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Nayda C, Gould J, Roberts RM. Psychologist attitudes, self-reported competence and practices associated with the use of dietary interventions for children presenting for psychological treatment. AUSTRALIAN PSYCHOLOGIST 2021. [DOI: 10.1080/00050067.2021.1944788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Cary Nayda
- School of Psychology, University of Adelaide, Adelaide, Australia
| | - Jacqueline Gould
- School of Psychology, University of Adelaide, Adelaide, Australia
- Healthy Mothers, Babies and Children, South Australian Health and Medical Research Institute, Adelaide, Australia
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Ball L, Somerville M, Crowley J, Calleja Z, Barnes K. Providing food to patients in primary care to induce weight loss: a systematic literature review. BMJ Nutr Prev Health 2021; 4:333-341. [PMID: 34308141 PMCID: PMC8258096 DOI: 10.1136/bmjnph-2020-000195] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 03/07/2021] [Accepted: 03/09/2021] [Indexed: 12/22/2022] Open
Abstract
PURPOSE Primary care is the ideal setting to promote weight management, warranting innovative ways to support patients. This systematic review aimed to determine whether providing food to patients in primary care can help to reduce body weight. METHODS Four databases were searched for studies that aimed to elicit weight loss by directly providing foodstuffs and/or supplements to patients in primary care settings. Interventions with adults of any gender or race were included. Interventions that involved other components such as exercise classes or education sessions were excluded. The methodological quality of each study was appraised using the Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies. RESULTS Four heterogeneous studies met the eligibility criteria, representing 476 adults. Two studies used meal-replacement products but differed in length and intensity, another study provided green tea and vitamin E supplementation, and the final study provided vouchers for use at a farmers' market hosted at a primary care clinic. Interventions ranged in length from 4 to 13 weeks. Three of the four studies observed weight loss in some form and all studies observed at least one other improvement in a health outcome such as waist circumference, blood pressure or fasting insulin levels. CONCLUSIONS A small yet notable body of literature supports the concept of providing food to patients in primary care settings to support weight loss. Further, high-quality research is needed on the efficacy and cost-effectiveness of this approach to ultimately inform policy initiatives for primary care.
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Affiliation(s)
- Lauren Ball
- School of Allied Health Sciences, Griffith University, Southport, Queensland, Australia
- Menzies Health Institute, Griffith University-Gold Coast Campus, Southport, Queensland, Australia
| | - Mari Somerville
- School of Allied Health Sciences, Griffith University, Southport, Queensland, Australia
- Menzies Health Institute, Griffith University-Gold Coast Campus, Southport, Queensland, Australia
| | - Jennifer Crowley
- Discipline of Nutrition and Dietetics, The University of Auckland, Auckland, New Zealand
| | - Zoe Calleja
- School of Allied Health Sciences, Griffith University, Southport, Queensland, Australia
- Menzies Health Institute, Griffith University-Gold Coast Campus, Southport, Queensland, Australia
| | - Katelyn Barnes
- School of Allied Health Sciences, Griffith University, Southport, Queensland, Australia
- Menzies Health Institute, Griffith University-Gold Coast Campus, Southport, Queensland, Australia
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Lucas CJ, McMahon AT, Charlton KE. Developing professional education for primary healthcare providers about nutrition. Aust J Prim Health 2020; 25:534-538. [PMID: 31738708 DOI: 10.1071/py19075] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2019] [Accepted: 08/05/2019] [Indexed: 11/23/2022]
Abstract
Nutrition care is an important component of primary health care as a way to promote positive lifestyle behaviours and reduce risks of chronic disease. Despite this, it appears that primary healthcare settings, including antenatal care, miss opportunities to deliver nutrition care. Time constraints, lack of nutrition knowledge and lack of confidence have been identified as barriers for primary healthcare providers in delivering nutrition care. Nutrition training to upskill primary healthcare providers to deliver nutrition care in a timely manner therefore appears warranted. This forum article discusses models and methods of continuing professional development (CPD) and the effectiveness of nutrition CPD for primary healthcare professionals. It includes a case study as an example of developing nutrition CPD for midwives using adult learning theory and concludes with implications for developing nutrition education resources for primary healthcare providers.
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Affiliation(s)
- Catherine J Lucas
- School of Medicine, University of Wollongong, Northfields Avenue, Wollongong, NSW 2522, Australia; and Corresponding author.
| | - Anne T McMahon
- School of Health and Society, University of Wollongong, Northfields Avenue, Wollongong, NSW 2522, Australia
| | - Karen E Charlton
- School of Medicine, University of Wollongong, Northfields Avenue, Wollongong, NSW 2522, Australia
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Dolatkhah N, Aghamohammadi D, Farshbaf-Khalili A, Hajifaraji M, Hashemian M, Esmaeili S. Nutrition knowledge and attitude in medical students of Tabriz University of Medical Sciences in 2017-2018. BMC Res Notes 2019; 12:757. [PMID: 31752999 PMCID: PMC6873575 DOI: 10.1186/s13104-019-4788-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 11/06/2019] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES In this cross-sectional study among 220 medical students we aimed to determine the nutritional knowledge and attitude of medical students through clinical training courses (externship and internship) of Tabriz University of Medical Sciences, Iran. A nutritional knowledge questionnaire included 51 questions was used to determine the correct, perceived and accuracy of knowledge of the participant in different aspects of nutrition sciences. The nutrition attitude questionnaire included 30 questions. Both questionnaires were confirmed in terms of the validity and reliability for assessing nutritional knowledge and attitude in this sample of Iranian medical students. Nutritional knowledge and attitude were calculated as percentage of correct or appropriate responses. RESULTS The correct knowledge was not significantly different among externs and interns (68.20 ± 7.50% and 67.87 ± 6.04% respectively, p = 0.729). Results showed that most of the participants (49.61% of externs and 57.14% of inters) had a poor nutritional knowledge, significantly varied by age (p = 0.035). The attitude index of the subjects was not significantly different among externs and interns (73.36 ± 9.42% and 74.59 ± 9.20%, p = 0.335). Most students (92.7%) had a very appropriate attitude toward nutrition, significantly varied by sex (p = 0.010). These findings indicate that there are multiple deficiencies in nutrition knowledge of medical students.
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Affiliation(s)
- Neda Dolatkhah
- Physical Medicine and Rehabilitation Research Center, Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Dawood Aghamohammadi
- Department of Anesthesiology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Azizeh Farshbaf-Khalili
- Physical Medicine and Rehabilitation Research Center, Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Majid Hajifaraji
- Dept. of Nutrition and Food Policy & Planning Research, National Nutrition & Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Hashemian
- Department of Biology, School of Art and Science, Utica College, New York, USA
| | - Sepideh Esmaeili
- Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
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Jancey J, James A, Lee A, Howat P, Hills AP, Anderson AS, Bordin C, Blackford K. Metabolic syndrome in rural Australia: An opportunity for primary health care. Aust J Rural Health 2019; 27:210-215. [PMID: 31062903 DOI: 10.1111/ajr.12500] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Revised: 09/06/2018] [Accepted: 01/06/2019] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To measure the impact of a 6-month home-based behaviour change intervention on reducing the risk of chronic disease as determined by metabolic syndrome status and cardiovascular risk score, and discuss implications for primary care in rural areas. DESIGN A two-arm randomised controlled trial of rural adults. SETTING The rural town of Albany in the Great Southern region of Western Australia. PARTICIPANTS Participants (n = 401) aged 50-69 years who were classified with or at risk of metabolic syndrome and randomly assigned to intervention (n = 201) or waitlisted control (n = 200) group. INTERVENTIONS A 6-month intervention program incorporating goal setting, self-monitoring and feedback, with motivational interviewing was conducted. MAIN OUTCOME MEASURES Change in metabolic syndrome status and cardiovascular risk. RESULTS Significant improvements in metabolic syndrome status and cardiovascular disease risk score (-0.82) were observed for the intervention group relative to control group from baseline to post-test. CONCLUSION This home-based physical activity and nutrition intervention reduced participants' risk of experiencing a cardiovascular event in the next 5 years by 1%. Incorporating such prevention orientated approaches in primary care might assist in reducing the burden of long-term chronic diseases. However, for realistic application in this setting, hurdles such as current national health billing system and availability of resources will need to be considered.
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Affiliation(s)
- Jonine Jancey
- Collaboration for Evidence, Research and Impact in Public Health (CERIPH), Curtin University, Bentley, Western Australia, Australia.,School of Public Health, Curtin University, Bentley, Western Australia, Australia
| | - Anthony James
- School of Public Health, Curtin University, Bentley, Western Australia, Australia
| | - Andy Lee
- School of Public Health, Curtin University, Bentley, Western Australia, Australia
| | - Peter Howat
- Collaboration for Evidence, Research and Impact in Public Health (CERIPH), Curtin University, Bentley, Western Australia, Australia.,School of Public Health, Curtin University, Bentley, Western Australia, Australia
| | - Andrew P Hills
- School of Health Sciences, University of Tasmania, Launceston, Tasmania, Australia
| | - Annie S Anderson
- Centre for Public Health Nutrition Research, Division of Cancer Research, Ninewells Medical School, University of Dundee, Aberdeen, Scotland
| | - Cassandra Bordin
- Collaboration for Evidence, Research and Impact in Public Health (CERIPH), Curtin University, Bentley, Western Australia, Australia
| | - Krysten Blackford
- Collaboration for Evidence, Research and Impact in Public Health (CERIPH), Curtin University, Bentley, Western Australia, Australia.,School of Public Health, Curtin University, Bentley, Western Australia, Australia
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Nutrition Counselling Practices among General Practitioners in Croatia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14121499. [PMID: 29207514 PMCID: PMC5750917 DOI: 10.3390/ijerph14121499] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Revised: 11/16/2017] [Accepted: 11/29/2017] [Indexed: 01/07/2023]
Abstract
Chronic non-communicable diseases are a significant public health problem and imbalanced nutrition is one of the most significant risk factor for them. The objective of this study was to examine Croatia’s general practitioners’ nutrition counselling practice and determine the factors that influence such practice. A cross-sectional study was conducted among 444 (17.0%) randomly selected general practitioners (GPs) in Croatia from May to July 2013 via a 32-item anonymous questionnaire. Study showed that 77.0% of participants had provided nutrition counselling exclusively to patients with specific health risks; 18.7% participants had provided nutrition counselling for all patients, regardless of their individual risks, while 4.3% had not provide nutrition counselling. As the most significant stimulating factor for implementing nutrition counselling in their daily work with patients, 55.6% of the participants identified personal interest regarding nutrition and the effects it has on health. The latter factor was more frequently emphasized among female general practitioners (p < 0.001) and general practitioners without chronic diseases (p < 0.001). The most significant barrier for nutrition counselling was lack of time (81.6%). It is necessary to make additional efforts to increase the frequency of nutrition counselling provided by general practitioners in Croatia. The majority of Croatian general practitioners could increase their nutrition counselling practice in order to promote balanced nutrition and improve the overall health status of their patients.
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Knowledge, attitude and practice of Lebanese primary care physicians in nutrition counseling: a self-reported survey. Prim Health Care Res Dev 2017; 18:629-634. [PMID: 28606212 DOI: 10.1017/s1463423617000330] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Aim This study aims to assess the knowledge, attitude and practice of primary care physicians (PCPs) in Lebanon regarding nutrition counseling and to investigate possible related barriers. BACKGROUND Nutrition counseling is an important aspect of patient care, especially with the increase in nutrition-related disorders. METHODS This is a descriptive study among a convenience sample of PCPs in Lebanon at two annual conferences in 2014 using an anonymous questionnaire. Findings Response rate was 54.6%. Overall, physicians considered that they have good to very good nutritional knowledge. Although they rated their formal nutritional education poorly, they had a positive attitude towards nutritional counseling and reported practicing general nutritional counseling with their patients. Barriers to nutritional counseling were: time, perceived poor patient adherence to diet, gap in physician's nutritional knowledge and lack of insurance coverage for dietitian fees. Changes should be made to medical education curricula to include nutrition courses related to prevalent health problems.
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Maternal and Pediatric Health Outcomes in relation to Gestational Vitamin D Sufficiency. Obstet Gynecol Int 2015; 2015:501829. [PMID: 26770200 PMCID: PMC4684854 DOI: 10.1155/2015/501829] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Revised: 10/27/2015] [Accepted: 11/19/2015] [Indexed: 02/06/2023] Open
Abstract
Juxtaposed with monumental improvement in maternal-fetal outcomes over the last century, there has been the recent emergence of rising rates of gestational complications including preterm birth, operative delivery, and gestational diabetes. At the same time, there has been a burgeoning problem with widespread vitamin D deficiency among populations of many developed nations. This paper provides a brief review of potential health outcomes recently linked to gestational vitamin D deficiency, including preterm birth, cesarean delivery, and gestational diabetes. Although immediate costs for obstetric complications related to gestational vitamin D insufficiency may be modest, the short- and long-term costs for pediatric healthcare resulting from such gestational complications may be enormous and present an enduring burden on healthcare systems. With increasing evidence pointing to fetal origins of some later life disease, securing vitamin D sufficiency in pregnancy appears to be a simple, safe, and cost-effective measure that can be incorporated into routine preconception and prenatal care in the offices of primary care clinicians. Education on gestational nutritional requirements should be a fundamental part of medical education and residency training, instruction that has been sorely lacking to date.
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Brown JA, Lee P, Ball L. Time and financial outcomes of private practice dietitians providing care under the Australian Medicare program: A longitudinal, exploratory study. Nutr Diet 2015. [DOI: 10.1111/1747-0080.12223] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Jessica A. Brown
- Menzies Health Institute Queensland; Griffith University; Southport Queensland Australia
| | - Patricia Lee
- Menzies Health Institute Queensland; Griffith University; Southport Queensland Australia
| | - Lauren Ball
- Menzies Health Institute Queensland; Griffith University; Southport Queensland Australia
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New Zealand Medical Students Have Positive Attitudes and Moderate Confidence in Providing Nutrition Care: A Cross-Sectional Survey. ACTA ACUST UNITED AC 2015. [DOI: 10.1155/2015/259653] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Throughout the world, medical students and doctors report inadequate nutrition education and subsequently lack of knowledge, attitude, and skills to include nutrition in patient care. This study described New Zealand’s students’ attitudes to and self-perceived skills in providing nutrition care in practice as well as perceived quantity and quality of nutrition education received in training. 183 medical students from New Zealand’s largest medical school (response rate 52%) completed a 65-item questionnaire, partially validated, using 5-point Likert scales. Students believed incorporating nutrition care into practice is important, yet they were less confident patients improve nutrition behaviours after receiving this care. Students were confident in skills related to nutrition in health and disease but less confident in skills related to general food knowledge. Greater quantity and quality of nutrition education received was associated with greater self-perceived skills in providing nutrition care to patients but not with attitudes towards incorporating nutrition care into practice. This cohort of New Zealand medical students places similarly high importance on nutrition care as students and doctors from other countries. Further investigations beyond graduation are required to inform whether additional nutrition education is warranted for these doctors.
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O'Reilly SL. Prevention of Diabetes after Gestational Diabetes: Better Translation of Nutrition and Lifestyle Messages Needed. Healthcare (Basel) 2014; 2:468-91. [PMID: 27429288 PMCID: PMC4934570 DOI: 10.3390/healthcare2040468] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Revised: 10/14/2014] [Accepted: 11/10/2014] [Indexed: 12/16/2022] Open
Abstract
Type 2 Diabetes Mellitus (T2DM) and Gestational Diabetes (GDM) are important and escalating problems worldwide. GDM increases the risk of complications in pregnancy and birth, as well as a 1 in 2 chance of developing T2DM later in life. The burden of GDM extends to offspring, who have an increased risk of obesity and diabetes-further perpetuating the cycle of diabetes within families. Clinical trial evidence demonstrates T2DM incidence reduced by up to 50% for women with GDM with nutrition and physical activity changes and the economic modeling suggests cost effectiveness. The key diet-related changes to reduce T2DM risk are reviewed, in addition to breastfeeding. The difficulties associated with the delivery of dietary and lifestyle behaviour change to women after GDM are discussed and focus on: complex healthcare system interactions needed for care delivery; women finding postpartum self-care challenging; and low levels of awareness being present across the board. In addition, studies currently underway to improve care provision in this important area will be examined.
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Affiliation(s)
- Sharleen L O'Reilly
- Centre for Physical Activity and Nutrition Research, Deakin University, 221 Burwood Highway, Burwood, Victoria 3125, Australia.
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Cass S, Ball L, Leveritt M. Australian practice nurses’ perceptions of their role and competency to provide nutrition care to patients living with chronic disease. Aust J Prim Health 2014; 20:203-8. [DOI: 10.1071/py12118] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2012] [Accepted: 01/18/2013] [Indexed: 11/23/2022]
Abstract
Nutrition is important in the management of chronic disease, and practice nurses in the Australian primary care setting are increasingly providing nutrition care to patients living with chronic disease. The aim of the present study was to investigate practice nurses’ perceptions of their role and competency to provide nutrition care to patients living with chronic disease in Australia. Twenty practice nurses currently employed in general practice participated in an individual semi-structured telephone interview. Interviews were transcribed verbatim and thematically analysed. Practice nurses perceived themselves to be in a prime position to provide opportunistic nutrition care to patients. Participants perceived that the ideal role of a practice nurse is to advocate for nutrition and provide a basic level of nutrition care to patients; however, the interpretation of the term ‘basic’ varied between participants. Participants perceived that practice nurses are highly trusted and approachable, which they valued as important characteristics for the provision of nutrition care. Barriers to providing nutrition care included time constraints, lack of nutrition knowledge and lack of confidence. Participants were concerned about the availability and accessibility of nutrition education opportunities for practice nurses. The present study has demonstrated that practice nurses perceive themselves as having a significant role in the provision of nutrition care to patients with chronic disease in the Australian primary care setting. Further investigation of strategies to enhance the effectiveness of nutrition care provision by practice nurses is warranted.
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de Pinho L, Moura PHT, Silveira MF, de Botelho ACC, Caldeira AP. Development and validity of a questionnaire to test the knowledge of primary care personnel regarding nutrition in obese adolescents. BMC FAMILY PRACTICE 2013; 14:102. [PMID: 23865564 PMCID: PMC3733686 DOI: 10.1186/1471-2296-14-102] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/20/2012] [Accepted: 06/10/2013] [Indexed: 01/06/2023]
Abstract
Background In light of its epidemic proportions in developed and developing countries, obesity is considered a serious public health issue. In order to increase knowledge concerning the ability of health care professionals in caring for obese adolescents and adopt more efficient preventive and control measures, a questionnaire was developed and validated to assess non-dietitian health professionals regarding their Knowledge of Nutrition in Obese Adolescents (KNOA). Methods The development and evaluation of a questionnaire to assess the knowledge of primary care practitioners with respect to nutrition in obese adolescents was carried out in five phases, as follows: 1) definition of study dimensions 2) development of 42 questions and preliminary evaluation of the questionnaire by a panel of experts; 3) characterization and selection of primary care practitioners (35 dietitians and 265 non-dietitians) and measurement of questionnaire criteria by contrasting the responses of dietitians and non-dietitians; 4) reliability assessment by question exclusion based on item difficulty (too easy and too difficult for non-dietitian practitioners), item discrimination, internal consistency and reproducibility index determination; and 5) scoring the completed questionnaires. Results Dietitians obtained higher scores than non-dietitians (Mann–Whitney U test, P < 0.05), confirming the validity of the questionnaire criteria. Items were discriminated by correlating the score for each item with the total score, using a minimum of 0.2 as a correlation coefficient cutoff value. Item difficulty was controlled by excluding questions answered correctly by more than 90% of the non-dietitian subjects (too easy) or by less than 10% of them (too difficult). The final questionnaire contained 26 of the original 42 questions, increasing Cronbach’s α value from 0.788 to 0.807. Test-retest agreement between respondents was classified as good to very good (Kappa test, >0.60). Conclusion The KNOA questionnaire developed for primary care practitioners is a valid, consistent and suitable instrument that can be applied over time, making it a promising tool for developing and guiding public health policies.
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Affiliation(s)
- Lucinéia de Pinho
- Health Sciences Postgraduate Program, State University of Montes Claros (Unimontes), Montes Claros, MG, Brazil.
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