Canadian Dietitians’ Understandings of, Attitudes Toward, and Engagement in Social Justice and Advocacy

Publication: Canadian Journal of Dietetic Practice and Research
9 September 2020

Abstract

Purpose: To explore Canadian dietitians’ understandings of, attitudes towards, and engagement in socially just dietetic practice and advocacy.
Methods: An online semi-qualitative survey sent to Canadian dietitians.
Results: Respondents’ understanding of social justice and socially just dietetics practice highlights the unique ways that social injustice and health inequities may be addressed by dietitians. Overall, respondents had a positive attitude toward dietitians’ roles in social justice advocacy. Support for dietitians’ advocacy roles was highest for food-related concerns, but it declined for concerns with indirect connections to dietitians’ food and nutrition expertise (e.g., environment). However, respondents still had uncertainty and divided perspectives concerning if and how social justice fits within dietitians’ scope of practice. They also had concerns about barriers that they felt limit dietitians’ ability to perform socially just practice. Respondents shared efforts to engage in socially just practice at intrapersonal, interpersonal, and structural levels.
Conclusions: Dietitians could be a critical influence on the determinants of health. This research points strongly to the need for a framework for socially just dietetic practice and advocacy that delineates what social justice looks like across the array of settings in which dietitians practice and within the array of fora that dietitians advocate to support nutrition and health.

Résumé

Objectif. Explorer la compréhension, l’attitude et l’engagement des diététistes canadiens à l’égard d’une pratique de la diététique socialement juste et de la défense de la justice sociale.
Méthodes. Un sondage semi-qualitatif en ligne a été envoyé à des diététistes canadiens.
Résultats. La compréhension qu’ont les répondants de la justice sociale et de la pratique diététique socialement juste met en lumière les façons uniques dont les injustices sociales et les inégalités sanitaires peuvent être abordées par les diététistes. Dans l’ensemble, les répondants avaient une attitude positive à l’égard du rôle des diététistes dans la défense de la justice sociale. L’appui envers le rôle de défenseurs des diététistes était le plus marqué pour les préoccupations entourant l’alimentation, mais diminuait relativement aux préoccupations indirectement liées à l’expertise des diététistes sur les aliments et la nutrition (p. ex. l’environnement). Cependant, les répondants avaient encore des incertitudes et des points de vue divergents quant à savoir si et comment la justice sociale s’inscrit dans le champ de pratique des diététistes. Ils avaient également des préoccupations au sujet des obstacles qui, selon eux, limitent la capacité des diététistes à adopter une pratique socialement juste. Les répondants ont parlé des efforts qu’ils déploient pour adopter des pratiques socialement justes aux plans intrapersonnel, interpersonnel et structurel.
Conclusions. Les diététistes pourraient avoir une influence de premier plan sur les déterminants de la santé. Cette recherche démontre clairement la nécessité d’élaborer un cadre en matière de pratique de la diététique socialement juste et de défense de la justice sociale qui définit en quoi consiste la justice sociale dans l’ensemble des contextes où pratiquent les diététistes et dans l’ensemble des forums où les diététistes militent en faveur de la nutrition et de la santé.

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References

1
Buettner-Schmidt K and Lobo ML. Social justice: a concept analysis. J Adv Nurs. 2012 Apr;68(4):948–58.
2
Donohoe M. Roles and responsibilities of health care professionals in combating environmental degradation and social injustice: education and activism. Monash Bioeth Rev. 2008 Apr 1;27(1–2):65–82.
3
Halman M, Baker L, and Ng S. Using critical consciousness to inform health professions education. Perspect Med Educ. 2017 Feb 1;6(1):12–20.
4
Wronka J. Human rights and social justice: social action and service for the helping and health professions. Thousand Oaks, CA: Sage Publications; 2016.
5
Partnership for Dietetic Education and Practice. The integrated competencies for dietetic education and practice; 2013 [cited 2020 Feb 21]. Available from: https://www.pdep.ca/library/Accreditation-Policies-and-Standards/PDEP-ICDEP-2013-.aspx.
6
Sandretto S, Ballard K, Burke P, Kane R, Lang C, Schon P, et al. Nailing jello to the wall: articulating conceptualizations of social justice. Teachers and Teaching: Theory and Practice. 2007;13(3):307–22.
7
DuPuis M, Harrison JL, Goodman D. Just food? In: Alkon AH, Agyeman J, editors. Cultivating food justice: race, class, and sustainability. Cambridge, MA: MIT Press; 2011. p. 283–308.
8
Fraser K and Brady J. Exploring social justice advocacy in dietetic education: a content analysis. Can J Diet Pract Res. 2019 Oct 3;80(1):2–7.
9
Brady J. Social justice and dietetic education: are we preparing practitioners to lead? Can J Diet Pract Res. 2020 Feb 19;81:1–7.
10
Canadian Institute for Health Information. Canada’s health care providers, 2014 to 2018—data tables. Ottawa, ON: CIHI; 2020.
11
Kasten G. Listen… and speak: a discussion of weight bias, its intersections with homophobia, racism, and misogyny, and their impacts on health. Can J Diet Pract Res. 2018 Aug 14;79(3):133–8.
12
Truth and Reconciliation Commission of Canada. Truth and Reconciliation Commission of Canada: calls to action; 2015 [cited 2020 Feb 21]. Available from: http://trc.ca/assets/pdf/Calls_to_Action_English2.pdf.
13
Ruel MT, Alderman H, and Maternal and Child Nutrition Study Group. Nutrition-sensitive interventions and programmes: how can they help to accelerate progress in improving maternal and child nutrition? Lancet. 2013 Aug 10;382(9891):536–51.
14
Goldberg DS. Social justice, health inequalities and methodological individualism in US health promotion. Public Health Ethics. 2012 Jul 1;5(2):104–15.
15
Hemphill B. Social justice as a moral imperative. Open J Occup Ther. 2015;3(2):9.
16
Peter F. Health equity and social justice. J Appl Philos. 2001 Jan 1;18(2):159–70.
17
Heidelberger L, Smith C, Robinson-O’Brien R, Earthman C, and Robien K. Registered dietitian nutritionists’ perspectives on integrating food and water system issues into professional practice. J Acad Nutr Diet. 2017 Feb 1;117(2):271–7.
18
Power E, Belyea S, and Collins P. “It’s not a food issue; it’s an income issue”: using Nutritious Food Basket costing for health equity advocacy. Can J Public Health. 2019 Jun 19;110(3):294–302.
19
Gingras J, De Jonge LA, and Purdy N. Prevalence of dietitian burnout. J Hum Nutr Diet. 2010 Jun;23(3):238–43.
20
Sprang G, Clark JJ, and Whitt-Woosley A. Compassion fatigue, compassion satisfaction, and burnout: factors impacting a professional’s quality of life. J Loss Trauma. 2007 May 7;12(3):259–80.
21
Hansen H, Braslow J, and Rohrbaugh RM. From cultural to structural competency—training psychiatry residents to act on social determinants of health and institutional racism. JAMA Psychiatry. 2018 Feb 1;75(2):117–8.
22
Jones A. Looking at the role of physician health advocacy in the Canadian health care system. UBCMJ. 2015;6(2):34–5.
23
McLaughlin AM. Clinical social workers: advocates for social justice. Adv Soc Work. 2009 Mar 19;10(1):51–68.
24
Birkenmaier J. On becoming a social justice practitioner. Soc Thought. 2003 Apr 16;22(2–3):41–54.
25
Kirkham SR and Browne AJ. Toward a critical theoretical interpretation of social justice discourses in nursing. Adv Nurs Sci. 2006 Oct–Dec 1;29(4):324–39.
26
Braun J and Beckie M. Against the odds: the survival of traditional food knowledge in a rural Alberta community. Canadian Food Studies / La Revue canadienne des études sur l’alimentation. 2014 May 15;1(1):54–71.
27
Jaffe J and Gertler M. Victual vicissitudes: consumer deskilling and the (gendered) transformation of food systems. Agric Human Values. 2006 Jun 1;23(2):143–62.

Information & Authors

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Published In

cover image Canadian Journal of Dietetic Practice and Research
Canadian Journal of Dietetic Practice and Research
Volume 82Number 1March 2021
Pages: 2 - 10

History

Version of record online: 9 September 2020

Authors

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Kathryn Fraser MScAHN(c)
Mount Saint Vincent University, Halifax, NS
Jennifer Brady RD, PhD
Mount Saint Vincent University, Halifax, NS

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1. Enhancing Response Ability: Dietetics as a Vehicle for Social Justice—A Primer

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