes. A benchmark of 80% skill application was utilized for a successful pass rate. Results: The only benchmark achieved was the critical action score within the femur fracture simulation (82.89% ±14.56). A success rate of 9.6% (8/83) was calculated across all simulations. The mean total percent scores were as follows; elbow dislocation 65.0 ± 11.0, femur fracture 55.3 ±10.0, heatstroke 67.7 ±17.5 and external hemorrhage 64.0 ±13.0. All means beyond the critical action femur, were below the benchmark of 80%. Conclusions: A knowledge gap exists between practicing clinicians and the 2020 CAATE EM standards. Considering the importance of ATs lifesaving skills, ATs should aim to choose CE to improve their EM skills. While this study only investigates EM, ATs may demonstrate knowledge gaps in other domains and therefore ATs should aim to diversify their CE to stay current with best practices.

Secondary Analysis Assesses Dietary Diversity Changes among Maya Guatemalan Women Post-Nutrition Interventions.

This study aimed to evaluate the change in the Dietary Diversity (DD) Index of Maya women of reproductive age living in rural areas of the Western Highlands of Guatemala after nutrition, health, and agroecology interventions. This is a secondary analysis study on DD from two matched groups from three villages in the Lake Atitlan area in the department of Sololá. The first cohort was recruited in 2017 (sample of n = 77). The second cohort was recruited in 2020 (sample of n = 61). Both were followed until 2021. The program provided various resources for assistance for food production and home improvements (sessions from 2018 to 2022). Agroecology sessions were conducted in the test farm. Due to the COVID-19, adjustments were made to continue the education and training sessions. Both cohort samples had a statistically significant increase in participants who consumed at least 15g from five groups of foods (2017: p = .00002; 2020: p = .045). There was a statistically significant increase in mean food groups consumed daily (2017: p < .00001; 2020: p = .005). Implementing interventions that include nutrition, health, and agroecology practices in the long term has demonstrated a statistically significant increase in the Dietary Diversity Index of Maya women in their reproductive years living in rural villages in the Western Highlands.