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Morrison-Koechl J, Heckman G, Banerjee A, Keller H. Factors associated with dietitian referrals to support long-term care residents advancing towards the end of life. J Hum Nutr Diet 2024; 37:673-684. [PMID: 38446530 DOI: 10.1111/jhn.13294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 02/14/2024] [Accepted: 02/15/2024] [Indexed: 03/07/2024]
Abstract
BACKGROUND Dietitians are central members of the multidisciplinary long-term care (LTC) healthcare team. The overall aim of this current investigation is to gain a better understanding of dietitian involvement in LTC resident's end-of-life care via referrals. METHODS Retrospective chart reviews for 164 deceased residents (mean age = 88.3 ± 7.3; 61% female) in 18 LTC homes in Ontario, Canada, identified dietitian referrals and documented eating challenges recorded over 2-week periods at four time points (i.e., 6 months, 3 months, 1 month and 2 weeks) prior to death. Nutrition care plans at the beginning of these time points were also noted. Logistic mixed effects regression models identified time-varying predictors of dietitian referrals. Bivariate tests identified associations between nutrition orders and dietitian referrals that occurred in the last month of life. RESULTS Nearly three-quarters (73%) of participants had at least one dietitian referral across the four observations. Referrals increased significantly with proximity to death; 45% of residents had a referral documented in the last 2 weeks of life. Dietitian referrals were associated with the number of eating challenges (odds ratio [OR] = 1.42, 95% confidence interval [CI] = 1.27, 1.58). Comfort-focused nutrition care orders were significantly more common when a dietitian was referred (25%) compared with when a dietitian was not referred (12%) in the final month of life (p = 0.04). CONCLUSIONS Our findings suggest that dietitians are involved in end-of-life and comfort-focused nutrition care initiatives, yet they are not engaged consistently for this purpose. This presents a significant opportunity for dietitians to upskill and champion palliative approaches to nutrition care within the multidisciplinary LTC team.
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Affiliation(s)
- Jill Morrison-Koechl
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - George Heckman
- Schlegel-UW Research Institute for Aging, Waterloo, Ontario, Canada
- School of Public Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, Canada
| | - Albert Banerjee
- Department of Gerontology, St. Thomas University, Fredericton, New Brunswick, Canada
| | - Heather Keller
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
- Schlegel-UW Research Institute for Aging, Waterloo, Ontario, Canada
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Senkus KE, Dudzik JM, Lennon SL, DellaValle DM, Moloney LM, Handu D, Rozga M. Medical nutrition therapy provided by a dietitian improves outcomes in adults with prehypertension or hypertension: a systematic review and meta-analysis. Am J Clin Nutr 2024:S0002-9165(24)00403-9. [PMID: 38641320 DOI: 10.1016/j.ajcnut.2024.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 04/10/2024] [Accepted: 04/16/2024] [Indexed: 04/21/2024] Open
Abstract
BACKGROUND Hypertension is an important risk factor for cardiovascular disease (CVD). Interventions with dietitians can help modify dietary intake and reduce hypertension risk. OBJECTIVES We aimed to examine the following research question: In adults with prehypertension or hypertension, what is the effect of medical nutrition therapy (MNT) provided by a dietitian on blood pressure (BP), CVD risk and events, and anthropometrics compared with standard care or no intervention? METHODS MEDLINE, CINAHL, and Cochrane Central databases were searched for randomized controlled trials (RCTs) published in peer-reviewed journals from 1985-2022. Risk of bias was assessed using version 2 of the Cochrane tool for RCTs. Meta-analyses were conducted using the DerSimonian-Laird random-effects model. Certainty of evidence (COE) was assessed for each outcome using the Grading of Recommendations, Assessment and Evaluation method. RESULTS Forty articles representing 31 RCTs were included and analyzed. MNT provided by a dietitian may reduce systolic [mean difference (MD): -3.63 mmHg; 95% confidence interval (CI): -4.35, -2.91 mmHg] and diastolic (MD: -2.02 mmHg; 95% CI: -2.56, -1.49 mmHg) BP (P < 0.001) and body weight (MD: -1.84 kg; 95% CI: -2.72, -0.96 kg; P < 0.001) and improve antihypertensive medication usage, relative risk of stroke (MD: 0.34; 95% CI: 0.14, 0.81; P = 0.02), and CVD risk score [standardized mean difference (SMD): -0.20; 95% CI: -0.30, -0.09; P < 0.001] compared with control participants, and COE was moderate. Additionally, MNT may reduce arterial stiffness (SMD: -0.45; 95% CI: -0.71, -0.19; P = 0.008) and waist circumference (SMD: -1.18 cm; 95% CI: -2.00, -0.36; P = 0.04), and COE was low. There was no significant difference in risk of myocardial infarction between groups. Dietitian interventions reduced BP and related cardiovascular outcomes for adults with prehypertension or hypertension. CONCLUSIONS Dietitians play a critical role in improving cardiometabolic risk factors for adults with elevated BP; thus, improved payment for and access to MNT services has the potential to significantly impact public health. This review was registered at PROSPERO as CRD42022351693.
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Affiliation(s)
- Katelyn E Senkus
- Department of Human Nutrition and Hospitality Management, College of Human Environmental Sciences, University of Alabama, Tuscaloosa, AL, United States
| | - Josephine M Dudzik
- Department of Nutrition and Food Studies, Steinhardt School of Culture, Education, and Human Development, New York University, New York, NY, United States
| | - Shannon L Lennon
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE, United States
| | - Diane M DellaValle
- Health and Human Performance Department, King's College, Wilkes-Barre, PA, United States
| | - Lisa M Moloney
- Evidence Analysis Center, Academy of Nutrition and Dietetics, Chicago, IL, United States
| | - Deepa Handu
- Evidence Analysis Center, Academy of Nutrition and Dietetics, Chicago, IL, United States
| | - Mary Rozga
- Evidence Analysis Center, Academy of Nutrition and Dietetics, Chicago, IL, United States.
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Ephrem C, Rizk R, Saadeh D, Hallit S, Obeid S, Martijn C. Orthorexia nervosa in dietitians and dietetics students-prevalence, risk factors, and interventions: a scoping review using a systematic approach. Nutr Rev 2024:nuae009. [PMID: 38381921 DOI: 10.1093/nutrit/nuae009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2024] Open
Abstract
CONTEXT Orthorexia nervosa (ON) is characterized by compulsive behaviors and increased concerns about healthful eating. Dietitians appear to be especially vulnerable to ON, and it is still debatable whether the disordered eating behaviors motivate individuals to enroll in nutrition programs, or whether these behaviors result from an exaggerated preoccupation with healthy eating triggered during their nutrition studies. OBJECTIVE The aim was to provide an overview of the present state of knowledge about the prevalence, risk factors, and interventions addressing ON among dietitians and dietetics students. More specifically, it was examined whether dietitians and dietetics students differ from students attending different education programs or other health professionals with regard to the severity and risk factors of ON, and whether the extent of ON changes during the progression in the nutrition education years of study. DATA SOURCES MEDLINE (Ovid), PubMed, EMBASE (Ovid), PsycInfo (EBSCO), CINAHL (EBSCO), Cochrane, ProQuest Central, CABI, ProQuest Dissertations, Google Scholar, ScienceDirect, and SpringerLink were searched on May 8, 2021, and updated on November 12, 2022. DATA EXTRACTION Records were screened for eligibility; study characteristics, methodology, and findings of included articles were extracted; and the methodological quality assessed using the AXIS tool. Each step was preceded by a calibration exercise and conducted independently and in duplicate by pairs of 2 reviewers. Any disagreements were resolved through discussions. DATA ANALYSIS A narrative synthesis was performed, whereby the characteristics, methodologies, and results of included studies were compared. CONCLUSIONS Results were inconclusive; yet, a general status of the relatively "high" prevalence of ON among dietitians and dietetics students was established, stressing the need for systematic research to understand and mitigate orthorexic tendencies in this group. It is still too early to answer questions pertaining to prevalence, risk factors, interventions, and differences between dietetics students and other majors when it comes to severity and progress of ON throughout the continuing years of study, or between dietitians and other professional groups. SYSTEMATIC REVIEW REGISTRATION Open Science Framework Identifier: DOI 10.17605/OSF.IO/BY5KF.
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Affiliation(s)
- Chloe Ephrem
- Clinical Psychological Science-Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Rana Rizk
- Nutrition Program, Department of Natural Sciences, Lebanese American University, Byblos, Lebanon
- Institut National de Santé Publique, d'Epidemiologie Clinique, et de Toxicology (INSPECT-LB), Beirut, Lebanon
| | - Danielle Saadeh
- Institut National de Santé Publique, d'Epidemiologie Clinique, et de Toxicology (INSPECT-LB), Beirut, Lebanon
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, Lebanon
- Applied Science Research Center, Applied Science Private University, Amman, Jordan
| | - Sahar Obeid
- Department of Social and Education Sciences, School of Arts and Sciences, Lebanese American University, Byblos, Lebanon
| | - Carolien Martijn
- Clinical Psychological Science-Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
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Weng V, Wiles N, Jenkins D, Amanatidis S, Kidd JC, Walsh JA, Baillie AJ, Naganathan V. The effectiveness of a home-based dietetic intervention for community-dwelling older adults. Australas J Ageing 2024. [PMID: 38217875 DOI: 10.1111/ajag.13264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 11/02/2023] [Accepted: 11/19/2023] [Indexed: 01/15/2024]
Abstract
OBJECTIVES The aim of this study was to describe the characteristics of clients receiving home-based dietetic intervention and to evaluate the effectiveness of these interventions in improving nutritional status, functional status, and quality of life in a culturally and socioeconomically diverse client group. METHODS Participants referred to a home-based dietetic service were recruited to this prospective cohort study. Dietetic interventions were recommended at baseline and reviewed at 3-month follow-up. Assessment of nutritional, functional and quality of life markers was measured using the Mini Nutritional Assessment (MNA), Timed Up and Go (TUG) and EQ-5D-5L, respectively, at baseline and after home-based dietetic intervention. RESULTS Participants (n = 99) were recruited from consecutive referrals. Participant's weight, body mass index (BMI), total daily energy and protein intake, MNA total score, and TUG significantly improved after a 3-month nutrition intervention (effect sizes 0.257, 0.257, 0.580, 0.533, 0.577 and 0.281, respectively). The most common interventions dietitians utilised were nutrition education, use of oral nutritional supplements (ONS) and meal fortification. In total, 339 dietetic interventions were recommended to participants at baseline with 197 (58.11%) implemented at 3 months, with meal planning and referral to other relevant allied health or Commonwealth Home Support Program (CHSP) services the most implemented interventions. CONCLUSIONS Home-based dietetic intervention improves nutritional status, functional status and quality of life in community-dwelling older adults referred for dietetic input. Improvements observed in nutritional and functional status were consistent with benchmarks of change from published literature.
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Affiliation(s)
- Vicky Weng
- Community Nutrition, Primary and Community Health, South Western Sydney Local Health District, Sydney, New South Wales, Australia
| | - Nicole Wiles
- Home Based Therapy, Aged Health Chronic Care and Rehabilitation, Sydney Local Health District, Sydney, New South Wales, Australia
| | - Deanna Jenkins
- Home Based Therapy, Aged Health Chronic Care and Rehabilitation, Sydney Local Health District, Sydney, New South Wales, Australia
| | - Sue Amanatidis
- Home Based Therapy, Aged Health Chronic Care and Rehabilitation, Sydney Local Health District, Sydney, New South Wales, Australia
| | - Joanna C Kidd
- Department of Speech Pathology, Campbelltown Hospital, South Western Sydney Local Health District, Sydney, New South Wales, Australia
| | - Jessica A Walsh
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Sydney Local Health District, Sydney, New South Wales, Australia
| | - Andrew J Baillie
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Sydney Local Health District, Sydney, New South Wales, Australia
| | - Vasi Naganathan
- Home Based Therapy, Aged Health Chronic Care and Rehabilitation, Sydney Local Health District, Sydney, New South Wales, Australia
- Concord Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
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Barbosa BB, Nielsen L, de Aguiar BS, Failla MA, Araújo LF, Mendes LL, Machado SP, Carioca AAF. Local Food Environment and Consumption of Ultra-Processed Foods: Cross-Sectional Data from the Nutritionists' Health Study-NutriHS. Int J Environ Res Public Health 2023; 20:6749. [PMID: 37754609 PMCID: PMC10531343 DOI: 10.3390/ijerph20186749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 08/17/2023] [Accepted: 09/10/2023] [Indexed: 09/28/2023]
Abstract
This study aimed to analyze whether community food environments are associated with individual food consumption among nutrition students and newly graduated nutritionists. This cross-sectional study used data from the Nutritionists' Health Study cohort, which included 357 undergraduate nutrition students from the city of Fortaleza, Ceará, Brazil. Exposure to the food environment was defined as the proximity and availability of food outlets within a 500 m buffer from the participants' homes. Food consumption was assessed using a Food Frequency Questionnaire and analyzed according to the NOVA classification. Multi-level linear regression models with fixed effects were used to estimate the presence of food outlets within the buffer and their association with food consumption. The presence of mini-markets in the buffer in the fourth quartile was associated with lower consumption of ultra-processed foods (UPF) when observing socioeconomic and lifestyle conditions (β = -3.29; 95% CI = -6.39 to -0.19). The presence of bakeries and coffee shops was related to lower consumption of ultra-processed foods among participants when observing socioeconomic conditions (β = -3.10; 95% CI = -6.18 to -0.02). There was no clear evidence of an association between the type of food outlet and UPF consumption. The community food environment seemed to influence food consumption among study participants, although clearer and more consistent evidence on this subject is needed.
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Affiliation(s)
- Brena Barreto Barbosa
- Postgraduate Program in Nutrition and Health, Ceará State University, Fortaleza 60714-903, CE, Brazil; (B.B.B.)
| | - Lucca Nielsen
- Coordination of Epidemiology and Information, Municipal Health Department of São Paulo, São Paulo 01002-900, SP, Brazil (M.A.F.)
| | - Breno Souza de Aguiar
- Coordination of Epidemiology and Information, Municipal Health Department of São Paulo, São Paulo 01002-900, SP, Brazil (M.A.F.)
| | - Marcelo Antunes Failla
- Coordination of Epidemiology and Information, Municipal Health Department of São Paulo, São Paulo 01002-900, SP, Brazil (M.A.F.)
| | - Larissa Fortunato Araújo
- Graduate Program in Public Health, Department of Community Health, Faculty of Medicine, Federal University of Ceará, Fortaleza 60020-181, CE, Brazil
| | - Larissa Loures Mendes
- Postgraduate Program in Nutrition and Health, Department of Nutrition, Federal University of Minas Gerais, Belo Horizonte 31270-901, MG, Brazil
| | - Soraia Pinheiro Machado
- Postgraduate Program in Nutrition and Health, Ceará State University, Fortaleza 60714-903, CE, Brazil; (B.B.B.)
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Carrillo-Álvarez E. Perspective: Food and Nutrition Insecurity in Europe: Challenges and Opportunities for Dietitians. Adv Nutr 2023; 14:995-1004. [PMID: 37543145 PMCID: PMC10509433 DOI: 10.1016/j.advnut.2023.07.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 07/23/2023] [Accepted: 07/27/2023] [Indexed: 08/07/2023] Open
Abstract
In recent years, the interest in food and nutrition insecurity in high-income countries has skyrocketed. However, its recognition in Europe is still developing. This perspective summarizes the evidence on food and nutrition insecurity across Europe in terms of prevalence, consequences, and current mitigation strategies, with the aim of outlining the challenges and opportunities for dietitians. Prevalence in the general population ranges between 5% and 20%, with higher rates identified in women, children, older adults, single-parent households, those with low educational attainment, and on low or unstable income and/or employment. In users of food aid, the prevalence of food insecurity is above 70%. Responses to food and nutrition insecurity include welfare policies and food assistance programs at regional and national levels. However, most current strategies are not successful in tackling the structural drivers of food and nutrition insecurity, nor do they guarantee diet quality. Despite limited involvement to-date, dietitians can play an important role in addressing food and nutrition insecurity across Europe. This narrative identifies 4 areas: 1) create awareness of the existence and severity of food and nutrition insecurity, 2) advocate for comprehensive, robust data on the determinants and prevalence, 3) partner with diverse stakeholders, social assistance providers, local authorities, and nongovernmental organizations in a comprehensive, intersectoral, and integrated manner, 4) participate in the development of political instruments and interventions that ensure equitable access to high-quality safe food.
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Affiliation(s)
- Elena Carrillo-Álvarez
- Public Health Specialist Network (ESDN PH), European Federation of Association of Dietetics (EFAD), Europe; Global Research on Wellbeing (GRoW) research group, Blanquerna School of Health Sciences, Universitat Ramon Lull, Barcelona, Spain.
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Shankar K, Chandrasekaran R, Jeripity Venkata P, Miketinas D. Investigating the Role of Nutrition in Enhancing Immunity During the COVID-19 Pandemic: Twitter Text-Mining Analysis. J Med Internet Res 2023; 25:e47328. [PMID: 37428522 PMCID: PMC10366666 DOI: 10.2196/47328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 05/09/2023] [Accepted: 05/09/2023] [Indexed: 07/11/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has brought to the spotlight the critical role played by a balanced and healthy diet in bolstering the human immune system. There is burgeoning interest in nutrition-related information on social media platforms like Twitter. There is a critical need to assess and understand public opinion, attitudes, and sentiments toward nutrition-related information shared on Twitter. OBJECTIVE This study uses text mining to analyze nutrition-related messages on Twitter to identify and analyze how the general public perceives various food groups and diets for improving immunity to the SARS-CoV-2 virus. METHODS We gathered 71,178 nutrition-related tweets that were posted between January 01, 2020, and September 30, 2020. The Correlated Explanation text mining algorithm was used to identify frequently discussed topics that users mentioned as contributing to immunity building against SARS-CoV-2. We assessed the relative importance of these topics and performed a sentiment analysis. We also qualitatively examined the tweets to gain a closer understanding of nutrition-related topics and food groups. RESULTS Text-mining yielded 10 topics that users discussed frequently on Twitter, viz proteins, whole grains, fruits, vegetables, dairy-related, spices and herbs, fluids, supplements, avoidable foods, and specialty diets. Supplements were the most frequently discussed topic (23,913/71,178, 33.6%) with a higher proportion (20,935/23,913, 87.75%) exhibiting a positive sentiment with a score of 0.41. Consuming fluids (17,685/71,178, 24.85%) and fruits (14,807/71,178, 20.80%) were the second and third most frequent topics with favorable, positive sentiments. Spices and herbs (8719/71,178, 12.25%) and avoidable foods (8619/71,178, 12.11%) were also frequently discussed. Negative sentiments were observed for a higher proportion of avoidable foods (7627/8619, 84.31%) with a sentiment score of -0.39. CONCLUSIONS This study identified 10 important food groups and associated sentiments that users discussed as a means to improve immunity. Our findings can help dieticians and nutritionists to frame appropriate interventions and diet programs.
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Affiliation(s)
- Kavitha Shankar
- Department of Nutrition and Food Sciences, Texas Woman's University Institute for Health Sciences, Houston, TX, United States
| | - Ranganathan Chandrasekaran
- Department of Information and Decision Sciences, University of Illinois at Chicago, Chicago, IL, United States
| | | | - Derek Miketinas
- Department of Nutrition and Food Sciences, Texas Woman's University Institute for Health Sciences, Houston, TX, United States
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Kamp KJ, Morgan H, Yoo L, Munson SA, Heitkemper MM, Levy RL. Symptom management needs of patients with irritable bowel syndrome and concurrent anxiety and/or depression: A qualitative study. J Adv Nurs 2023; 79:775-788. [PMID: 36511394 PMCID: PMC9877173 DOI: 10.1111/jan.15532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 11/09/2022] [Accepted: 12/01/2022] [Indexed: 12/15/2022]
Abstract
AIMS To understand the experiences and needs of symptom management among individuals with irritable bowel syndrome and concurrent symptoms of anxiety and/or depression. DESIGN This study used a qualitative descriptive research design. METHODS Individuals with a diagnosis of irritable bowel syndrome and concurrent symptoms of anxiety and/or depression participated were recruited through an online ResearchMatch and a listserv. Semi-structured interviews focused on symptoms and experiences with symptom management interventions conducted from June to August 2020. Interviews were transcribed and data were analysed based on thematic analysis. RESULTS Twelve individuals participated in this study; all reported current irritable bowel syndrome and anxiety/depression symptoms. The data analysis cumulated with three themes related to symptom management: (a) irritable bowel syndrome negatively impacts physical and mental well-being; (b) a trial and error approach to symptom management; and (c) challenges with healthcare professionals supporting symptom management including negative interactions with healthcare professionals and lack of nutritional expertize and support. CONCLUSION There is a need for individualized approaches which consider patients' current symptoms of anxiety and depression, previous experiences with the trial-and-error process and consideration for intervention delivery methods. IMPACT There is a limited qualitative research focusing on the experiences of individuals with irritable bowel syndrome and concurrent symptoms of anxiety and/or depression. This research highlights the need for individualized approaches to enhance symptom management that acknowledges patients' psychological state and past negative experiences with providers and prior dietary regimens.
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Affiliation(s)
- Kendra J. Kamp
- Department of Biobehavioral Nursing and Health Informatics, School of Nursing, University of Washington, Seattle, Washington, USA
| | | | - Linda Yoo
- Department of Biobehavioral Nursing and Health Informatics, School of Nursing, University of Washington, Seattle, Washington, USA
| | - Sean A. Munson
- Department of Human Centered Design & Engineering, University of Washington, Seattle, Washington, USA
| | - Margaret M. Heitkemper
- Department of Biobehavioral Nursing and Health Informatics, School of Nursing, University of Washington, Seattle, Washington, USA
| | - Rona L. Levy
- School of Social Work, University of Washington, Seattle, Washington, USA
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Roesler A, Probst Y. Insights from dietitians providing individualised dietetic care to people living with disabilities: A single site exploration in the community. J Hum Nutr Diet 2023; 36:657-663. [PMID: 36604984 DOI: 10.1111/jhn.13133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 01/02/2023] [Indexed: 01/07/2023]
Abstract
BACKGROUND The present study aims to share insights and lessons learnt by dietitians providing individualised care to people living with disabilities in the community. This is important to build the evidence to inform dietetic best practice standards. METHODS The study involved a cross-sectional data audit of dietitian reports for clients living with a disability seen at a metropolitan dietitian clinic in South Australia. Content analysis of the reports was conducted. Initial coding occurred deductively followed by inductive qualitative content analysis. RESULTS Thirty-one participants consented to have their dietitian reports included in the study. Intellectual disabilities made up the majority (48%) of disabilities reported in the sample. Nutrition diagnoses predominantly related to energy imbalances (54%). Barriers to dietary change included a reliance on others and limitations in the disability support system. Kitchen skills and cooking were the most often employed nutrition strategy suggested by dietitians. Following dietetic intervention, improvements were seen in the types of foods people with a disability consumed along with changes to their body weight. Dietitians reported the importance of effective communication with the care team and providing engaging methods to instigate dietary behaviour change. CONCLUSIONS The present study highlights that there are opportunities to build on individualised dietetic care provided to people living with disabilities. These opportunities include addressing excess energy consumption, fostering collaborations with other health providers and understanding how to better work with carers. Further research is required to understand how to progress these opportunities forward and to understand the generalisability of the findings.
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Affiliation(s)
- Anna Roesler
- Caring Futures Institute, Flinders University, Bedford Park, SA, Australia
| | - Yasmine Probst
- School Medical, Indigenous and Health Sciences, Wollongong University, Wollongong, NSW, Australia.,Illawarra Health and Medical Research Institute, Wollongong, NSW, Australia
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Carpio-Arias TV, Crovetto-Mattassi M, Durán-Agüero S, Parra-Soto S, Landaeta-Díaz L, Cerezo de Ríos S, Bejarano-Roncancio JJ, Cordón-Arrivillaga K, Vitullo M, Perichart-Perera O, Averos NV, Anahí Rodríguez S, Morales GM, Meza-Miranda ER, Nava-González EJ, Miranda-Durán M, Mauricio-Alza S, Ortiz-Fiorito A, Núñez-Martínez B, Ivankovich-Guillén S. Barriers and Opportunities for Clinical Nutritionists in 13 Latin American Countries: A Qualitative Study. J Prim Care Community Health 2023; 14:21501319231204580. [PMID: 37902498 PMCID: PMC10617253 DOI: 10.1177/21501319231204580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 09/09/2023] [Accepted: 09/13/2023] [Indexed: 10/31/2023] Open
Abstract
A clinical nutritionist (CN) is a university-educated professional trained to perform preventive and recovery functions in the health of patients. The actions of these professionals, both worldwide and in Latin America, may face barriers and opportunities that require careful identification and examination. The main objective of this study is to identify the most important barriers and opportunities for the clinical nutritionist in 13 Latin American countries. A qualitative study was carried out; the initial phase involved conducting in-depth individual interviews with 89 informants, experienced CNs from 13 Latin American countries. After calculating the mean and standard deviation, we ranked the top 10 most frequently reported barriers by assigning a score ranging from 1 to 10. Additionally, 3 opportunities were identified with a lower score from 1 to 3. Means and standard deviation were calculated to sort the responses. Results: the most important barrier was the absence of public policies that regulate and/or monitor compliance with the staffing of CNs according to the number of hospital beds, while the most important opportunity was the advances in technology such as software, body analysis equipment and other tools used in Nutritional Care. The identified barriers can interfere with the professional performance of CNs and, moreover, make it difficult to monitor the good nutritional status of patients. It is recommended to consider the barriers identified in this study, as well as the opportunities, with a view to improving the quality of hospital services with an adequate supply of nutritionists.
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Affiliation(s)
| | | | - Samuel Durán-Agüero
- Escuela de Nutrición y Dietética. Facultad de Ciencias para el Cuidado de la Salud. Universidad San Sebastián, Los Leones, Chile
| | | | | | | | | | | | - María Vitullo
- Carrera de Nutrición de la Facultad de Ciencias Biomédicas de la Universidad Austral, Buenos Aires, Argentina
| | | | | | | | | | - Eliana Romina Meza-Miranda
- Universidad Nacional de Asunción – Centro Multidisciplinario de Investigaciones Tecnológicas, San Lorenzo, Paraguay
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Barber C, Blair M, McCaffrey TA, Palermo C. Employability and employment outcomes of nutrition science graduates: A qualitative exploration. Nutr Diet 2022. [PMID: 36196518 DOI: 10.1111/1747-0080.12777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 07/11/2022] [Accepted: 09/01/2022] [Indexed: 11/30/2022]
Abstract
AIMS This study aimed to explore experiences of employability and employment for graduates of a three-year nutrition science degree. METHODS Qualitative narrative interviews were conducted with a maximum variation sample of 22 nutrition science graduates from one large university in Australia. All graduates (n = 126) from the initiation of the degree in 2015 to current 2021 graduates were eligible for inclusion if they had not gone on to study dietetics. The interviews elicited their stories and experiences of employability and journeys to employment post-graduation. Interviews were analysed using the framework method. RESULTS Analysis of the graduate interviews identified four themes: (1) from graduation to employment; (2) there are challenges to obtaining employment; (3) curriculum can enable employability; and (4) employability resources can support career prospects. In this group, the nutrition science degree on its own was not deemed sufficient to land employment in a desired nutrition-related field. The process of obtaining employment was supported by work experience, social networks, interpersonal skills, and a willingness to relocate. CONCLUSION Building employability skills in the curriculum through the development of professional social networks and a professional identity may be important in improving the employability of nutrition science graduates.
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Affiliation(s)
- Charlotte Barber
- Department of Nutrition, Dietetics and Food, Faculty of Medicine, Nursing & Health Sciences, Monash University, Clayton, Victoria, Australia
| | - Merran Blair
- Department of Nutrition, Dietetics and Food, Faculty of Medicine, Nursing & Health Sciences, Monash University, Clayton, Victoria, Australia
| | - Tracy A McCaffrey
- Department of Nutrition, Dietetics and Food, Faculty of Medicine, Nursing & Health Sciences, Monash University, Clayton, Victoria, Australia
| | - Claire Palermo
- Department of Nutrition, Dietetics and Food, Faculty of Medicine, Nursing & Health Sciences, Monash University, Clayton, Victoria, Australia
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12
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Hewko SJ, Mann KJ. A situational analysis of Registered Dietitians' participation in network marketing. J Hum Nutr Diet 2022; 36:932-948. [PMID: 36168872 DOI: 10.1111/jhn.13093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 09/05/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Registered Dietitians (RDs) are allied health professionals with advanced training in nutrition and food science. In order to practice, RDs must maintain registration with the regulatory body in their jurisdiction. METHODOLOGY We conducted a situational analysis to better understand: i) RDs participation as independent sales consultants (ISCs) for network marketing companies, and ii) the role of regulatory bodies in overseeing network marketing participation among RDs. We conducted semi-structured interviews with individuals who had, within the past five years, concurrently been an RD and an ISC, and with three representatives of non-RD regulatory bodies in the province of Ontario. Other sources of discursive data included relevant articles published in academic journals and in the mainstream media, documentary series and circulating memes. RESULTS Our results are depicted in three maps (ordered situational, arenas and positional). Overall, much of what was highlighted in the reviewed articles and expressed in the analytic maps about network marketing remained unsaid in RD interviews (n = 8). PRINCIPAL CONCLUSIONS RDs who participate in network marketing were often able to achieve a level of personal fulfilment that seemed unattainable through their professional work alone. However, the stigma of network marketing participation seemed to diminish the benefits of ISC work. Consistent, clear guidelines from RD regulatory bodies are desired by RD/ISCs. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Sarah J Hewko
- Department of Human Sciences, University of Prince Edward Island, 550 University Avenue, Charlottetown, PE, C1A 4N3, Canada
| | - Kristen J Mann
- Dietetic Intern, Department of Human Sciences, University of Prince Edward Island, 550 University Avenue, Charlottetown, PE, C1A 4N3, Canada.,Community Dietitian, Health PEI, 161 St. Peters Road, Charlottetown, PE, C1A 5P6, Canada
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13
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Nitschke E, Gottesman K, Hamlett P, Mattar L, Robinson J, Tovar A, Rozga M. Impact of Nutrition and Physical Activity Interventions Provided by Nutrition and Exercise Practitioners for the Adult General Population: A Systematic Review and Meta-Analysis. Nutrients 2022; 14:nu14091729. [PMID: 35565696 PMCID: PMC9103154 DOI: 10.3390/nu14091729] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 04/15/2022] [Accepted: 04/18/2022] [Indexed: 12/18/2022] Open
Abstract
Healthy dietary intake and physical activity reduce the risk of non-communicable diseases. This systematic review and meta-analysis aimed to examine the effect of interventions including both nutrition and physical activity provided by nutrition and exercise practitioners for adults in the general population (those without diagnosed disease). The MEDLINE, CINAHL, Cochrane Central, Cochrane Database of Systematic Reviews and SportDiscus databases were searched for randomized controlled trials (RCTs) published from 2010 until April 2021. Outcomes included physical activity, fruit and vegetable intake, waist circumference, percent weight loss, quality of life (QoL) and adverse events. Grading of Recommendations Assessment, Development and Evaluation (GRADE) methods were used to synthesize and grade evidence. Meta-analyses were stratified according to participant health status. The database search identified 11,205 articles, and 31 RCTs were included. Interventions increased physical activity amount [standardized mean difference (SMD) (95% CI): 0.25 (0.08, 0.43)] (low certainty evidence); increased vegetable intake [SMD (95% CI): 0.14 (0.05, 0.23)] (moderate certainty evidence); reduced waist circumference [MD (95% CI): −2.16 cm (−2.96, −1.36)] (high certainty evidence); and increased likelihood of achieving 5% weight loss for adults with overweight and obesity [relative risk (95% CI): 2.37 (1.76, 3.19)] (high certainty evidence). Very low and low certainty evidence described little-to-no effect on QoL or adverse events. Nutrition and exercise practitioners play key roles in facilitating positive lifestyle behaviors to reduce cardiometabolic disease risk in adults.
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Affiliation(s)
- Erin Nitschke
- Department of Exercise Science, Laramie County Community College, 1400 E College Drive, Cheyenne, WY 82007, USA;
| | - Kimberly Gottesman
- Department of Kinesiology, Nutrition and Food Science, California State University Los Angeles, 5151 South University Drive, Los Angeles, CA 90032, USA;
| | - Peggy Hamlett
- Department of Movement Sciences, University of Idaho, 875 Perimeter Drive, Moscow, ID 83844, USA;
| | - Lama Mattar
- Department of Natural Sciences, School of Arts and Sciences, Lebanese American University, Beirut 10150, Lebanon;
| | - Justin Robinson
- Kinesiology Department, Point Loma Nazarene University, 3900 Lomaland Dr, San Diego, CA 92106, USA;
| | - Ashley Tovar
- Gilead Sciences, 333 Lakeside Dr, Foster City, CA 94404, USA;
| | - Mary Rozga
- Evidence Analysis Center, Academy of Nutrition and Dietetics, 120 S Riverside Plaza, Suite 2190, Chicago, IL 60606, USA
- Correspondence: ; Tel.: +1-(312)-899-1758
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14
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Hicks-Roof K, Xu J, Fults AK, Latortue KY. Beyond the clinical walls: registered dietitian nutritionists providing medical nutrition therapy in the home setting. Nutr Res Pract 2021; 15:789-797. [PMID: 34858555 PMCID: PMC8601946 DOI: 10.4162/nrp.2021.15.6.789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 05/05/2021] [Accepted: 06/22/2021] [Indexed: 11/05/2022] Open
Abstract
BACKGROUD/OBJECTIVES Registered dietitian nutritionists (RDN) are providers of medical nutrition therapy (MNT) to address health and chronic disease. Traditionally, RDNs have provided care in healthcare facilities including hospitals and private care facilities. The purpose of this study was to determine how RDN individualized MNT in the home impacted nutrition, physical activity, and food security. SUBJECTS/METHODS This is a secondary data analysis. The mean age of the participants (n = 1,007) was 51.6 years old with a mean body mass index (BMI) of 34.1 kg/m2. Individualized MNT visits were delivered by an RDN in the home setting from January to December 2019. Participants were referred by healthcare professionals or self-referred. Participants had MNT benefits covered by their health insurance plan (43.3% Medicaid; 39.8% private insurance; 7.9% Medicare, 9% other). Health outcomes related to nutrition care were measured. Outcomes included self-reported consumption of nutrition factors and physical activity. Our secondary outcome focused on food security. The changes in weight, BMI, physical activity, and nutrition factors were analyzed by a linear regression model or linear mixed model, adjusting for age, sex, baseline value, and number of appointments. Food security was summarized in a 2 by 2 contingency table. RESULTS Baseline values had significantly negative impacts for all changes and number of appointments was significant in the changes for weight and BMI. Increases in physical activity were significant for both female and male participants, 10.4 and 12.6 minutes per day, respectively, while the changes in weight and BMI were not. Regarding dietary factors, the consumption total servings per day of vegetables (0.13) and water (3.35) significantly increased, while the consumption of total servings of whole grain (−0.27), fruit (−0.32), dairy (−0.80) and fish (−0.81) significantly decreased. About 24% (of overall population) and 45% (of Medicaid population) reported improvements in food security. CONCLUSIONS This study found that home visits were a useful setting for MNT delivered by RDNs. There is a strong need for individualized counseling to meet the participants' needs and personal goals.
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Affiliation(s)
- Kristen Hicks-Roof
- Department of Nutrition & Dietetics, Brooks College of Health, University of North Florida, Jacksonville, FL 32224, USA
| | - Jing Xu
- Department of Health Administration, University of North Florida, Jacksonville, FL 32224, USA
| | - Amanda K Fults
- Department of Behavioral Health and Nutrition, College of Health Sciences, University of Delaware, Newark, DE 19713, USA
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15
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Counsell AB, Nguyen AD, Baysari MT, Kannangara DRW, Gamboa S, Day RO. Expanding the role of Australian community dietitians in gout management. Int J Rheum Dis 2021; 24:1402-1408. [PMID: 34658154 DOI: 10.1111/1756-185x.14224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 09/24/2021] [Accepted: 09/27/2021] [Indexed: 11/28/2022]
Abstract
AIM Gout is a common form of inflammatory arthritis with suboptimal management. Management guidelines for gout highlight the importance of both pharmacological and non-pharmacological treatments. Dietitians can potentially assist in improving gout's associated dietary and lifestyle factors, and thereby play a role in improving its management. The aim of this study was to investigate perspectives of Australian community dietitians on whether their role in gout management could be expanded to improve management and treatment of gout. METHOD A snowballing recruitment strategy was used. Dietitians known to the research team were invited to participate and then they suggested further dietitians. Semi-structured interviews (one-on-one) were conducted with 16 dietitians. The focus was on their experiences of contributing to the management of gout, including any barriers and facilitators experienced. Interviews were transcribed verbatim and independently analyzed by 2 reviewers to identify themes. RESULTS The main reported role of dietitians in gout management was providing patient education. An identified facilitator was dietitians' understanding of gout and its dietary management. Barriers included the emphasis placed on medications for treatment by clinicians and patients, consultation costs, limitations in the evidence for the efficacy of dietary changes and lack of specific training in gout for dietitians. Dietitians predominantly managed the other metabolic conditions commonly associated with gout. CONCLUSION Currently, the role dietitians play in gout management is limited. However, dietitians have the potential to take on larger roles in gout education and can also indirectly contribute by way of management of commonly associated comorbidities in gout patients.
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Affiliation(s)
- Allyce B Counsell
- St Vincent's Clinical School, UNSW Sydney, Sydney, New South Wales, Australia.,Department of Clinical Pharmacology & Toxicology, St Vincent's Hospital, Sydney, New South Wales, Australia
| | - Amy D Nguyen
- St Vincent's Clinical School, UNSW Sydney, Sydney, New South Wales, Australia.,Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Melissa T Baysari
- Biomedical Informatics and Digital Health, School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Diluk R W Kannangara
- St Vincent's Clinical School, UNSW Sydney, Sydney, New South Wales, Australia.,Department of Clinical Pharmacology & Toxicology, St Vincent's Hospital, Sydney, New South Wales, Australia
| | - Sarah Gamboa
- Faculty of Medicine and Health Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Richard O Day
- St Vincent's Clinical School, UNSW Sydney, Sydney, New South Wales, Australia.,Department of Clinical Pharmacology & Toxicology, St Vincent's Hospital, Sydney, New South Wales, Australia.,Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
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16
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Lieffers JRL, Vanzan AGT, Rover de Mello J, Cammer A. Nutrition Care Practices of Dietitians and Oral Health Professionals for Oral Health Conditions: A Scoping Review. Nutrients 2021; 13:nu13103588. [PMID: 34684589 PMCID: PMC8539677 DOI: 10.3390/nu13103588] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 10/02/2021] [Accepted: 10/02/2021] [Indexed: 02/04/2023] Open
Abstract
Background: Oral health conditions, such as dental caries, pose a substantial burden worldwide. Although there are many risk factors for poor oral health, diet is often implicated as a cause of these issues. The purpose of this scoping review was to identify and map studies that have captured information on the “real-world” nutrition care practices of oral health professionals (OHPs) and dietitians to optimize oral health, and specifically the dentition and periodontium. Methods: A search of peer-reviewed articles was conducted using MEDLINE, CINAHL, and Embase. Articles that addressed the review objective and met the following criteria were included: English language, published since 2000, and study conducted in a high-income country. Results: Overall, 70 articles were included. Most articles reported on cross-sectional survey studies and provided self-reported data on OHP practices; few articles reported on dietitians. Most articles reported only general/unspecific information on assessment and intervention practices, such as dietary analysis, nutrition counselling, and diet advice, and lacked specific information about the care provided, such as the dietary assessment tools used, type of information provided, and time spent on these activities. Barriers to the provision of nutrition care by OHPs were common and included time and lack of remuneration. Few studies reported on collaboration between dietitians and OHPs. Conclusions: Several studies have captured self-reported information on nutrition care practices of OHPs related to oral health; however, there is limited information available on the details of the care provided. Few studies have examined the practices of dietitians.
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17
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O'Brien MW, Shields CA, Dunbar MJ, Crowell SJ, Fowles JR. Physical Activity Counselling and Exercise Prescription Practices among Dietitians Across Nova Scotia. CAN J DIET PRACT RES 2021; 83:35-40. [PMID: 34582268 DOI: 10.3148/cjdpr-2021-025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
The purpose of this study was to assess the perceptions and practices around physical activity counselling and exercise prescription of dietitians in Nova Scotia. Dietitians (n = 95) across Nova Scotia completed an online self-reflection survey regarding their current physical activity and exercise (PAE) practices. Most (51%; n = 48) reported no previous PAE educational training. Dietitians infrequently prescribed exercise to their patients (16% ± 26% of appointments) or provided PAE referrals (17% ± 24%). Dietitians reported moderate confidence (57% ± 21%) performing PAE counselling and included PAE-related content in half of patient appointments (52% ± 31%). Almost all respondents (95%) identified interest in further PAE education or training. Open-ended responses also demonstrated the need for community-based exercise programs (28% of providers) and qualified exercise professionals to refer to (25%). Overall, dietitians report rarely providing patients with written exercise prescriptions or referrals to other professionals for PAE content but do frequently include PAE in patient appointments. Dietitians in Nova Scotia are well positioned to promote PAE, but more educational training and improved referral systems to qualified exercise professionals or community exercise programs is strongly desired. Exercise professionals and dietitians should concurrently advocate for these changes and collaborate to help more patients lead physically active lifestyles.
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Affiliation(s)
- Myles W O'Brien
- Centre of Lifestyle Studies, School of Kinesiology, Acadia University, Wolfville, NS.,Nova Scotia Health Authority, Wolfville, NS.,Divison of Kinesiology, Dalhousie University, Halifax, NS
| | - Christopher A Shields
- Centre of Lifestyle Studies, School of Kinesiology, Acadia University, Wolfville, NS
| | | | | | - Jonathon R Fowles
- Centre of Lifestyle Studies, School of Kinesiology, Acadia University, Wolfville, NS.,Nova Scotia Health Authority, Wolfville, NS
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18
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Akutsu RDC, Rocha A, Viana V, Akutsu L, Silva IC, Botelho RBA, Han H, Raposo A, Ariza-Montes A, Araya-Castillo L, Zandonadi RP. Well-Being at Work: A Cross-Sectional Study on the Portuguese Nutritionists. Int J Environ Res Public Health 2021; 18:7839. [PMID: 34360131 PMCID: PMC8345680 DOI: 10.3390/ijerph18157839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 07/21/2021] [Accepted: 07/22/2021] [Indexed: 11/16/2022]
Abstract
This exploratory, nationwide cross-sectional study was performed to investigate the well-being of Portuguese nutritionists, in addition to outlining their professional and demographic profile. Descriptive analyses were carried out to determine the measures relating to centralising tendency and dispersion of the sample. We compared means and proportions through t-tests and Analysis of Variance (ANOVA). The sample size was 206 individuals, respecting a minimum of eight respondents per item to validate the instrument. We recruited Nutritionists from Portugal nationwide using the list of electronic mail provided by the Order of Nutritionists. We sent an electronic mail to all the Nutritionists registered in this Order. We also used messaging applications and social networks (Instagram, Facebook) to reach Nutritionists who were not accessing electronic mail. Most respondents are women (92.5%), young (mean age = 31.4 ± 8.07 years; 54.2% of participants aging under 30 years), single, and with no children. More than half are Catholic (73.8%) and have less than ten years of nutritionist undergraduate completion (55.4%). The only variable that influences well-being at work is the economic variable Household Monthly Income. Those who earn less than €500.00 per month perceive themselves at a lesser state of work well-being than those who earn from €2501.00 to €5000.00 per month.
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Affiliation(s)
- Rita de Cássia Akutsu
- Department of Nutrition, Faculty of Health Sciences, University of Brasília, Brasília 70910-900, Brazil; (R.d.C.A.); (R.B.A.B.); (R.P.Z.)
| | - Ada Rocha
- GreenUPorto, Faculty of Nutrition and Food Sciences, University of Porto, 4150-180 Porto, Portugal; (A.R.); (V.V.)
| | - Victor Viana
- GreenUPorto, Faculty of Nutrition and Food Sciences, University of Porto, 4150-180 Porto, Portugal; (A.R.); (V.V.)
| | - Luiz Akutsu
- Court Union Accounts, Brasília 70042-900, Brazil;
| | | | - Raquel Braz Assunção Botelho
- Department of Nutrition, Faculty of Health Sciences, University of Brasília, Brasília 70910-900, Brazil; (R.d.C.A.); (R.B.A.B.); (R.P.Z.)
| | - Heesup Han
- College of Hospitality and Tourism Management, Sejong University, 98 Gunja-Dong, Gwanjin-Gu, Seoul 143-747, Korea
| | - António Raposo
- CBIOS (Research Center for Biosciences and Health Technologies), Universidade Lusófona de Humanidades e Tecnologias, Campo Grande 376, 1749-024 Lisboa, Portugal
| | - Antonio Ariza-Montes
- Social Matters Research Group, Universidad Loyola Andalucía, C/Escritor Castilla Aguayo, 4, 14004 Córdoba, Spain;
- Faculty of Business Administration, Universidad Autónoma de Chile, Santiago 7500912, Chile
| | - Luis Araya-Castillo
- Facultad de Economía y Negocios, Universidad Andrés Bello, Santiago 7591538, Chile;
| | - Renata Puppin Zandonadi
- Department of Nutrition, Faculty of Health Sciences, University of Brasília, Brasília 70910-900, Brazil; (R.d.C.A.); (R.B.A.B.); (R.P.Z.)
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19
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Young AM, Hickman I, Campbell K, Wilkinson SA. Implementation science for dietitians: The 'what, why and how' using multiple case studies. Nutr Diet 2021; 78:276-285. [PMID: 34184377 DOI: 10.1111/1747-0080.12677] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 04/09/2021] [Accepted: 04/26/2021] [Indexed: 11/29/2022]
Abstract
AIM Implementation science theories, models and frameworks help to address evidence-practice gaps, which have increasing importance for dietetic practice. This paper aims to provide dietitians with insight into how implementation science can be applied to practice, using multiple 'real-life' case studies. METHODS Three case studies were purposively selected across areas of dietetics practice to demonstrate application of commonly-used implementation theories, models and frameworks. Reflections from the authors were provided in response to a structured set of questions outlining how the theoretical approach was selected and used, and considerations for future application. Within and cross-case analysis was undertaken. RESULTS Dietitians used diverse implementation theories, models and frameworks to identify barriers and enablers, to plan for implementation, and to guide the selection of implementation strategies. Implementation theory was used to evaluate the implementation process in one case study. Cross-case analysis identified that mentoring by those with implementation expertise, multidisciplinary implementation teams, and leadership and investment in research and translation at an organisational and departmental level as key enablers. CONCLUSIONS This paper offers dietitians insight into how implementation science can be applied to improve the uptake of evidence-based practices within nutrition and dietetics, and suggests that there needs to be investment in implementation science as a foundation science within nutrition and dietetics, including education, training and mentoring for dietitians.
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Affiliation(s)
- Adrienne M Young
- Department of Nutrition and Dietetics, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
| | - Ingrid Hickman
- Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia.,Department of Nutrition and Dietetics, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
| | - Katrina Campbell
- Healthcare Excellence and Innovation, Metro North Hospital and Health Service, Herston, Queensland, Australia
| | - Shelley A Wilkinson
- School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, Queensland, Australia
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20
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Hutchesson M, Rollo M, Burrows T, McCaffrey TA, Kirkpatrick SI, Kerr D, Truby H, Clarke E, Collins CE. Current practice, perceived barriers and resource needs related to measurement of dietary intake, analysis and interpretation of data: A survey of Australian nutrition and dietetics practitioners and researchers. Nutr Diet 2021; 78:365-373. [PMID: 34109725 DOI: 10.1111/1747-0080.12692] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 04/15/2021] [Accepted: 05/11/2021] [Indexed: 01/26/2023]
Abstract
AIM To inform future training and professional development for individuals who measure, analyse and interpret dietary intake data. METHODS A cross-sectional online survey was distributed via e-newsletter to members of Dietitians Australia, Dietitian Connection and Nutrition Society Australia. The survey included 37 questions on three key areas of practice: (a) methods used to assess dietary intake, (b) barriers faced when conducting dietary intake assessment and (c) resources needed to optimise collection, analysis and interpretation of dietary intake data. RESULTS Of 173 responses, 103 respondents provided complete data over 2 weeks. Of these, 76% were APDs. The majority (90%) indicated that dietary assessment was important in their role. Respondents (63%) undertook dietary assessments to inform individual/patient care. When assessing intakes, the majority (79%) were interested in examining food/food group intakes. Paper based methods were most commonly used and diet histories, food frequency questionnaires and 24-hour recalls were the most frequently used methods. The biggest barrier identified to implementing dietary assessment methods into practice was participant burden. Over a third of respondents reported they had received specific training on selecting an appropriate dietary assessment method. The majority of respondents (83%) believed having access to a dietary assessment methods toolkit would be useful. CONCLUSION Survey findings provide insight into the need for further capacity building strategies, including professional development to improve collection, analysis and interpretation of dietary intake for Australian nutritionists and dietitians. The creation of online resources could help overcome identified barriers and provide a link to best practice methodologies and contemporary tools.
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Affiliation(s)
- Melinda Hutchesson
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia.,Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia
| | - Megan Rollo
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia.,Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia
| | - Tracy Burrows
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia.,Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia
| | - Tracy A McCaffrey
- Department of Nutrition, Dietetics and Food, Monash University, Melbourne, Australia
| | - Sharon I Kirkpatrick
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Canada
| | - Deborah Kerr
- School of Public Health, Curtin University, Perth, Australia
| | - Helen Truby
- School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Australia
| | - Erin Clarke
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia.,Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia
| | - Clare E Collins
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia.,Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia
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21
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Puri IY, Mohd Yusof BN, Abu Zaid Z, Ismail A, Haron H, Lipoeto NI. Currents Nutritional Practices of Nutritionists in the Management of Type 2 Diabetes Patients at Public Health Centres in Padang, Indonesia. Nutrients 2021; 13:nu13061975. [PMID: 34201355 PMCID: PMC8229169 DOI: 10.3390/nu13061975] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 05/28/2021] [Accepted: 05/31/2021] [Indexed: 11/16/2022] Open
Abstract
(1) Background: The interest in nutrition practices and education is slowly gaining traction among Indonesian nutritionists. However, there is a lack of local studies that evaluate nutritional practices, especially in the management of type 2 diabetes (T2DM). This cross-sectional study aimed to determine the nutritional practices among nutritionists and the adequacy of the current practices in the management of Type 2 Diabetes Mellitus (T2DM) patients at the Public Health Clinic in Padang (PHC), Indonesia. (2) Methods: An online survey form was distributed to all the nutritionists (n = 50) involved in the management of T2DM patients in their daily practices at the PHC. Socio-demographic characteristics, the current practice of T2DM, the need for DM nutrition education, and an evaluation questionnaire on the Indonesian Non-Communicable Diseases guideline and the Public Health Centre guideline were captured in the survey. (3) Result: A total of 48 completed survey forms were received, providing a response rate of 96% from the recruited nutritionists. One-third (37.5%) of the respondents counselled between one and ten patients per day. Nearly half (41.7%) conducted a monthly follow-up session for the patients at their respective PHC in the previous three months. Each nutritionist educated five to ten T2DM patients. The most common nutrition education topics delivered included appropriate menus (89.6%) as well as the etiology and symptoms of T2DM (85.5%). Almost all the nutritionists (93.8%) used leaflets and about 35.4% used poster education. Around 70.8% of counseling sessions lasted 30 min and two-thirds (66.7%) of the sessions included nutrition education. Based on the results, about half (52.1%) of them claimed that T2DM patients were reluctant to attend individual nutrition education. One-fifth of them (20.8%) claimed that it was because the T2DM patients were not interested in the tool kits and materials used. (4) Conclusions: T2DM patients are reluctant to attend individual nutrition education due to uninteresting tool kits and materials.
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Affiliation(s)
- Ice Yolanda Puri
- Department of Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Malaysia; (I.Y.P.); (Z.A.Z.)
- Department of Nutrition, Faculty of Public Health, Andalas University, Padang, West Sumatera 25175, Indonesia
| | - Barakatun-Nisak Mohd Yusof
- Department of Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Malaysia; (I.Y.P.); (Z.A.Z.)
- Correspondence: ; Tel.: +60-(03)-976-926-06
| | - Zalina Abu Zaid
- Department of Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Malaysia; (I.Y.P.); (Z.A.Z.)
| | - Amin Ismail
- Department of Nutrition, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Malaysia;
| | - Hasnah Haron
- Nutritional Science Programme, Centre of Healthy Ageing and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia;
| | - Nur Indrawaty Lipoeto
- Department of Nutrition Sciences, Faculty of Medicine, Andalas University, Padang, West Sumatera 25127, Indonesia;
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Rushton A, Young A, Keller H, Bauer J, Bell J. Delegation Opportunities for Malnutrition Care Activities to Dietitian Assistants-Findings of a Multi-Site Survey. Healthcare (Basel) 2021; 9:healthcare9040446. [PMID: 33920280 PMCID: PMC8068993 DOI: 10.3390/healthcare9040446] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 03/29/2021] [Accepted: 04/08/2021] [Indexed: 01/04/2023] Open
Abstract
Approximately one-third of adult inpatients are malnourished with substantial associated healthcare burden. Delegation frameworks facilitate improved nutrition care delivery and high-value healthcare. This study aimed to explore knowledge, attitudes, and practices of dietitians and dietitian assistants regarding delegation of malnutrition care activities. This multi-site study was nested within a nutrition care implementation program, conducted across Queensland (Australia) hospitals. A quantitative questionnaire was conducted across eight sites; 87 dietitians and 37 dietitian assistants responded and descriptive analyses completed. Dietitians felt guidelines to support delegation were inadequate (agreement: <50% for assessment/diagnosis, care coordination, education, and monitoring and evaluation); dietitian assistants perceived knowledge and guidelines to undertake delegated tasks were adequate (agreement: >50% food and nutrient delivery, education, and monitoring and evaluation). Dietitians and dietitian assistants reported confidence to delegate/receive delegation (dietitian agreement: >50% across all care components; dietitian assistant agreement: >50% for assessment/diagnosis, food and nutrient delivery, education, monitoring and evaluation). Practice of select nutrition care activities were routinely performed by dietitians, rather than assistants (p < 0.001 across all nutrition care components). The process for care delegation needs to be improved. Clarity around barriers and enablers to delegation of care prior to implementing reforms to the current models of care is key.
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Affiliation(s)
- Alita Rushton
- Department of Nutrition and Dietetics, The Prince Charles Hospital, Chermside, QLD 4032, Australia;
| | - Adrienne Young
- School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, QLD 4072, Australia; (A.Y.); (J.B.)
- Department of Nutrition and Dietetics, Royal Brisbane Women’s Hospital, Herston, QLD 4029, Australia
| | - Heather Keller
- Schlegel-University of Waterloo Research Institute for Aging, Waterloo, ON N2L 3G1, Canada;
| | - Judith Bauer
- School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, QLD 4072, Australia; (A.Y.); (J.B.)
| | - Jack Bell
- Department of Nutrition and Dietetics, The Prince Charles Hospital, Chermside, QLD 4032, Australia;
- School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, QLD 4072, Australia; (A.Y.); (J.B.)
- Correspondence: ; Tel.: +61-07-3139-6172
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Sastre LR, Van Horn LT. Family medicine physicians' report strong support, barriers and preferences for Registered Dietitian Nutritionist care in the primary care setting. Fam Pract 2021; 38:25-31. [PMID: 33020818 DOI: 10.1093/fampra/cmaa099] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Previous studies have examined barriers (e.g. time) for Family Medicine Providers (FMPs) to provide nutrition and lifestyle counseling, however, to date no studies have examined access or interest to Registered Dietitian Nutritionist (RDN) care for patients. OBJECTIVE The objective of this study was to explore FMP access, referral practices, barriers and preferences for RDN care. METHODS A cross-sectional online survey, with content and face validation was conducted with Family Medicine Departments within large academic health care systems in the Southeastern United States. The main variables of interest included: FMP access, interest, current referrals and referral preferences for RDN care, barriers to referrals and overall perceptions regarding RDN care. Descriptive analysis of close-ended responses was performed with SPSS 26.0. Open-ended responses were analysed using inductive content analysis. RESULTS Over half of the respondents (n = 151) did not have an RDN on-site (64%) yet were highly interested in integrating an RDN (94.9%), with reported preferences for full-time on-site, part-time on-site or off-site RDN care (49.1%, 39.5% and 11.4% respectively). The greatest reported barriers to RDN referrals were perceived cost for the patient (64.47%) and uncertainty how to find a local RDN (48.6%). The most consistent theme reported in the open-ended responses were concerns regarding reimbursement, e.g. 'Insurance does not cover all of the ways I would like to use an RDN'. CONCLUSIONS FMPs report interest and value in RDN services despite multiple perceived barriers accessing RDNs care. Opportunities exist for interprofessional collaboration between dietetic and FMP professional groups to address barriers.
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Affiliation(s)
- Lauren R Sastre
- Department of Nutrition Science, East Carolina University, Greenville, NC, USA
| | - Leslie T Van Horn
- Department of Human Nutrition, Winthrop University, Rock Hill, SC, USA
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Jacobs M, Harris J, Craven K, Sastre L. Sharing the 'weight' of obesity management in primary care: integration of registered dietitian nutritionists to provide intensive behavioural therapy for obesity for Medicare patients. Fam Pract 2021; 38:18-24. [PMID: 32076702 DOI: 10.1093/fampra/cmaa006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Clinical provision of intensive behavioral therapy for obesity (IBTO) has been a reimbursable treatment for obesity since 2012. However, gaps remain in the literature regarding its impact on patient outcomes. OBJECTIVES The primary objective of this study was to examine the integration of registered dietitian nutritionist provided IBTO into a primary care setting and evaluate clinic outcomes for Medicare Part B beneficiaries. A secondary objective was to examine intensity of IBTO (quantity of IBTO visits) versus clinical outcomes and influence of socioeconomic factors. METHODS A case-control retrospective chart review was conducted at a rural, Academic Family Medicine Clinic in Eastern North Carolina for patients seen between 1 January 2016 and 1 January 2019. In order to be included in the treatment group, patients had to be female, white or black race, have Medicare insurance and a body mass index ≥ 30 kg/m2. RESULTS Mixed model analysis showed statistically significant improvements in clinical outcomes from IBTO treatment. Weight decreased by nearly 3 pounds, while body mass index was half a point lower. A1C was 0.1 units lower for IBTO patients, and they took prescription medication and average of 6 days less than the control group. Minorities and older respondents experienced smaller, all else constant, and annual fixed effects suggest that differentials widen over time. CONCLUSIONS Registered dietitian nutritionist (RDN) provision of IBTO has demonstrated benefit in improving clinical outcomes including weight, A1C, and reduced medication duration (use) as demonstrated by the IBTO treatment group versus control. IBTO intensity was not predictive of success, and its impact was reduced with older and African American patients. IBTO is beneficial and can be delivered within the primary care setting by a RDN.
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Affiliation(s)
- Molly Jacobs
- Department of Health Services and Information Management, East Carolina University, Greenville, SC, USA
| | - Jordan Harris
- Department of Nutrition Science, East Carolina University, Greenville, SC, USA
| | - Kay Craven
- Department of Family Medicine, East Carolina University, Greenville, SC, USA
| | - Lauren Sastre
- Department of Nutrition Science, East Carolina University, Greenville, SC, USA
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25
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Rushton A, Edwards A, Bauer J, Bell JJ. Dietitian assistant opportunities within the nutrition care process for patients with or at risk of malnutrition: a systematic review. Nutr Diet 2021; 78:69-85. [PMID: 33416208 DOI: 10.1111/1747-0080.12651] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 11/06/2020] [Accepted: 11/10/2020] [Indexed: 12/12/2022]
Abstract
AIM Shifting to models of care that incorporate delegation of nutrition care process actions to dietitian assistants could facilitate effective and efficient nutrition care delivery. This review aimed to determine if delegation of malnutrition care activities to dietitian assistants, when compared with routine nutrition care practices influences patient, healthcare and/or workforce outcomes for adult hospital inpatients with or at risk of malnutrition. METHODS This review was undertaken in accordance with PRISMA guidelines, with five databases (CINAHL, Medline, PsycINFO, Embase and Scopus) searched systematically for studies published up to and including February 2020. Exclusion criteria included review articles and studies conducted in community settings. RESULTS The search yielded 3431 results, with 11 studies eligible for inclusion. Across all domains of the nutrition care process, there is emerging evidence dietitian assistants may improve the delivery of nutrition care practices, patient, healthcare and workforce outcomes. Findings demonstrated various roles and scope of dietitian assistants' practice throughout the studies. Positive patient outcomes were found when dietitian assistants were part of a multi-disciplinary model of care. CONCLUSIONS Implementing delegation of components of the nutrition care process to dietitian assistants is vital in the current health climate and should be considered in a future multidisciplinary model of nutrition care. Exploration of dietitian assistant roles and opportunities are required to expand and strengthen the evidence.
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Affiliation(s)
- Alita Rushton
- Department of Nutrition and Dietetics, The Prince Charles Hospital, Chermside, Queensland, Australia.,School of Human Movement and Nutrition Sciences, The University of Queensland, Saint Lucia, Queensland, Australia
| | - Anna Edwards
- School of Human Movement and Nutrition Sciences, The University of Queensland, Saint Lucia, Queensland, Australia
| | - Judith Bauer
- School of Human Movement and Nutrition Sciences, The University of Queensland, Saint Lucia, Queensland, Australia
| | - Jack J Bell
- Department of Nutrition and Dietetics, The Prince Charles Hospital, Chermside, Queensland, Australia.,School of Human Movement and Nutrition Sciences, The University of Queensland, Saint Lucia, Queensland, Australia
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26
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Rahmawati W, van der Pligt P, Worsley A, Willcox JC. Indonesian antenatal nutrition education: A qualitative study of healthcare professional views. Womens Health (Lond) 2021; 17:17455065211066077. [PMID: 34892998 PMCID: PMC8669879 DOI: 10.1177/17455065211066077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 11/11/2021] [Accepted: 11/22/2021] [Indexed: 11/15/2022]
Abstract
BACKGROUND Early lifestyle intervention, including antenatal nutrition education, is required to reduce the triple burden of malnutrition. Understanding healthcare professionals' views and experiences is essential for improving future nutrition education programmes for Indonesian pregnant women. This study aimed to investigate the views of Indonesian antenatal healthcare professionals regarding nutrition education for pregnant women and the improvements required to provide more effective antenatal nutrition education. METHODS A descriptive qualitative study involved semi-structured interviews was conducted with 24 healthcare professionals, including nutritionists (n = 10), midwives (n = 9) and obstetricians (n = 5) in Malang, Indonesia, between December 2018 and January 2019. Data were analysed using thematic analysis. RESULTS The study identified four main themes. First, healthcare professionals were aware of the importance of providing antenatal nutrition education, which included supporting its targeted delivery. Second, there were differing views on who should provide nutrition education. Most midwives and obstetricians viewed nutritionists as the prime nutrition education provider. Nutritionists were confident in their capability to provide nutrition education. However, some nutritionists reported that only a few women visited primary health centres and received nutrition counselling via this pathway. Third, healthcare professionals revealed some barriers in providing education for women. These barriers included a limited number of nutritionists, lack of consistent guidelines, lack of healthcare professionals' nutrition knowledge and lack of time during antenatal care services. Fourth, participants expressed the need to strengthen some system elements, including reinforcing collaboration, developing guidelines, and enhancing capacity building to improve future antenatal nutrition education. CONCLUSIONS Healthcare professionals play a central role in the provision of antenatal nutrition education. This study highlighted the importance of educational models that incorporate various antenatal nutrition education delivery strategies. These methods include maximizing referral systems and optimizing education through multiple delivery methods, from digital modes to traditional face-to-face nutrition education in pregnancy classes and community-based health services.
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Affiliation(s)
- Widya Rahmawati
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
- Department of Nutrition Science, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia
| | - Paige van der Pligt
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
| | - Anthony Worsley
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
| | - Jane C Willcox
- School of Allied Health, College of Science, Health and Engineering, La Trobe University, Bundoora, VIC, Australia
- Centre for Quality and Patient Safety Research–Epworth HealthCare Partnership, Institute of Health Transformation, School of Nursing & Midwifery, Deakin University, Burwood, VIC, Australia
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia
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27
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de Almeida GM, Recine E, Fagundes A. Objectives and Competencies in Food and Nutrition Education in the Brazilian Undergraduate Nutrition Program. J Nutr Educ Behav 2020; 52:385-393. [PMID: 31699618 DOI: 10.1016/j.jneb.2019.10.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 09/30/2019] [Accepted: 10/01/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To identify the objectives and competencies sought by the discipline of food and nutrition education (FNE) in the training of nutritionists. DESIGN A qualitative study, based on the Theory of Social Representations. SETTING A total of 381 Brazilian public and private higher education institutions with undergraduate courses in nutrition were invited to complete an online questionnaire. PARTICIPANTS A total of 104 professors of FNE participated in the study. ANALYSIS Qualitative analysis using the Discourse of the Collective Subject method and the Central Core Theory. RESULTS The FNE discipline aims to bring awareness to the importance of the promotion of health and food and nutrition security, to break with the biological and normative vision of food, to problematize the factors related to food, and to seek strategies of promoting healthy eating habits. In addition to preparing students for their role as educators, from planning to the evaluation of FNE actions, the intended competencies range from the development of criticality in educational practices to the application of appropriate pedagogical approaches. CONCLUSION The objectives of FNE and the desired competencies are articulated and involve, among others, preparing nutritionists for their role of educators.
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Affiliation(s)
- Géssica Mercia de Almeida
- Graduate Program in Human Nutrition, Nutrition Department, Faculty Health Sciences, University of Brasília, Brasília, Brazil; Faculty of Nutrition, Federal University of Goiás, Goiânia, Goiás, Brazil.
| | - Elisabetta Recine
- Graduate Program in Human Nutrition, Nutrition Department, Faculty Health Sciences, University of Brasília, Brasília, Brazil
| | - Andhressa Fagundes
- Graduate Program in Nutrition Sciences, Nutrition Department, Federal University of Sergipe, São Cristóvão, Sergipe, Brazil
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Kelly JT, Conley M, Hoffmann T, Craig JC, Tong A, Reidlinger DP, Reeves MM, Howard K, Krishnasamy R, Kurtkoti J, Palmer SC, Johnson DW, Campbell KL. A Coaching Program to Improve Dietary Intake of Patients with CKD: ENTICE-CKD. Clin J Am Soc Nephrol 2020; 15:330-340. [PMID: 32111701 PMCID: PMC7057309 DOI: 10.2215/cjn.12341019] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Accepted: 01/22/2020] [Indexed: 12/26/2022]
Abstract
BACKGROUND AND OBJECTIVES The dietary self-management of CKD is challenging. Telehealth interventions may provide an effective delivery method to facilitate sustained dietary change. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS This pilot, randomized, controlled trial evaluated secondary and exploratory outcomes after a dietitian-led telehealth coaching intervention to improve diet quality in people with stage 3-4 CKD. The intervention group received phone calls every 2 weeks for 3 months (with concurrent, tailored text messages for 3 months), followed by 3 months of tailored text messages without telephone coaching, to encourage a diet consistent with CKD guidelines. The control group received usual care for 3 months, followed by nontailored, educational text messages for 3 months. RESULTS Eighty participants (64% male), aged 62±12 years, were randomized to the intervention or control group. Telehealth coaching was safe, with no adverse events or changes to serum biochemistry at any time point. At 3 months, the telehealth intervention, compared with the control, had no detectable effect on overall diet quality on the Alternative Health Eating Index (3.2 points, 95% confidence interval, -1.3 to 7.7), nor at 6 months (0.5 points, 95% confidence interval, -4.6 to 5.5). There was no change in clinic BP at any time point in any group. There were significant improvements in several exploratory diet and clinical outcomes, including core food group consumption, vegetable servings, fiber intake, and body weight. CONCLUSIONS Telehealth coaching was safe, but appeared to have no effect on the Alternative Healthy Eating Index or clinic BP. There were clinically significant changes in several exploratory diet and clinical outcomes, which require further investigation. CLINICAL TRIAL REGISTRY NAME AND REGISTRATION NUMBER Evaluation of Individualized Telehealth Intensive Coaching to Promote Healthy Eating and Lifestyle in CKD (ENTICE-CKD), ACTRN12616001212448.
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Affiliation(s)
- Jaimon T Kelly
- Faculty of Health Science and Medicine and .,Menzies Health Institute, Griffith University, Brisbane, Queensland, Australia
| | | | - Tammy Hoffmann
- Centre for Research in Evidence Based Practice, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Jonathan C Craig
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
| | - Allison Tong
- School of Public Health, The University of Sydney, Sydney, New South Wales, Australia.,Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | | | | | - Kirsten Howard
- School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Rathika Krishnasamy
- Department of Nephrology, Sunshine Coast University Hospital, Birtinya, Queensland, Australia.,Centre for Kidney Disease Research, University of Queensland, Brisbane, Queensland, Australia
| | - Jagadeesh Kurtkoti
- Department of Renal Medicine, Gold Coast University Hospital, Southport, Queensland, Australia.,School of Medicine and
| | - Suetonia C Palmer
- Department of Medicine, University of Otago Christchurch, Christchurch, New Zealand; and
| | - David W Johnson
- Centre for Kidney Disease Research, University of Queensland, Brisbane, Queensland, Australia.,Department of Nephrology, Princess Alexandra Hospital, Brisbane, Queensland, Australia.,Translational Research Institute, Brisbane, Queensland, Australia
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Gooding B, Probst Y, Houston L, Neale E. Exploring perceptions, barriers and use of systematic reviews amongst nutrition professionals and nutrition students. Nutr Diet 2019; 77:151-159. [PMID: 31854509 DOI: 10.1111/1747-0080.12598] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 10/27/2019] [Accepted: 11/01/2019] [Indexed: 12/01/2022]
Abstract
AIM Systematic reviews (SRs) are a core component of evidence-based practice and are widely used in developing nutrition policy. This study aimed to examine nutrition professionals and students' perceptions, barriers and use of SRs. A secondary aim was to examine confidence using and conducting SRs. METHODS A self-administered online survey was developed, pilot-tested and implemented via SurveyMonkey. The survey consisted of 29 items separated into demographics, perceptions, use, and knowledge of SRs, confidence in using and conducting SRs, and barriers to use and conduct of SRs. The survey was disseminated via professional newsletters and social media. RESULTS Ninety-four nutrition professionals/students completed the survey. Survey results indicated respondents valued SRs, with SRs used most commonly to update knowledge. While most respondents (67%) were confident in using SRs, many (59%) expressed a lack of confidence in conducting a SR. In particular, few respondents (12%) reported confidence in conducting meta-analyses. The majority of respondents were aware that SRs underpinned guidelines and nutrition resources, however, few (21%) respondents identified that self-substantiation of health claims were based on SRs. Time, access to scientific database, lack of workplace support and confidence were the main barriers to SRs use. CONCLUSIONS SRs were reported as being valued by nutrition professionals and students, though time constraints, a lack of confidence and organisations which did not prioritise research were barriers to conducting SRs. The findings of this survey highlight a need for training and education as potential strategies to promote SR engagement in nutrition professionals and students.
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Affiliation(s)
- Bethany Gooding
- School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
| | - Yasmine Probst
- School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia.,Illawarra Health and Medical Research Institute, Wollongong, New South Wales, Australia
| | - Lauren Houston
- School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia.,Illawarra Health and Medical Research Institute, Wollongong, New South Wales, Australia
| | - Elizabeth Neale
- School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia.,Illawarra Health and Medical Research Institute, Wollongong, New South Wales, Australia
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Forsgård RA. Lactose digestion in humans: intestinal lactase appears to be constitutive whereas the colonic microbiome is adaptable. Am J Clin Nutr 2019; 110:273-279. [PMID: 31175813 PMCID: PMC6669050 DOI: 10.1093/ajcn/nqz104] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Accepted: 05/02/2019] [Indexed: 01/21/2023] Open
Abstract
Globally, ∼70% of adults are deficient in intestinal lactase, the enzyme required for the digestion of lactose. In these individuals, the consumption of lactose-containing milk and dairy products can lead to the development of various gastrointestinal (GI) symptoms. The primary solution to lactose intolerance is withdrawing lactose from the diet either by eliminating dairy products altogether or substituting lactose-free alternatives. However, studies have shown that certain individuals erroneously attribute their GI symptoms to lactose and thus prefer to consume lactose-free products. This has raised the question whether consuming lactose-free products reduces an individual's ability to absorb dietary lactose and if lactose-absorbers should thus avoid these products. This review summarizes the current knowledge regarding the acclimatization of lactose processing in humans. Human studies that have attempted to induce intestinal lactase expression with different lactose feeding protocols have consistently shown lack of enzyme induction. Similarly, withdrawing lactose from the diet does not reduce intestinal lactase expression. Evidence from cross-sectional studies shows that milk or dairy consumption is a poor indicator of lactase status, corroborating the results of intervention studies. However, in lactase-deficient individuals, lactose feeding supports the growth of lactose-digesting bacteria in the colon, which enhances colonic lactose processing and possibly results in the reduction of intolerance symptoms. This process is referred to as colonic adaptation. In conclusion, endogenous lactase expression does not depend on the presence of dietary lactose, but in susceptible individuals, dietary lactose might improve intolerance symptoms via colonic adaptation. For these individuals, lactose withdrawal results in the loss of colonic adaptation, which might lower the threshold for intolerance symptoms if lactose is reintroduced into the diet.
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Affiliation(s)
- Richard A Forsgård
- Pharmacology, Faculty of Medicine, University of Helsinki, Helsinki, Finland,Nutrition-Gut-Brain Interactions Research Centre, Faculty of Health and Medicine, School of Medical Sciences, Örebro University, Örebro, Sweden,Address correspondence to RAF (e-mail: )
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Rodrigo L, Pérez-Martinez I, Lauret-Braña E, Suárez-González A. Descriptive Study of the Different Tools Used to Evaluate the Adherence to a Gluten-Free Diet in Celiac Disease Patients. Nutrients 2018; 10:nu10111777. [PMID: 30453479 PMCID: PMC6267102 DOI: 10.3390/nu10111777] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 11/07/2018] [Accepted: 11/14/2018] [Indexed: 12/12/2022] Open
Abstract
Celiac disease (CD) is a genetically conditioned autoimmune process that appears in susceptible people. It can affect people of any age, and slightly predominates in females. It has a fairly homogenous global distribution, with an average prevalence of 1⁻2%, the frequency having increased in recent decades. The only effective treatment is a strict and permanent gluten-free diet (GFD), although the level of compliance is poor, at about 50% of cases. To monitor the effectiveness of the GFD, several procedures involving various approaches are employed: (a) Periodic visits by expert Nutritionists; (b) Clinical follow-up; (c) Serological time controls of specific antibodies; (d) Serial endoscopies with collection of duodenal biopsies; (e) Use of structured questionnaires; and (f) Determination of gluten peptides derived from gluten in faeces and/or urine. All of these procedures are useful when applied, alone or in combination, depending on the cases. Some patients will only need to consult to their doctors, while others will require a multidisciplinary approach to assess their compliance with the GFD. In children, normalization of duodenal mucosa was achieved in 95% of cases within two years, while it is more delayed in adults, whose mucosa take longer time (3⁻5 years) to heal completely.
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Affiliation(s)
- Luis Rodrigo
- Gastroenterology Unit, Hospital Universitario Central de Asturias (HUCA), CSIC, Avda. de Roma s/n, 33011 Oviedo, Spain.
| | - Isabel Pérez-Martinez
- Gastroenterology Unit, Hospital Universitario Central de Asturias (HUCA), CSIC, Avda. de Roma s/n, 33011 Oviedo, Spain.
| | - Eugenia Lauret-Braña
- Gastroenterology Unit, Hospital Universitario Central de Asturias (HUCA), CSIC, Avda. de Roma s/n, 33011 Oviedo, Spain.
| | - Adolfo Suárez-González
- Gastroenterology Unit, Hospital Universitario Central de Asturias (HUCA), CSIC, Avda. de Roma s/n, 33011 Oviedo, Spain.
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Timon CM, Cooper SE, Barker ME, Astell AJ, Adlam T, Hwang F, Williams EA. A Comparison of Food Portion Size Estimation by Older Adults, Young Adults and Nutritionists. J Nutr Health Aging 2018; 22:230-236. [PMID: 29380850 DOI: 10.1007/s12603-017-0937-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVES To investigate the ability of older adults, younger adults and nutritionists to assess portion size using traditional methods versus a computer-based method. This was to inform the development of a novel dietary assessment method for older adults "The NANA system". DESIGN Older and younger adults assessed the portion size of self-served portions of foods from a buffet style set up using traditional and computerised portion size assessment aids. Nutritionists assessed the portion size of foods from digital photographs using computerised portion size aids. These estimates were compared to known weights of foods using univariate analyses of covariance (ANCOVA). SETTING The University of Sheffield, United Kingdom. SUBJECTS Forty older adults (aged 65 years and over), 41 younger adults (aged between 18 and 40 years) and 25 nutritionists. RESULTS There was little difference in the abilities of older and younger adults to assess portion size using both assessment aids with the exception of small pieces morphology. Even though the methods were not directly comparable among the test groups, there was less variability in portion size estimates made by the nutritionists. CONCLUSION Older adults and younger adults are similar in their ability to assess food portion size and demonstrate wide variability of estimation compared to the ability of nutritionists to estimate portion size from photographs. The results suggest that the use of photographs of meals consumed for portion size assessment by a nutritionist may improve the accuracy of dietary assessment. Improved portion size assessment aids are required for all age groups.
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Affiliation(s)
- C M Timon
- Claire Marie Timon, Room S2.58 Institute of Food and Health, Science Centre South, University College Dublin, Belfield, Dublin 4, Ireland, , Phone: 0035317162442, Fax: 003531716 6104
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Abstract
Type 1 and type 2 diabetes are complex, chronic diseases that are best managed by a multidisciplinary care team. Type 1 diabetes is most commonly diagnosed in the pediatric population, although the prevalence of type 2 diabetes in youth is increasing rapidly. A registered dietitian (RD) is a critical member of the diabetes team who provides focused nutrition education from diagnosis and throughout routine follow-up care. Specifically in the pediatric population, the RD also assesses growth and development, as well as eating behaviors, food choices and meal patterns. Based on a review of research, ongoing support from an RD improves glycemic control and delays onset of diabetes complications. In addition, dietitian-led nutrition education helps better manage lipid levels and aids in weight management. A sample model describing RD involvement in a pediatric diabetes care team is discussed in further detail.
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Affiliation(s)
- Tracie J Steinke
- Section of Endocrinology, Nationwide Children's Hospital, Columbus, OH, USA
| | - Elena L O'Callahan
- Section of Endocrinology, Nationwide Children's Hospital, Columbus, OH, USA
| | - Jennifer L York
- Section of Endocrinology, Nationwide Children's Hospital, Columbus, OH, USA
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Hunt K, Stiller K. Dietetic and educational interventions improve clinical outcomes of diabetic and obese clients with mental impairment. Nutr Diet 2017; 74:236-242. [PMID: 28731608 DOI: 10.1111/1747-0080.12340] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Revised: 11/27/2016] [Accepted: 12/03/2016] [Indexed: 12/13/2022]
Abstract
AIM The aim of this study was to evaluate the effect of dietetic and educational interventions provided to clients with type 2 diabetes (with or without obesity) or obesity-only residing in supported residential facilities and characterised by mental impairment. METHODS A retrospective audit involving the retrieval of information from medical records and databases was undertaken to evaluate the effect of dietetic and educational interventions. Clinical outcomes were weight, body mass index and glycosylated haemoglobin (HbA1c) levels. RESULTS A total of 91 clients were included, 47 with type 2 diabetes (with or without obesity) and 44 with obesity-only. All but one had schizophrenia, an intellectual disability or another psychological condition. After interventions, the diabetic subgroup demonstrated significant decreases in weight (mean [SD] initial = 101.5 [20.7], final = 97.8 [20.6] kg, P = 0.001) and body mass index (mean [SD] initial = 35.8 [8.1], final = 34.4 [7.8] kg/m2 , P = 0.001) and a non-significant decrease in HbA1c over time. The obesity-only subgroup showed no significant change in outcomes. Factors significantly negatively impacting at least one outcome included the presence of schizophrenia (P ≤ 0.017) and refusal of intervention(s) (P ≤ 0.048), whereas a significant positive impact was seen for a greater total number of visits to a dietitian or diabetes educator (P ≤ 0.024). CONCLUSIONS These results provide evidence to support the effectiveness of dietetic and educational interventions for this vulnerable client group.
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Affiliation(s)
- Kerri Hunt
- Supported Residential Facilities Health Access Team, Sefton Park Primary Health Care Services, Central Adelaide Local Health Network, Adelaide, South Australia, Australia
| | - Kathy Stiller
- Central Adelaide Local Health Network, Royal Adelaide Hospital, Adelaide, South Australia, Australia
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Theurich MA, McCool ME. Moving National Breastfeeding Policies into Practice: A Plea to Integrate Lactation Education and Training into Nutrition and Dietetics Programs in the United States. J Hum Lact 2016; 32:563-7. [PMID: 27280979 DOI: 10.1177/0890334416652596] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Accepted: 05/09/2016] [Indexed: 11/16/2022]
Abstract
In 2011, the Surgeon General's Call to Action to Support Breastfeeding called on all health professional organizations, medical schools, and credentialing boards to establish and incorporate minimum lactation education and training requirements into their credentialing, licensing, and certification processes and to include breastfeeding education in undergraduate and graduate education and training programs. Given the commonalities between the fields of nutrition and breastfeeding, it has been proposed that nutrition professionals are an underutilized resource in the field of lactation management. Considering the lack of breastfeeding knowledge and skills among health professionals, nutrition professionals should be afforded opportunities to learn lactation management during their studies. The United States Breastfeeding Committee published Core Competencies in Breastfeeding Care and Services for All Health Professionals in 2010. However, professional nutrition and lactation credentialing boards should cooperate to integrate mandatory minimum standards of lactation education for nutrition professionals. Undergraduate and graduate programs in nutrition and dietetics should incorporate lactation content into their core curricula to comply with such standards. In addition, dietetics programs should offer optional clinical lactation experiences for students who aspire to become an International Board Certified Lactation Consultant.
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Affiliation(s)
- Melissa Ann Theurich
- Dr von Hauner Children's Hospital, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - Megan Elizabeth McCool
- University of Regensburg, Department of Epidemiology and Preventive Medicine, Regensburg, Germany
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Davies VF, Kupek E, de Assis MA, Engel R, da Costa FF, Di Pietro PF, Natal S, Thompson D, Baranowski T. Qualitative analysis of the contributions of nutritionists to the development of an online instrument for monitoring the food intake of schoolchildren. J Hum Nutr Diet 2014; 28 Suppl 1:65-72. [PMID: 24480047 DOI: 10.1111/jhn.12209] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND The Consumo Alimentar e Atividade Fisica de Escolares (CAAFE) questionnaire is an online research tool that has been developed to enable the self-report of physical activity and diet by Brazilian schoolchildren aged 7-10 years. Formative research was conducted with nutritionists during the development of the web-based questionnaire. The suggestions and insights obtained were used to design a tool to monitor schoolchildren's food consumption based on the concept of healthy and unhealthy food indicators. The present study aimed to report the focus group discussions conducted with nutritionists concerning the CAAFE questionnaire. METHODS Focus group discussions were conducted using a semi-structured questionnaire, and these were then analysed thematically. RESULTS Twenty-four nutritionists participated (four focus groups; average per group: six people); the majority (n = 22) had experience with 7-10-year-old children. Four themes emerged: (i) healthy and unhealthy food indicators; (ii) suggestions for the online instrument; (iii) potential applications; and (iv) challenges for its construction. CONCLUSIONS Comments made by nutritionists enabled the construction of an instrument that is able to answer questions related to food consumption in schools and at home.
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Affiliation(s)
- V F Davies
- Graduate Program in Public Health, Center for Health Sciences at The Federal University of Santa, Santa Catarina, Brazil
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