An Evidence-based Approach to Developing the Collaborative, Client-Centred Nutrition Education (3CNE) Framework and Practice Points

Publication: Canadian Journal of Dietetic Practice and Research
26 February 2016

Abstract

Purpose: The purpose of this, the third phase of a 3-phase research project, was to develop guidelines for client-centred nutrition education (NE).
Methods: A 3-phase study was conducted using a progressive development design, where each phase informed the subsequent phase. Phase 1 was a national online survey of dietitians’ perceptions of consumers’ NE needs and preferences; results informed the Phase 2 national online survey of consumers about their NE needs and preferences. Phase 3 involved national 2-part teleconference consultations with dietitians to discuss implications of the Phase 2 findings for NE practice. This paper is the report of Phase 3.
Results: Discussion group participants were 22 dietitians from around Canada who had been in practice for an average of 14.5 years. Discussions resulted in the development of the Collaborative Client-Centred Nutrition Education (3CNE) conceptual framework and related Practice Points that explicate the complexity of NE practice.
Conclusion: The 3CNE framework and Practice Points provide a means to inform precepting students and interns, and for use in planning for the professional development of practicing dietitians on providing client-centred NE.

Résumé

Objectif. L'objectif de la troisième et dernière phase de ce projet de recherche était d'élaborer des lignes directrices pour l'éducation à la nutrition axée sur le client.
Méthodes. Une étude en trois phases a été menée à l'aide d'une méthodologie progressive, dans le cadre de laquelle chaque phase orientait la phase subséquente. La phase 1 consistait en une enquête en ligne menée à l'échelle nationale sur la perception des diététistes à l'égard des besoins et des préférences en matière d'éducation à la nutrition des consommateurs. Les résultats de cette enquête ont orienté l'enquête en ligne à l'échelle nationale de la phase 2 menée auprès des consommateurs au sujet de leurs besoins et de leurs préférences en matière d'éducation à la nutrition. La phase 3 consistait en des consultations par téléconférence menées en deux parties à l'échelle nationale avec des diététistes afin de discuter des répercussions des résultats de la phase 2 sur la pratique relative à l'éducation à la nutrition. Ce document est le rapport de la phase 3.
Résultats. Vingt-deux diététistes de partout au Canada pratiquant depuis en moyenne 14,5 ans ont participé au groupe de discussion. Les discussions ont mené à l'élaboration du cadre conceptuel collaboratif de l'éducation à la nutrition axée sur le client (3CNE) et de points de pratique connexes qui expliquent la complexité de la pratique d'éducation à la nutrition.
Conclusion. Le cadre 3CNE et les points de pratique sont un moyen d'orienter le préceptorat des étudiants et internes, et contribuent à la planification du développement professionnel des diététistes praticiens en matière d'éducation à la nutrition axée sur le client.

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References

1
Frank A. At the will of the body. New York, NY: Houghton Mifflin; 1991.
2
Wilber K. Grace and grit: spirituality and healing in the life and death of Treya Killam Wilber. Boston, MA: Shambhala Publishing; 1992.
3
Bolen JS. Close to the bone: life-threatening illness and the search for meaning. New York: Touchstone; 1996.
4
Neufeldt A, McGinley P. Human spirituality in relation to quality of life. In: Brown R, ed. Quality of life for people with disabilities: models, research and practice. 2nd ed. Cheltenham: Stanley Thornes; 1997. p. 292–309.
5
Larsson M, Hedelin B, and Athlin E Lived experiences of eating problems for patients with head and neck cancer during radiotherapy J Clin Nurs. 2003 12 4 562 -70
6
Morley C. Women's experiences of eating with changed health status. Doctoral dissertation. University of Calgary; 2002.
7
Conner M, Norman P. (eds.). Predicting health behaviour. 2nd ed. London: Open University Press; 2005.
8
Contento I Chapter 2 theoretical frameworks or models for nutrition education J Nutr Educ. 1995 27 287 -90
9
Rosal MC, Ebbeling CB, Lofgren I, Ockene JK, Ockene IS, and Hebert JR Facilitating dietary change: the patient-centered counseling model J Am Diet Assoc. 2001 101 3 332 -41
10
Gable J. Counseling skills for dieticians. Cambridge, MA: Blackwell Science; 1997.
11
Snetselaar L. Nutrition counseling skills: assessment, treatment and evaluation. Rockville, MD: Aspen Publications; 1983.
12
Hodges P, Vickery C. Effective counseling: strategies for dietary management. Rockville MD: Aspen Publishers Inc.; 1989.
13
Snetselaar L. Nutrition counseling skills for medical nutrition therapy. Rockville, MD: Aspen Publications; 1997.
14
Curry K, Jaffe A. Nutrition counseling and communication skills. Philadelphia, PA: WB Saunders; 1998.
15
Bauer K, Sokolik C. Basic nutrition counseling skill development. Pacific Grove, CA: Brooks/Cole Publishing; 2001.
16
Bisogni CA, Connors M, Devine CM, and Sobal J Who we are and how we eat: a qualitative study of identities in food choice J Nutr Educ Behav. 2002 34 128 -39
17
Satter E. How to get your kids to eat… but not too much. Palo Alto, CA: Bull Publishing; 1987.
18
Abusabha R, Peacock J, and Achterberg C How to make nutrition education more meaningful through facilitated group discussions J Am Diet Assoc. 1999 99 1 72 -6
19
Hauchecorne CM, Barr SI, and Sork TJ Evaluation of nutrition counseling in clinical settings: do we make a difference? J Am Diet Assoc. 1994 94 4 437 -40
20
MacLellan D. Client-centred nutrition counselling: an exploratory study. Doctoral dissertation. University of Saskatchewan; 2005.
21
MacLellan D and Berenbaum S Dietitians’ opinions and experiences of client-centred nutrition counselling Can J Diet Prac Res. 2006 67 119 -24
22
MacLellan D, Morley C, Traviss K, and Cividin T Towards evidence-based client centred nutrition education guidelines: dietitian and consumer survey results Can J Diet Pract Res. 2011 72 3 111 -6
23
Tapp D The ethics of relational stance in family nursing: resisting the view of “nurse as expert” J Fam Nurs. 2000 6 69 -91
24
Patton MQ. Qualitative evaluation and research methods. 3rd ed. Thousand Oaks, CA: Sage; 2001.
25
Krueger R, Casey M. Focus groups: a practical guide for applied research. 4th ed. Thousand Oaks, CA: Sage Publications; 2008.
26
van Manen M. Researching lived experience: human science for an action sensitive pedagogy. London, ON: Althouse Press; 1998.
27
Statistics Canada. Rural Small Town Can Anal bull. 2001;3(3).
28
British Columbia Cancer Agency Nutrition Services. Oncology nutrition clinical practice guidelines. Vancouver, BC: BC Cancer Agency; 2002.
29
Canadian Diabetes Association. Clinical practice guidelines; 2013 [cited 2015 Sep 28]. Available from: http://guidelines.diabetes.ca/fullguidelines
30
Paisley J, Brown CM, and Greenberg M Information needs of women at risk of breast cancer Can J Diet Pract Res. 2008 69 2 59 -64
31
Desroches S, Lapointe A, Deschênes SM, Bissonnette-Maheux V, Gravel K, Thirsk J, and Légaré F Dietitians’ perspectives on interventions to enhance adherence to dietary advice for chronic diseases in adults Can J Diet Pract Res. 2015 76 103 -8
32
Prochaska JO and Diclemente CC Transtheoretical therapy: toward a more integrative model of change Psychotherapy: Theory, Research & Practice. 1982 19 276 -88
33
Hartmuller VW and Desmond SM Professional and patient perspectives on nutritional needs of patients with cancer Oncol Nurs Forum. 2004 31 989 -96
34
Schon D. The reflective practitioner. New York: Basic Books; 1983.
35
Benner P. From novice to expert - excellence and power in clinical nursing practice. Don Mills, ON: Addison-Wesley Publishing Company, Nursing Division; 1984.
36
Mezirow J. Fostering critical reflection in adulthood: a guide to transformative learning and emancipatory learning. San Francisco: Jossey-Bass; 1990.
37
Mezirow J. Learning as transformation: critical perspectives on a theory in progress. San Francisco: Jossey Bass; 2000.
38
College of Dietitians of Ontario. 2013-2014 annual report. Toronto, ON; 2014.

Supplementary Material

Supplementary Table (cjdpr-2015-048suppl.pdf)

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Published In

cover image Canadian Journal of Dietetic Practice and Research
Canadian Journal of Dietetic Practice and Research
Volume 77Number 2June 2016
Pages: 78 - 83

History

Version of record online: 26 February 2016

Authors

Affiliations

Catherine Morley PhD, PDt, FDC
School of Nutrition and Dietetics, Acadia University, Wolfville, NS
Deborah MacLellan PhD, PDt, FDC
Faculty of Science, University of PEI, Charlottetown, PEI
Karol Traviss MSC, RD, FDC
Food, Nutrition and Health, University of British Columbia, Vancouver, BC
Theresa Cividin MA, RD
Vancouver Acute Services, Vancouver Coastal Health, Vancouver, BC

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