Opportunities and Challenges for Practical Training in Public Health: Insights from Practicum Coordinators in Ontario

Conceptualising sustainability in Canadian dietetic practice: A scoping review

BACKGROUND

Dietitians (RDs) are well-positioned to promote sustainable food systems and diets. This research aims to review the literature for how RDs in Canada define sustainability and determine the types of relevant activities that exist in practice as described in published literature.

METHODS

Using standardised scoping review methods, researchers searched CINAHL, ACASP, PubMed and ENVCOM databases to identify peer-reviewed articles and conducted a grey literature search to locate other publications related to sustainability in Canadian dietetic practice. Qualitative, thematic coding methods were used to examine definitions and existing practice. The PRISMA extension for scoping reviews guided reporting.

RESULTS

The search resulted in 1059 documents and, after screening, 11 peer-reviewed and 16 grey literature documents remained. Ten unique definitions were used, the most common being Sustainable Diets. Definitions were multidimensional, including environmental, social, economic and health dimensions, and 31 unique subtopics. However, existing practice activities appear to reduce actions to one to two dimensions. Existing practice areas well-reflected include Food and Nutrition Expertise, Management and Leadership, Food Provision and Population Health Promotion. Notable gaps include action in Professionalism and Ethics and Nutrition Care.

CONCLUSIONS

No single definition supports all professional contexts, and agency in choice of language to define the work is helpful for contextual clarity. Strengthening practitioners' ability to analyse issues using systems thinking and applying this in practice will help to address challenges and reduce risks of trade-offs. Updates to competency standards that reflect the breadth of existing activities, as well as curricular supports or practice standards, are needed.

Mapping the Roles of Nutrition and Dietetics Professionals in Sustainable Food Systems and Exploring Opportunities for Strategic Collaboration

Current food systems drive environmental damage, social injustices, and undermine health, and these challenges are complex and seemingly intractable. Collaboration is required to transition to more sustainable food systems (SFS). Registered Dietitians and Nutritionists (RDs) are an under-leveraged and well-positioned group to contribute to addressing food systems challenges because of their locations in the system and their existing skillsets. Drawing on research with dietitians, this perspective paper presents both a theoretical proposal as well as collective expertise in supporting sustainable development of the global food system. It highlights where RDs work in food systems with the aim to reveal multiple points of entry where RDs can and do contribute to SFS across food systems, approaches to apply, as well as opportunities for collaboration within and beyond the profession. Educational and societal barriers exist that prevent systematic RD engagement; however, examples of established work provide models to follow.

Moving Dietetics Forward with Queer Pedagogy: A Post-Structural Qualitative Study Exploring the Education and Training Experiences of Canadian Dietitians for LGBTQ Care

BACKGROUND

Lesbian, gay, bisexual, trans, and other sexually and gender diverse (LGBTQ) people often experience health disparities and disparities in accessing safe health care. Yet dietetic curriculum and training opportunities for LGBTQ care is limited.

OBJECTIVE

The objective of this research was to explore the perspectives and professional training experiences within LGBTQ-focused topics of Canadian dietitians in order to inform future curriculum and pedagogy.

DESIGN

This research is framed within poststructuralist philosophies. Semi-structured qualitative interviews were conducted.

PARTICIPANTS/SETTING

To be eligible, participants needed to be dietitians within Canada who had an interest in discussing gender and sexual diversity within the profession. Although the research call was open to all Canadian dietitians who wanted to discuss gender and sexual diversity within the profession, only dietitians who self-identified as allies to LGBTQ groups ended up participating in this project. Of the sixteen dietitians who participated, eleven participants self-identified as members of LGBTQ groups and five self-identified as straight. All participants took part in online interviews done in private locations of their choosing from September 2020 to January 2021.

ANALYSIS

A systematic thematic analysis was conducted.

RESULTS

Three themes, including 1) Understanding the ethics of dietetic education, 2) Recognizing the cis- and hetero-normativity of dietetic education, and 3) Moving forward with queer pedagogy, were noted from the data.

CONCLUSIONS

Participants explored the lack of LGBTQ focus and content during their professional training and believed such gaps were problematic to the caring philosophies of dietetics. Participants offered insights into how dietetic educators can disrupt ingrained cis- hetero-normativity and rigid binary gender norms within dietetics education and curriculum.

How Can Dietitians Leverage Change for Sustainable Food Systems in Canada?

Purpose: In this paper, we begin to set out language defining sustainable food systems (SFS) in Canada, through the voices of dietitians, and identify leverage points where dietitians can affect change. Methods: Dietitians of Canada members were invited to a Delphi Inquiry process; questions explored a vision of SFS in Canada, barriers to that vision, and actions. Results were independently analysed by 2 members of the research team who used the Framework for Strategic Sustainable Development to structure the data. Results: Fifty-eight members participated. The resultant vision describes a future food system in 15 thematic areas of the social and ecological systems. Barriers are described according to how they undermine sustainability. High-leverage actions areas included: (i) facilitating knowledge development within the profession and public, (ii) influencing organizational policy to support SFS, and (iii) and influencing public policy. Approaches to such action included: (i) facilitating cross-sectoral collaboration and (ii) applying reflexive approaches. Conclusions: This research suggests a multidimensional understanding of food systems sustainability among dietitians. The vision provides some language to describe what dietitians mean by SFS and can be used as a compass point to orient action. Action areas and approaches have the potential to drive systemic change while avoiding unintended consequences.