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Journal of Human Nutrition and... Aug 2023Exact quantification of research conducted by dietitians and tracking the effectiveness of interventions or training programs to increase either evidence-based practice... (Review)
Review
BACKGROUND
Exact quantification of research conducted by dietitians and tracking the effectiveness of interventions or training programs to increase either evidence-based practice (EBP) or research behaviours have been hampered by the variety of tools used to measure these constructs.
METHODS
In this narrative review, we identified and classified the various tools previously used to measure constructs related to research and/or EBP in the dietetics profession, and to summarise estimates of the constructs measured.
RESULTS
We identified and classified 15 scored tools that had been used at least once in the dietetics profession and extracted tool parameter estimates from 22 resulting papers. We also identified six unscored tools and three qualitative studies. The most frequent constructs measured were attitudes and behaviours. Very few tools measured objective knowledge (skills). No objective measures of research outputs were identified. Several tools were closely related to one another.
CONCLUSIONS
Even when tools were used across multiple papers, reporting method varied making comparisons difficult. This review should encourage future researchers to utilise existing tools when possible, and encourage the development or adaptation and testing of tools that fill identified gaps. The constructs measured by the tools identified may also provide a starting point for the development of educational interventions aiming to increase research or EBP skills among dietitians. Only by using consistent tools will the dietetics profession be able to track the progress in increasing research conduct and EBP implementation over time.
Topics: Humans; Dietetics; Evidence-Based Practice; Nutritionists; Qualitative Research
PubMed: 36325998
DOI: 10.1111/jhn.13112 -
Canadian Journal of Dietetic Practice... Jun 2021Dysphagia affects up to 35% of older adults living in the community and is considered a significant risk factor for malnutrition and aspiration. Early intervention is...
Dysphagia affects up to 35% of older adults living in the community and is considered a significant risk factor for malnutrition and aspiration. Early intervention is important, yet dietitian referrals for dysphagia management in primary care are disproportionately low considering the prevalence of dysphagia and its risk factors. As little is known about dietitian's current dysphagia identification and assessment practices in Canada, an online survey was developed. Registered dietitians practicing in primary care were invited to participate. Of the 70 surveys completed, nearly 75% do not have a dysphagia screening process where they practice, and only 8% reported performing noninstrumental, clinical swallowing assessment (CSA). Lack of competency or skills required to complete dysphagia screening and assessment was the most reported barrier. Many respondents were unsure or did not believe CSA fell within their scope of practice, and over 70% reported needing hands-on dysphagia screening and assessment training. Current practices in primary care could be placing individuals with dysphagia, and those at risk, in jeopardy of being overlooked. Initiatives to increase dysphagia awareness, create screening processes, and increase awareness of dietitian's scope of practice are needed to enable primary care dietitians to develop competency in dysphagia screening and assessment.
Topics: Aged; Canada; Deglutition; Deglutition Disorders; Humans; Nutritionists; Primary Health Care
PubMed: 33876997
DOI: 10.3148/cjdpr-2021-002 -
Journal of Nutritional Science and... 2022The Tokyo 2020 Olympics and Paralympics finished on 5 November 2021. A total of 870,000 meals were provided in the main dining facility during the events. Sports...
The Tokyo 2020 Olympics and Paralympics finished on 5 November 2021. A total of 870,000 meals were provided in the main dining facility during the events. Sports nutrition research in Japan began before the previous Tokyo Olympics, which was held in 1964. A book about sports nutrition in Japan had already been published, in 1949. A number of previous studies have examined nutrition among Olympic athletes, and influential research on sports nutrition in Japan includes a series of studies on sports anemia. This series covered basic research into the mechanisms of sports anemia through to the prevention of sports anemia. However, anemia among athletes remains an important issue. In Japan, an accreditation system for sports dietitians was established in 2007, and a scientific association for sports nutrition was established in 2004. However, the connection between basic research and practice remains a substantial problem.
Topics: Humans; Japan; Sports; Athletes; Nutritionists; Nutritional Status
PubMed: 36437031
DOI: 10.3177/jnsv.68.S89 -
Journal of the Academy of Nutrition and... Sep 2022Awareness of the social determinants of health has been increasing in recent years. These include equitable access to health care and foods that support healthy eating...
Academy of Nutrition and Dietetics: Revised 2022 Standards of Practice and Standards of Professional Performance for Registered Dietitian Nutritionists (Competent, Proficient, and Expert) in Public Health and Community Nutrition.
Awareness of the social determinants of health has been increasing in recent years. These include equitable access to health care and foods that support healthy eating patterns. A wide range of issues related to these determinants influence practice in the public health and community nutrition field. In response to these evolving needs, the Public Health and Community Nutrition Dietetic Practice Group, with guidance from the Academy of Nutrition and Dietetics Quality Management Committee, has developed Standards of Practice and Standards of Professional Performance as a tool for Registered Dietitian Nutritionist (RDNs) currently in practice or interested in working in public health and community nutrition, to assess their current skill levels and to identify areas for professional development. The Standards of Practice address the four steps of the Nutrition Care Process for community and public health RDNs: assessment, diagnosis, intervention, and evaluation/monitoring. The Standards of Professional Performance consists of six domains of professional performance for community and public health RDNs: Quality in Practice, Competence and Accountability, Provision of Services, Application of Research, Communication and Application of Knowledge, and Utilization and Management of Resources. Within each standard, specific indicators provide measurable action statements that illustrate the ways in which RDNs can address population nutrition and health. The indicators describe three skill levels (Competent, Proficient, and Expert) for RDNs. These tools highlight the unique scope of expertise that RDNs provide to the field of public health and community nutrition.
Topics: Academies and Institutes; Clinical Competence; Dietetics; Humans; Nutritionists; Public Health
PubMed: 35988945
DOI: 10.1016/j.jand.2022.04.005 -
Journal of the Academy of Nutrition and... Sep 2020Current systems of food production and consumption are challenged by factors such as natural resource constraints, relative unaffordability of nutrient-dense foods,...
Academy of Nutrition and Dietetics: Revised 2020 Standards of Professional Performance for Registered Dietitian Nutritionists (Competent, Proficient, and Expert) in Sustainable, Resilient, and Healthy Food and Water Systems.
Current systems of food production and consumption are challenged by factors such as natural resource constraints, relative unaffordability of nutrient-dense foods, persistent social inequities, and high rates of diet-related disease. Registered dietitian nutritionists (RDNs) play a critical role in protecting the health of current and future populations by advancing sustainable, resilient, and healthy food and water systems. By definition, such systems can meet current dietary needs without jeopardizing the ability to meet the needs of future generations; can withstand or adapt to disturbances over time; and can equitably facilitate disease prevention and well-being for all individuals. This area of practice within nutrition and dietetics requires recognition of the complex interrelationships among indiviudal health and economic, environmental, and social domains of food and nutrition, and allows RDNs to bring unique expertise to diverse interprofessional teams. The Revised 2020 Standards of Professional Performance for RDNs (Competent, Proficient, and Expert) in Sustainable, Resilient, and Healthy Food and Water Systems update the 2014 standards and cover the following 6 standards of professional performance: Quality in Practice, Competence and Accountability, Provision of Services, Application of Research, Communication and Application of Knowledge, and Utilization and Management of Resources. Within each standard, specific indicators provide measurable action statements that illustrate how the RDN can apply the principles of sustainable food systems to a variety of practice settings. The indicators describe 3 skill levels (ie, competent, proficient, and expert) for RDNs in this focus area.
Topics: Academies and Institutes; Clinical Competence; Conservation of Natural Resources; Dietetics; Food Supply; Humans; Nutritionists; Practice Guidelines as Topic; Sustainable Development; Water Supply
PubMed: 32829776
DOI: 10.1016/j.jand.2020.05.010 -
Public Health Nutrition Jun 2018Noting the upstream positioning of sustainable food systems (SFS) to multiple global crises, the present review described examples of emerging and promising practices to... (Review)
Review
Education, practical training and professional development for public health practitioners: a scoping review of the literature and insights for sustainable food system capacity-building.
OBJECTIVE
Noting the upstream positioning of sustainable food systems (SFS) to multiple global crises, the present review described examples of emerging and promising practices to support SFS-oriented education, practical training (PT) and continuing professional development (CPD) among trainees and public health practitioners (PHP). A secondary objective was to compile the evidence into practical considerations for educators, supervising practitioners and professional associations.
DESIGN
A scoping review of the literature published between 2007 and 2017 was conducted in May 2017 using four databases: CINAHL, MEDLINE, Scopus and HSSA, along with bibliography hand-searching and expert consultation. Articles were screened for relevance and specificity by independent raters.
RESULTS
Nineteen articles were included for analysis. Two-thirds of the articles related to dietitians and public health nutritionists. Emerging practices included curriculum-based considerations, incorporation of 'sustainability' within professional competencies and self-reflection related to SFS. Descriptions of SFS-related education, PT and CPD practices appeared largely in the literature from developed countries. Articles converged on the need for ecosystems, food systems and sustainability considerations within and across practice to support current and future practitioners.
CONCLUSIONS
There is growing interest in SFS but guidance to support educators and preceptors is lacking. Updates to dietary guidelines to reflect issues of sustainability are a timely prompt to examine the education, training and development needs of trainees and PHP. Practical examples of emerging practices can empower PHP to promote SFS in all areas of practice. More research is needed to address identified gaps in the literature and to improve SFS-specific education, PT and CPD.
Topics: Capacity Building; Curriculum; Food Supply; Humans; Nutritionists; Professional Competence; Public Health; Sustainable Development
PubMed: 29433593
DOI: 10.1017/S1368980017004207 -
Journal of Human Nutrition and... Jun 2022
Topics: Humans; Dietetics; Gastrointestinal Diseases; Nutritionists; Surveys and Questionnaires; Randomized Controlled Trials as Topic
PubMed: 35578390
DOI: 10.1111/jhn.13010 -
Nutrition & Dietetics: the Journal of... Nov 2020Meaningful client-dietitian relationships are central to effective dietetic practice. The chronic disease management setting provides an opportunity to examine what is...
AIM
Meaningful client-dietitian relationships are central to effective dietetic practice. The chronic disease management setting provides an opportunity to examine what is meaningful and how these relationships are constructed, because the dietitian and client generally have multiple interactions over an extended period of time. This study aimed to explore dietitians' perspectives of how they develop meaningful relationships with clients managing lifestyle-related chronic diseases.
METHODS
Study design and analysis were guided by Charmaz's constructivist grounded theory. Dietitians working in Australia with clients managing chronic diseases were recruited through initial, snowball and theoretical sampling. Online videoconference and telephone semi-structured interviews were conducted. Recorded interview transcripts were analysed using repeated reviews comprising initial, focused and theoretical coding and memoing.
RESULTS
Twenty-two dietitians were recruited. A conceptual model developed from the data showed the dietitian's role in developing the client-dietitian relationship is complex. Key elements were identified and described as 'Sensing a Professional Chemistry', and the dietitian's skills in 'Balancing Professional and Social Relationships' and 'Managing Tension with Competing Influences'. Influences were categorised as relating to the client and dietitian as individuals (eg, their values), their support network and external contextual factors (eg, working with interpreters).
CONCLUSION
Developing relationships with clients in the chronic disease context appears complex due to the dietitian's role of managing multiple interrelated elements and influential factors simultaneously. To deepen understanding, research should explore clients' perspectives of relationship development and how knowledge of practitioner-client relationships in other disciplines may be utilised to enhance dietetic service delivery.
Topics: Australia; Chronic Disease; Dietary Services; Dietetics; Humans; Nutritionists
PubMed: 31659826
DOI: 10.1111/1747-0080.12588 -
Journal of the Academy of Nutrition and... Jun 2021Management of food and nutrition systems (MFNS) encompasses the varied roles of registered dietitian nutritionists (RDNs) with administrative responsibilities for food...
Academy of Nutrition and Dietetics: Revised 2021 Standards of Professional Performance for Registered Dietitian Nutritionists (Competent, Proficient, and Expert) in Management of Food and Nutrition Systems.
Management of food and nutrition systems (MFNS) encompasses the varied roles of registered dietitian nutritionists (RDNs) with administrative responsibilities for food and nutrition services within an organization. RDNs in MFNS are frequently employed in acute care, but also expand into a multitude of other settings in which management of nutrition and foodservice is required, for example, foodservice departments in assisted living and post-acute and long-term care; colleges and universities, kindergarten through grade 12 and pre-kindergarten schools and childcare; retail foodservice operations; correctional facilities; and companies that produce, distribute, and sell food products. RDNs in MFNS aim to create work environments that support high-quality customer-centered care and services, attract and retain talented staff, and foster an atmosphere of collaboration and innovation. The Management in Food and Nutrition Systems Dietetic Practice Group, with guidance from the Academy of Nutrition and Dietetics Quality Management Committee, has revised the Standards of Professional Performance (SOPP) for RDNs in MFNS for 3 levels of practice: competent, proficient, and expert. The SOPP describes 6 domains that focus on professional performance: Quality in Practice, Competence and Accountability, Provision of Services, Application of Research, Communication and Application of Knowledge, and Utilization and Management of Resources. Indicators outlined in the SOPP depict how these standards apply to practice. The standards and indicators for RDNs in MFNS are written with the leader in mind-to support an individual in a leadership role or who has leadership aspirations. The SOPP is intended to be used by RDNs for self-evaluation to assure competent professional practice.
Topics: Academies and Institutes; Dietary Services; Dietetics; Food Services; Humans; Nutritionists; Practice Guidelines as Topic; Practice Management; Professional Competence; Quality of Health Care; Scope of Practice; Societies
PubMed: 34874011
DOI: 10.1016/j.jand.2021.02.007 -
Journal of Human Nutrition and... Oct 2023Expanding the primary care workforce to alleviate general practitioner (GP) workload, improve access and improve quality of care is a current UK strategy. Evidence...
BACKGROUND
Expanding the primary care workforce to alleviate general practitioner (GP) workload, improve access and improve quality of care is a current UK strategy. Evidence suggests dietitians can improve patient outcomes and make cost savings. The present study aimed to evaluate a dietitian working as an expert generalist and first contact practitioner (FCP) in a general practice multi-disciplinary team (MDT) to provide appropriate care to patients and reduce GP workload.
METHODS
A dietitian was employed for 6 months at 0.6 full-time equivalents in a group of general practices in Devon, UK. Data were collected on the referral source, patient satisfaction, health outcomes and changes in prescribing data for all patients seen by the dietitian. Focus groups and interviews provided data to understand the experience of introducing a dietitian into the team.
RESULTS
This model of service delivery showed the dietitian acting as an expert generalist, a FCP and able to educate the MDT. A range of professionals within the MDT referred patients with a wide range of diagnoses (both paediatric and adults) and the dietitian acted as a FCP for 29% of patients. Saving were made for the optimisation of medicine management.
CONCLUSIONS
The dietitian can improve patient-centred care for several patient groups; enhance learning for staff around nutrition and dietary issues; and contribute to more efficient working and cost savings around prescription of nutritional products. This was an evaluation of one service and further research is needed to understand the value dietitians can contribute and the factors supporting effective and efficient working in this context.
Topics: Adult; Humans; Child; Nutritionists; Nutritional Status; Diet; Workforce; Patient-Centered Care; Dietetics
PubMed: 37526210
DOI: 10.1111/jhn.13217