Is there enough behaviour change science in nutrition and dietetics curricula in Australia and New Zealand? A descriptive study

Exploring Food and Nutrition Programming for People Living With HIV/AIDS: Interviews With Service Providers in Nova Scotia, Canada

There is a lack of nutritional programming and resources available for people living with HIV/AIDS (PLWHA) in Nova Scotia, Canada. This is problematic for several reasons, including that adequate food and nutrition knowledge is integrated to effective medical therapy and wellness for PLWHA. The aim of this research was to explore and describe the beliefs, values, and experiences of HIV-service providers involved programming for PLWHA in Nova Scotia. Using a post-structuralist lens, semi-structured interviews were conducted with nine service providers. Thematic analysis of interview transcripts identified four main themes: (1) recognizing the social determinants of health, (2) acknowledging and disrupting layered stigma, (3) understanding the commensality, and (4) navigating and utilizing networks of care. These findings suggest that those developing, delivering, and evaluating food and nutrition-related programming must engage in community-inclusive approaches that recognize the varied social determinants of health that shape the lived of PLWHA, leverage existing networks and resources, and actively disrupt layered stigma. Also, in agreement with existing evidence, participants stressed the value of communicating and supporting the practice of eating together (commensality) and cultivating networks of care.

Teaching and assessment of communication skills in dietetics: a scoping review

BACKGROUND

Communication is a core element of dietetic practice, and although communication skills are a prominent feature of dietetic curricula, research suggests a need for more consistent approaches. The evidence on how communication skills are taught and assessed in dietetics has not been synthesised leaving uncertainty about best practice. This scoping review aimed to examine and map the research literature relating to the teaching and assessment of communication skills in dietetics.

METHODS

The review was conducted in accordance with the Joanna Briggs Institute (JBI) methodology for scoping reviews. Five electronic databases, two theses databases and eight conference proceedings were systematically searched for research on how communication skills are taught and assessed in dietetics. The search had no geographical or time limits. Studies were independently screened by two authors, summarised thematically using the Kirkpatrick Model and narratively synthesised.

RESULTS

The 45 included studies were organised thematically into three categories: (i) the inclusion of communication skills education in dietetics, suggesting that dietitians have variable experiences; (ii) approaches to teaching communication skills in dietetics, characterised predominantly by a move away from didactic approaches in favour of experiential opportunities for learning such as simulation; and (iii) assessment of communication skills in dietetics, including the use of both dietetic-specific and generic tools.

CONCLUSIONS

The included studies demonstrate that although a variety of teaching strategies are used in the development of communication skills in dietetics, there is potential for more robust evaluation and more diverse approaches to support dietetic educators to prepare the dietetic workforce.

Pharmacists' perceptions and delivery of health behaviour change recommendations: Mapping the COM-B model

BACKGROUND

Pharmacists are trusted and accessible healthcare professionals who are well-positioned to deliver brief health behaviour change technique-based interventions for chronic health conditions. However, little is known about the factors influencing pharmacists' use of behaviour change techniques and their capacity to deliver these interventions within community pharmacy.

OBJECTIVES

This study employed the COM-B model to explore the factors that explain pharmacists' delivery of behaviour change techniques in practice. A secondary objective was to ascertain whether capability, opportunity, and motivation are associated with and explain significant variance in the use of behaviour change techniques during patient interactions.

METHODS

Two-hundred and eleven Australian pharmacists (mean age = 36.1, SD = 10.7) completed a survey on their capability, opportunity, and motivation to deliver behaviour change techniques, and their delivery and frequency of use in practice.

RESULTS

Most pharmacists (91.3%) use behaviour change techniques during patient interactions. Results from a simple linear regression showed that a composite COM score was associated with pharmacists' behaviour change technique use F(1,195) = 47.12, β = 0.44, 95 % CI [0.09, 0.16], p < .001, and their frequency of use (F(1,198) = 44.19, β = 0.43, 95 % CI [0.02, 0.06], p < .001). While capability, opportunity, and motivation were individually associated with the range and frequency of behaviour change technique used, motivation was the only significant variable in the composite model for range (β = 0.35, 95 % CI [0.11, 0.41], p < .001) and frequency of behaviour change technique use (β = 0.22, 95 % CI [0.01, 0.09], p < .05).

CONCLUSIONS

Pharmacist motivation was the most important construct explaining behaviour change technique use. Interventions should seek to foster pharmacist motivation and may benefit from adopting COM-B as a behaviour change framework, to understand the factors influencing the delivery of behaviour change interventions.

Training Australian Dietitians in Behavior Change Techniques Through Educational Workshops: Protocol for a Randomized Controlled Trial

BACKGROUND

The use of education alone as a technique to change behavior in interventions is usually insufficient, particularly in health interventions. Behavior change techniques have been shown to be effective in fostering positive changes in health behaviors such as diet and physical activity. The upskilling of health professionals can increase perceived capability and motivation toward eliciting change in clients' behaviors. However, to date, dietitians have received limited training in behavior change and have expressed a need for continuous professional development.

OBJECTIVE

The study objectives are to (1) develop and evaluate the effectiveness and acceptability of two 2-hour behavior change workshops on changing dietitians behavior (ie, range of behavior change techniques used and frequency of use) across 3 time points; (2) determine if participation in these workshops will elicit changes in dietitians' perceived capability, opportunity, and motivation toward using behavior change techniques; and (3) determine the acceptability of the training and its application in practice by dietitians.

METHODS

We will recruit registered dietitians (N=140) in Australia to participate in this randomized controlled trial. Participants will be randomly assigned to either the intervention or 3-month waitlist control condition and complete outcome measures at 3 time points: baseline, after the workshop, and follow-up at 3 months. Both groups will complete 2 workshops on behavior change that are guided by the COM-B (Capability, Opportunity, Motivation, and Behavior) Model and embedded with behavior change techniques. The primary outcome is changes in behavior, (ie, the range of behavior change techniques used and their frequency of use). Secondary outcomes include changes in perceived capability, opportunity, motivation, and preparedness as a health professional toward delivering behavior change techniques. The acceptability of the workshops will also be assessed after the workshop through the postworkshop survey and semistructured interviews. A series of 2-way repeated measures ANOVAs and regressions will be used. Qualitative data will be analyzed using thematic analysis.

RESULTS

Participant recruitment commenced in June 2023. The results of the study are expected to be published in November 2024. The results will allow us to assess comparisons between the intervention and waitlist control groups, as well as changes in perceived capability, opportunity, motivation, and preparedness over a 3-month period. It will also provide an understanding of the acceptability of the training as a form of continuous professional development for dietitians.

CONCLUSIONS

If found to be effective, the results of this 2-arm randomized controlled trial will guide future training and continuous professional development for health professionals in changing behavior in practice. Our findings will contribute to our understanding of the application of behavior change techniques in practice with clients and identify components of COM-B where dietitians may need future support.

TRIAL REGISTRATION

ACTRN12623000525684; https://www.anzctr.org.au/ACTRN12623000525684.aspx.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

PRR1-10.2196/49723.