Exploring the relevance of intersectionality in Australian dietetics: Issues of diversity and representation

Supporting nutrition and dietetics students' relationships with food and body image: Adopting a co-created curricula approach

AIMS

The aims of this study were to: (1) explore perspectives of university students' and academics' regarding disordered eating, eating disorders and body image in relation to pedagogy and curricula and (2) to evaluate a co-designed student seminar and an academic workshop on these topics.

METHODS

A participatory action research approach was employed whereby an educational intervention was co-created by academics and students. An online seminar was presented to students and a 1-h workshop was presented to academic staff. Evaluation was conducted via a post-seminar anonymous survey for students and a pre- and post-anonymous workshop survey for academics with a mix of Likert-scale questions and open text boxes. Qualitative data were open coded, both deductively and inductively, and quantitative data were analysed descriptively.

RESULTS

One hundred and seventeen students attended the voluntary education seminar. Six themes were identified from student qualitative data which included feeling safe, empowered, inspired, connected, emotional and reflective. Problematic aspects of pedagogy and curricula were identified by students and included: using personal data for teaching, demonising language to describe food/bodies and not always feeling safe or supported to discuss disordered eating. Twenty academics shared divergent perspectives-some reported feeling concerned and challenged by the content (exploring disordered eating with students), others noted the complexity of the area, and others reported low/moderate confidence or indifference in the space and felt this content outside of their scope as educators.

CONCLUSION

Curricula interventions that reduce triggering and shaming and increase space and support for strengthening students' relationships with food and their bodies are valued by nutrition and dietetics students. We encourage academics to consider pedagogical approaches and expand discourse in this space.

Recruitment, retention, and experiences of Australian male dietitians: A cross-sectional online survey

AIM

Male dietitians are under-represented in the global dietetics workforce, including in Australia. This study explores Australian males' experiences as dietitians in the Australian workforce, with the aim to identify influences that initially attracted them to dietetics, as well as barriers that may affect their decision to stay in or leave the profession.

METHODS

A cross-sectional, semi-quantitative web-based survey was distributed to male dietitians using purposive, snowball sampling. Closed and open-ended questions were included. Descriptive statistics were generated, and content analysis of free-text responses identified major themes.

RESULTS

Seventy-one respondents opened the survey link, of which 65 respondents attempted the survey. Fifty-four (83.1%) respondents agreed that dietetics is female-dominated. An interest in food and nutrition was the most reported reason for studying dietetics (73.8%). Of the 55 respondents who were not intending to retire in the next 5 years, 15 (27.3%) stated they were somewhat or extremely likely to leave the profession of dietetics. Respondents identified issues that impacted their experiences as a male dietitian, including gender differences, a lack of male role models, barriers to career progression/employment, and perceptions of a lack of respect and impact within healthcare.

CONCLUSIONS

Australian male dietitians perceive systemic, social, and personal factors that have influenced their career experiences. Greater exposure to prominent male role models may be self-perpetuating in improving male dietitian recruitment and eventually, retention. A multi-pronged approach is needed to improve the rate of recruitment of male dietitians, with a role for tertiary education providers and peak dietetics bodies.

Diversity in the Australian speech-language pathology workforce: Addressing Sustainable Development Goals 3, 4, 8, and 10

PURPOSE

Individuals have multiple intersecting identities, unique perspectives, and experiences which provide opportunities for new ways to interact, support inclusion and equity, and address the Sustainable Development Goals (SDGs). This commentary explores the diversity of the speech-language pathology workforce in Australia.

RESULT

A survey of Australian speech-language pathologists (SLPs; n = 1,638) distributed in November and December 2021 explored personal characteristics and experiences of the workforce. Almost 30% of SLPs who responded reported having experiences or perspectives that were relevant to service users and a quarter described other lived experiences, which included disability, cultural and linguistic background, mental health, caring responsibilities, neurodiversity, and being LGBTQI+.

CONCLUSION

This commentary affirms the value of diversity among allied health professions to enrich practice with individuals and communities. By understanding the diversity of the speech-language pathology workforce and perspectives of historically marginalised or invisible groups, the profession can introduce strategies to more meaningfully engage and support people with diverse backgrounds and perspectives in the workforce and enhance service equity and accessibility for people with communication and swallowing disabilities. This commentary focusses on SDG 3, SDG 4, SDG 8, SDG 10.

An Examination of the Practice Approaches of Canadian Dietitians Who Counsel Higher-Weight Adults Using a Novel Framework: Emerging Data on Non-Weight-Focused Approaches

Non-weight-focused approaches (NWFAs) may be used by some clinicians when working with higher-weight clients. In contrast to weight-focused approaches (WFAs), NWFAs de-emphasize or negate weight loss and emphasize overall diet quality and physical activity. The extent to which WFAs, NWFAs, or a combination of both WFAs and NWFAs are used by dietitians is unknown in Canada and globally. This study surveyed Canadian Registered Dietitians (RDs) who counsel higher-weight clients to assess which practice approaches are most commonly used, how they view the importance of weight, and how they define "obesity" for the study population. Five practice approaches were initially defined and used to inform the survey: solely weight-focused; moderately weight-focused; those who fluctuate between weight-focused/weight-inclusive approaches (e.g., used both approaches); weight inclusive and; weight liberated. Participants (n = 383; 94.8% women; 82.2% white) were recruited using social media and professional listservs. Overall, 45.4% of participants used NWFAs, 40.5% fluctuated between weight-focused/moderately weight-focused, and 14.1% used weight-focused approaches (solely weight focused and moderately weight focused). Many participants (63%) agreed that weight loss was not important for higher-weight clients. However, 81% of participants received no formal preparation in NWFAs during their education or training. More research is needed to understand NWFAs and to inform dietetic education in support of efforts to eliminate weight stigma and provide inclusive access to care.

Healthy Eating Policy: Racial Liberalism, Global Connections and Contested Science

The challenges to designing and implementing ethically and politically meaningful eating policies are many and complex. This article provides a brief overview of Anne Barnhill and Matteo Bonotti's Healthy Eating Policy and Political Philosophy: A Public Reason Approach while also critically engaging with the place of racial justice, global interconnectedness, and debates over science in thinking about ethics and politics of public health nutrition and policy. I do not aim to burden Barnhill and Bonotti with the responsibility to fully address these issues, but considering the interconnection of these issues and the ever pressing effects of climate change on local and global food systems, we collectively need to turn to these difficult and pressing questions about what a just food system looks like, what concerns are centred, and who is left out. I group these engagements with Barnhill and Bonotti under three headings: racial liberalism, global food system, and contested nutrition science. I conclude with some remarks about locality.

Using document analysis to revise competency frameworks: Perspectives from the revision of competency standards for dietitians

Introduction/Objective

In resource poor environments, low cost methods are needed to review competency standards to ensure they remain reflective of the current health workforce. This study aims to show how document analysis can be used to inform the revision of competency frameworks and standards.

Methods

Altheide and Schneider's document analysis was modified to revise the National Competency Standards for Dietitians in Australia. This involved an eight-step process: (i) define the goal, (ii) identify documents for analysis, (iii) choose the analysis approach, (iv) engage with the documents and perform the analysis, (v) draft revisions, (vi) stakeholder engagement, (vii) final revisions, (viii) dissemination. Documents were sought through a combination of literature searches, review of document databases, and targeted document sourcing for documents relevant to contemporary dietetic practice. Framework analysis was used to analyse the data, with the thematic framework including four categories: (i) Aboriginal and Torres Strait Islander peoples, (ii) Consumer perspectives, (iii) Contemporary and future dietetic roles, and (iv) Contemporary wording and structure of competency. All included documents were indexed and charted which informed revisions to the standards.

Results

Sixty-seven documents were reviewed. Four new competency standards were added to address the skills and attributes required of dietitians to work effectively with Aboriginal and Torres Strait Islander peoples. One competency standard was modified to include an individualized approach as this was deemed important by consumers but not previously included in the standards. The revised standards also place greater emphasis on dietitian's role in teaching and learning. In addition, there are now multiple standards that refer to advocacy, sustainability is referenced multiple times, a new standard specific to advanced care planning has been included, and their structure and wording was revised to ensure it was contemporary.

Conclusion

Using document analysis to revise competency standards offers an efficient and low-cost method to update competency standards in a resource poor environment. This addresses a key issue with competency standards where unless revised frequently they can become rapidly out of date. Further research is needed to learn if document analysis can be used as a method to create rather than revise competency standards.