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Heafala A, Rundle-Thiele S, Ball L, Mitchell LJ. Cocreating eating disorder education solutions: A design thinking approach to dietetics curricula in Australia. J Hum Nutr Diet 2024. [PMID: 38856699 DOI: 10.1111/jhn.13333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 05/22/2024] [Accepted: 05/24/2024] [Indexed: 06/11/2024]
Abstract
BACKGROUND As the prevalence of eating disorders continues to increase, there is an urgent need to equip the emerging dietetics workforce to provide care to this growing population. The present study aimed to describe a five-step design thinking process that was applied to brainstorm ideas and develop and test solutions for consideration in the future. METHODS A pragmatic, five-step design thinking approach was used during a 1-day, in-person design thinking retreat. Purposive sampling was used to identify key stakeholders, including subject matter, learning and teaching, as well as lived experience experts, dietetics students and recent graduates. Reflexive thematic analysis was used to analyse brainstormed and design solution ideas. RESULTS Seventeen participants attended the design thinking retreat in April 2023. Four education prototypes were developed and tested by stakeholders including: (1) a change to accreditation requirements for dietetics curricula; (2) a multimodal learning package for penultimate year students; (3) embedding disordered eating and eating disorder content into existing curriculum and upskilling educators; and (4) codesigning an eating disorder module. CONCLUSIONS The design thinking retreat engaged a variety of stakeholders in curriculum design resulting in an array of prototype approaches that aimed to embed eating disorder content into university curricula. Further research is needed to test the prototypes and understand what impact this has on dietetics students' feelings of preparedness to provide care to people seeking this support.
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Affiliation(s)
- Alana Heafala
- School of Health Sciences and Social Work, Gold Coast Campus, Griffith University, Southport, QLD, Australia
- Menzies Health Institute Queensland, Gold Coast Campus, Griffith University, Southport, QLD, Australia
| | - Sharyn Rundle-Thiele
- Social Marketing @ Griffith, Griffith Business School, Griffith University, Nathan, QLD, Australia
| | - Lauren Ball
- Centre for Community Health and Wellbeing, University of Queensland, St Lucia, QLD, Australia
| | - Lana J Mitchell
- School of Health Sciences and Social Work, Gold Coast Campus, Griffith University, Southport, QLD, Australia
- Menzies Health Institute Queensland, Gold Coast Campus, Griffith University, Southport, QLD, Australia
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Gunsalus KTW, Mixon JK, House EM. Medical Nutrition Education for Health, Not Harm: BMI, Weight Stigma, Eating Disorders, and Social Determinants of Health. MEDICAL SCIENCE EDUCATOR 2024; 34:679-690. [PMID: 38887425 PMCID: PMC11180054 DOI: 10.1007/s40670-024-02025-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/08/2024] [Indexed: 06/20/2024]
Abstract
Effective nutrition training is fundamental to medical education. Current training is inadequate and can cause harm to students and patients alike; it leaves physicians unprepared to counsel on nutrition, places undue focus on weight and body mass index (BMI), can exacerbate anti-obesity bias, and increase risk for development of eating disorders, while neglecting social determinants of health and communication skills. Physicians and educators hold positions of influence in society; what we say and how we say it matters. We propose actionable approaches to improve nutrition education to minimize harm and pursue evidence-based, effective, and equitable healthcare.
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Affiliation(s)
- Kearney T. W. Gunsalus
- Department of Biochemistry and Molecular Biology, Augusta University/University of Georgia Medical Partnership, Athens, GA USA
| | - Jordan K. Mixon
- Augusta University/University of Georgia Medical Partnership, Athens, GA USA
| | - Ellen M. House
- Department of Psychiatry and Health Behavior, Augusta University/University of Georgia Medical Partnership, Athens, GA USA
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Bennett CJ, Barber C, Rose E, Palermo C, Dart J. Supporting nutrition and dietetics students' relationships with food and body image: Adopting a co-created curricula approach. Nutr Diet 2024; 81:306-315. [PMID: 38246599 DOI: 10.1111/1747-0080.12862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 10/31/2023] [Accepted: 12/20/2023] [Indexed: 01/23/2024]
Abstract
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.
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Affiliation(s)
- Christie Jane Bennett
- Department of Nutrition, Dietetics and Food, Sub-Faculty of Clinical and Molecular Medicine, Faculty of Medicine Nursing and Health Sciences, Monash University, Victoria, Australia
| | - Charlotte Barber
- Department of Nutrition, Dietetics and Food, Sub-Faculty of Clinical and Molecular Medicine, Faculty of Medicine Nursing and Health Sciences, Monash University, Victoria, Australia
| | - Estelle Rose
- Department of Nutrition, Dietetics and Food, Sub-Faculty of Clinical and Molecular Medicine, Faculty of Medicine Nursing and Health Sciences, Monash University, Victoria, Australia
| | - Claire Palermo
- Department of Nutrition, Dietetics and Food, Sub-Faculty of Clinical and Molecular Medicine, Faculty of Medicine Nursing and Health Sciences, Monash University, Victoria, Australia
| | - Janeane Dart
- Department of Nutrition, Dietetics and Food, Sub-Faculty of Clinical and Molecular Medicine, Faculty of Medicine Nursing and Health Sciences, Monash University, Victoria, Australia
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Heafala A, Ball L, Rundle-Thiele S, Mitchell LJ. 'Through education, we can make change': A design thinking approach to entry-level dietetics education regarding eating disorders. Nutr Diet 2024. [PMID: 38804016 DOI: 10.1111/1747-0080.12885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 03/27/2024] [Accepted: 05/07/2024] [Indexed: 05/29/2024]
Abstract
AIMS To co-create strategies and identify opportunities to integrate eating disorder content within dietetics curricula at one Australian university with stakeholders using a design thinking approach. METHODS A pragmatic mixed-methods, participatory design approach was used. An online survey explored the learning needs of dietetic students and recent graduates regarding eating disorders. Following the survey, a one-day design thinking retreat was held with stakeholders who were identified from the research team's professional networks. Eating disorder dietitians, learning experts, dietetic students, graduates, and those with lived experience were asked to identify strategies to enhance students' confidence and competence to provide care for people living with eating disorders. Quantitative data were analysed using descriptive statistics and qualitative data were analysed using inductive coding and reflexive thematic analysis. RESULTS Sixty-four students (n = 55, 86%) and recent graduates (n = 9, 14%) completed the online survey (26% response). Seventeen stakeholders attended the retreat. Four themes were identified: (1) changing perceptions of eating disorder care from specialist to 'core business'; (2) desiring and advocating for a national change to dietetics curricula; (3) importance of lived experience at the centre of curriculum design and delivery; and (4) collaborating to co-design and deliver eating disorder content at university. CONCLUSION Raising awareness, upskilling students and educators, enhanced collaboration between universities and stakeholders, and the inclusion of lived experience were key to preparing students to provide care to people seeking support for eating disorders. Further research is needed to assess the impact these strategies have on dietetic students' confidence and competence.
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Affiliation(s)
- Alana Heafala
- School of Health Sciences and Social Work, Gold Coast Campus, Griffith University, Southport, Queensland, Australia
- Menzies Health Institute Queensland, Gold Coast Campus, Griffith University, Southport, Queensland, Australia
| | - Lauren Ball
- Centre for Community Health and Wellbeing, University of Queensland, St Lucia, Queensland, Australia
| | - Sharyn Rundle-Thiele
- Social Marketing @ Griffith, Griffith Business School, Griffith University, Nathan, Queensland, Australia
| | - Lana J Mitchell
- School of Health Sciences and Social Work, Gold Coast Campus, Griffith University, Southport, Queensland, Australia
- Menzies Health Institute Queensland, Gold Coast Campus, Griffith University, Southport, Queensland, Australia
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Magni O, Detopoulou P, Fappa E, Perrea A, Levidi D, Dedes V, Tzoutzou M, Gioxari A, Panoutsopoulos G. Eating Attitudes, Stress, Anxiety, and Depression in Dietetic Students and Association with Body Mass Index and Body Fat Percent: A Cross-Sectional Study. Diseases 2024; 12:108. [PMID: 38785763 PMCID: PMC11120143 DOI: 10.3390/diseases12050108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2024] [Revised: 05/14/2024] [Accepted: 05/16/2024] [Indexed: 05/25/2024] Open
Abstract
University students face challenges impacting psychology and dietary choices. The present work examined the association between eating attitudes, stress, anxiety, and depression to body mass index (BMI) and body fat percentage in Dietetics students. Respondents completed the Eating Attitudes Test-26 (EAT-26), the Depression Anxiety Stress Scales (DASS), a validated Food Frequency Questionnaire, and the Hellenic Physical Activity Questionnaire (HPAQ). Anthropometry and a bioimpedance analysis were performed. The EAT-26 score was 11 (8-16) and the DASS score was 20 (11-36) (medians and interquartile ranges). Disordered eating was detected in 20% of men and 15% of women. Depressive symptomatology was detected in 30% of males and 23% of females, anxiety in 35% of males and 40% of females, and stress in 29% of males and 35% of females. EAT-26 and DASS scores were highly correlated (r = 0. 0.221, p = 0.001). The EAT-26 oral control subscale (B = 0.430, SE = 0.184, p = 0.026) was positively correlated with BMI in men in the models, adjusted for age, physical activity, and Mediterranean Diet Score, while no association was documented for % body fat. The DASS depression score was not related to BMI in multi-adjusted models. In conclusion, disordered eating, depression, stress, and anxiety are present in this sample of university students. The relationship between disordered eating and BMI needs consideration in programs targeting overweight or underweight in Dietetics students.
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Affiliation(s)
- Olga Magni
- Department of Nutritional Sciences and Dietetics, University of the Peloponnese, 24100 Kalamata, Greece
| | - Paraskevi Detopoulou
- Department of Nutritional Sciences and Dietetics, University of the Peloponnese, 24100 Kalamata, Greece
- Department of Clinical Nutrition, General Hospital Korgialenio Benakio, 11526 Athens, Greece
| | - Evangelia Fappa
- Department of Nutritional Sciences and Dietetics, University of the Peloponnese, 24100 Kalamata, Greece
| | - Anastasia Perrea
- Department of Nutritional Sciences and Dietetics, University of the Peloponnese, 24100 Kalamata, Greece
| | - Despoina Levidi
- Department of Nutritional Sciences and Dietetics, University of the Peloponnese, 24100 Kalamata, Greece
| | - Vasilios Dedes
- Department of Nutritional Sciences and Dietetics, University of the Peloponnese, 24100 Kalamata, Greece
| | - Milia Tzoutzou
- Department of Nutritional Sciences and Dietetics, University of the Peloponnese, 24100 Kalamata, Greece
| | - Aristea Gioxari
- Department of Nutritional Sciences and Dietetics, University of the Peloponnese, 24100 Kalamata, Greece
| | - Georgios Panoutsopoulos
- Department of Nutritional Sciences and Dietetics, University of the Peloponnese, 24100 Kalamata, Greece
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