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- Lordly, Daphne MA PDt3
- Mager, Diana PhD RD3
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- Black, Jennifer L PhD RD2
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- Buchholz, Andrea C PhD RD2
- Carrier, Natalie PhD RD2
- Duizer, Lisa PhD2
- Dworatzek, Paula PhD RD2
- Fraser, Valli RD2
- Gillis, Doris PhD PDt2
- Johnson, Frances MSc RD2
- Keller, Heather H PhD RD FDC2
- Keller, Heather H RD PhD FDC2
- Kirk, Sara F L PhD2
- Lengyel, Christina PhD RD2
- Lieffers, Jessica R MSc RD2
- Lordly, Daphne DEd PDt FDC2
- Lordly, Daphne MAHE PDt2
- Mager, Diana R PhD RD2
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- Mann, Linda PDt MBA2
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- McQueen, Kay RD2
- Mourtzakis, Marina PhD2
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- In 2014, a national initiative aimed at defining a research agenda for nutrition and mental health among diverse stakeholders was completed and included insights from more than 300 registered dietitians. This study explores the data from dietitians based on their years of practice, mental health experiences, and community of practice in relationship to identified mental health and nutrition research priorities. Analysis of numerical data (n = 299) and content analysis of open-ended responses (n = 269) revealed that respondents desired research for specific mental health conditions (MHCs), emotional eating, food addiction, populations with special needs, and people encountering major life transitions (e.g., recovery from abuse, refugees). Findings from the quantitative and textual data suggested that dietitians want research aimed at addressing the concerns of those in the community, fostering consumer nutrition knowledge and skill acquisition, and developing services that will impact quality of life. Subgroup analysis indicated that dietitians: (i) in early years of practice want information about specific MHCs; (ii) living in smaller towns and rural areas want data about the cost benefits of dietetics practice in mental health; and (iii) who also had additional stakeholder roles (e.g., service provider) selected priorities that address gaps in mental health services. This study highlights opportunities to tailor nutrition and mental health research that advance dietetics practice.
- Barriers to dietitians' participation in research include lack of time, self-perceived competence, confidence, administrative support, and funding. Providence Health Care, a multi-site health care organization in Vancouver, British Columbia implemented the Practice-based Research Challenge (RC), a 1-year research program, to support interdisciplinary teams of nurses and allied health professionals to conduct practice-relevant research projects. Funding, mentoring, and research education were provided to research teams. From 2011 to 2015, 37% of all dietitians in the organization were involved in the RC in 4 cohorts of the 1-year program. An online survey was conducted to understand these dietitians' interest and experience in the RC. The survey results indicated that the major reasons for participating in the program were to increase knowledge, improve patient care, and to work on a project of interest. Respondents thought they gained knowledge, enhanced professional development, and improved patient care. A majority stated they would likely conduct future research. The RC enabled and supported dietitians' participation in research; infrastructure supports for research and enabling a culture of research participation are key contributors to promoting dietitians involvement in research.
- Michelle R. Hoffmann MSc,
- Abeer S. Alzaben MSc,
- Simone E. Enns BSc,
- Margaret A. Marcon MD, FRCPC,
- Justine Turner MD, PhD, FRCPC, and
- Diana R. Mager PhD, MSc, RD
To identify parental influences affecting micronutrient supplementation in children and adolescents (2–18 years of age) with Celiac Disease (CD), a multi-method (survey, focus groups) study was conducted. A 35-item questionnaire consisting of open- and closed-ended questions was launched nationally via Canadian Celiac Association internet sites. Five focus groups were conducted using a semi-structured interview guide. The survey and semi-structured interview guide content was vetted for face and content validity. Thematic analyses were conducted on the focus group content and open-ended survey questions, and χ2 and Fischer’s exact analysis were performed on closed-ended survey data. Survey respondents were predominantly mothers (97%) of female children (80 F, 49 M) between the ages of 9–12 (31%) with CD, residing in western provinces (55%) with a combined family income ≥$100 000/year (63%). Seventy-seven percent of parental respondent’s children or adolescents consumed micronutrient supplements, for 1–5 years (52%), 7 days a week (65%), as both multi-vitamin and single vitamin preparations (40%). Parental influences on child micronutrient use included health beliefs and knowledge, parental supplement use, supplement characteristics, age of child (above or below 13 years), household routines, and provincial residential status (P < 0.05). Parents relied on health professional recommendation (69%; MD, RD) and the internet (21%) as sources of information regarding child micronutrient supplementation. Parental health beliefs and knowledge, socio-demographic factors, and practitioner recommendation influence micronutrient supplement use in children and adolescents with CD.- We examined the impact of an optional experiential learning activity (ELA) on student engagement and performance in 2 undergraduate nutrition courses. The ELA involved completion of a 3-day food record, research lab tour, body composition assessment, and reflective take-home assignment. Of the 808 students in the 2 courses (1 first-year and 1 second-year course), 172 (21%) participated. Engagement was assessed by the Classroom Survey of Student Engagement (CLASSE), and performance was assessed by percentile rank on midterm and final exams. Students’ perceived learning was assessed using a satisfaction survey. Paired-samples t tests examined change in CLASSE scores and percentile rank from baseline to follow-up. Frequencies and thematic analysis were used to examine responses to Likert scale and open-ended questions on the satisfaction survey, respectively. There was an 11%–22% increase (P < 0.05) in the 3 dimensions of student engagement and a greater increase in percentile rank between the midterm and final exams among participants (7.63 ± 21.9) versus nonparticipants (−1.80 ± 22.4, P < 0.001). The majority of participants indicated the ELA enhanced their interest and learning in both their personal health and the course. Findings suggest ELAs related to personal health may improve interest, engagement, and performance among undergraduate students.
- Kara Vogt MEd, RD,
- Frances Johnson MSc, RD,
- Valli Fraser RD,
- Jiak Chin Koh MSc, RD,
- Kay McQueen RD,
- Jaki Thornhill RD, and
- Vashti Verbowski RD
The Professional Development Network (PDN) program was implemented to enhance mentoring and learning opportunities for dietitians at a multisite health care organization. Program development, implementation, and evaluation were carried out by a Professional Practice Council composed of dietitians in the organization. An exploratory evaluation was conducted after the first year of PDN implementation. Evaluation data were collected from an online survey containing open- and closed-ended questions and PDN documents submitted by dietitians. Data were analyzed with descriptive statistics and thematic analysis. Survey results indicate the PDN provided a mechanism for dietitians to learn from each other, apply learning to their career development, reflect on their strengths, and connect with others in the department. Analysis of PDN documents showed that dietitians pursued learning related to clinical practice, technology, private practice, and research. Mentoring interactions were also described by participants within PDN documents. Findings from this study demonstrate how multiple frameworks from academic literature can be integrated to create a professional development program in a dietetics practice environment. Evaluation results from this study may provide useful insights for others interested in implementing professional development programming.- nutritionDay is a 1-day cross-sectional survey identifying how nutrition care is provided. This paper provides results of the first 2 Canadian nutritionDay surveys. In November 2010 and 2011, data from standardized questionnaires were collected from 193 units in Canadian hospitals consisting of unit demographics and patient information including weight history, health status, nutrition assessment, nutrition therapy, food intake and 30-day outcomes. Results indicated that overall, 46% of the 1905 patients reported weight loss in the previous 3 months, and in half of these it was greater than 5 kg. Only 50% of the units had nutrition teams and nutrition therapy was provided to less than 14% of patients. More than 50% of patients ate less than normal in the previous week and 57% ate less than half of their meal on nutritionDay. Within the next 30 days the majority of patients went home, 10% remained in hospital, and 6% were readmitted. In this study, nutritionDay provided relevant information on nutrition assessment, weight history, food intake, nutrition therapy, length of stay, and outcomes in participating Canadian institutions. Data from 2010 and 2011 can help to both reflect on current practices and define continuous improvements through benchmarking with the overall goal of mitigating suboptimal nutrition intake during hospitalization.
- Social media has become a popular platform for reputable health organizations to disseminate health information to the public. However, future health professionals may receive little training in social media communication. To train future dietetic professionals, we incorporated a social media assignment into a Communications course curriculum to facilitate effective use of social media for the profession. For the assignment, students were instructed to make 2 posts on Facebook. The posts were due 3 weeks apart so that students received feedback on their first post before making their second post. To demonstrate the type of social media communication commonly used by reputable health organizations, the first post raised awareness or provided nutrition education. The second post used Facebook’s “comment” feature, to respond to another student’s first post, demonstrating the use of social media for community engagement. Both posts included a hyperlink that the user could click to get more information. Students were evaluated on the hook, main points, professionalism, credibility, and effectiveness of inviting the reader to the hyperlinked website and its ease of navigation. Dietetics educators should be encouraged to incorporate social media education into their curriculums for the benefit of future dietitians and their clients.
- Many Canadian school jurisdictions have developed nutrition policies to promote health and improve the nutritional status of children, but research is needed to clarify adherence, guide practice-related decisions, and move policy action forward. The purpose of this research was to evaluate policy adherence with a review of online lunch menus of elementary schools in Nova Scotia (NS) while also providing transferable evidence for other jurisdictions. School menus in NS were scanned and a list of commonly offered items were categorized, according to minimum, moderate, or maximum nutrition categories in the NS policy. The results of the menu review showed variability in policy adherence that depended on food preparation practices by schools. Although further research is needed to clarify preparation practices, the previously reported challenges of healthy food preparations (e.g., cost, social norms) suggest that many schools in NS are likely not able to use these healthy preparations, signifying potential noncompliance to the policy. Leadership and partnerships are needed among researchers, policy makers, and nutrition practitioners to address the complexity of issues related to food marketing and social norms that influence school food environments to inspire a culture where healthy and nutritious food is available and accessible to children.
- The purpose of this study was to provide preliminary Canadian research assessing nutrition students’ cultural competence and to identify areas for future education initiatives in dietetic education that could ultimately improve dietitians’ cultural competence. A mixed-methods study was conducted using a 24-item questionnaire that was administered to students enrolled in third- and fourth-year undergraduate nutrition classes (n = 133). In total, 115 questionnaires were analyzed for quantitative data, and 109 were analyzed for qualitative data. The students scored an overall medium–high level of cultural competence. Out of the 5 areas examined (skills, attitudes, awareness, desires, knowledge), students’ multicultural knowledge scores were the lowest. It was found that a lower number of barriers to learning about other cultures were significantly associated with a higher overall cultural competence score, and taking a course in cultural foods significantly increased the students’ knowledge and overall cultural competence (P ≤ 0.05). The qualitative data found that students felt the cultural competence curriculum had gaps and identified several ideas for improvement. In conclusion, this research data provides novel insights into the cultural competence of Canadian dietetic students and additionally supports future research and curriculum development to enhance cultural competence.
- Josie Geller PhD,
- Jillian Avis BA,
- Suja Srikameswaran PhD,
- Joanna Zelichowska MA,
- Katie Dartnell RD,
- Bailey Scheuerman RD,
- Arnaldo Perez MA,
- Allison Rasquinha MA,
- Krista E. Brown MA,
- Jean-Pierre Chanoine MD, PhD, and
- Geoff Ball PhD, RD
Clinical acumen is often used to assess families’ motivation prior to initiating pediatric obesity management due to a lack of available tools. The purpose of this pilot study was to (i) develop and (ii) pilot test the “Readiness and Motivation Interview for Families” (RMI-Family) in pediatric weight management. We conducted 5 focus groups with parents (n = 15), youth with obesity (n = 11), and health care providers (n = 8) to explore perceptions of barriers to making healthy behaviour changes, which led to the creation of the RMI-Family as a semi-structured interview. Five domains (treat foods, overeating, emotional eating, total physical activity, and screen time) emerged from the focus groups to inform the development of the RMI-Family, which was then pilot tested with a sample of youth with obesity and their parents (n = 11 dyads). Interviewers administered the RMI-Family to youth (age 12.8 ± 1.7 years; body mass index [BMI] z-score: 2.71 ± 0.43) and parents (age 47.1 ± 3.7 years; BMI: 33.5 ± 10.1 kg/m2). The RMI-Family was feasible to administer, easily understood by families, and may be a useful tool for assessing families’ motivation. Research is underway to determine the psychometric properties and utility of the RMI-Family in predicting clinical outcomes in pediatric weight management.- Brief nutrition screening tools are desired for research and practice. Seniors in the Community: Risk Evaluation for Eating and Nutrition (SCREEN-II, 14 items) and the abbreviated version SCREEN-II-AB (8 items) are valid and reliable nutrition screening tools for older adults. This exploratory study used a retrospective cross-sectional design to determine the construct validity of a subset of 3 items (weight loss, appetite, and swallowing difficulty) currently on the SCREEN-II and SCREEN-II-AB tools. Secondary data on community-dwelling senior males (n = 522, mean ± SD age = 86.7 ± 3.0 years) in the Manitoba Follow-up Study (MFUS) study were available for analysis. Participants completed the mailed MFUS Nutrition Survey that included SCREEN-II items and questions pertaining to self-rated health, diet healthiness, and rating of the importance of nutrition towards successful aging as the constructs for comparison. Self-perceived health status (F = 14.7, P < 0.001), diet healthiness (ρ = 0.17, P = 0.002) and the rating of nutrition's importance to aging (ρ = 0.10, P = 0.03) were correlated with the 3-item score. Inferences were consistent with associations between these construct variables and the full SCREEN-II. Three items from SCREEN-II and SCREEN-II-AB demonstrate initial construct validity with self-perceived health status and diet healthiness ratings by older males; further exploration for criterion and predictive validity in more diverse samples is needed.
- Tracy Cullen RD, MS,
- Janelle Hatch RD, MHSc,
- Wanda Martin RN, PhD,
- Joan Wharf Higgins PhD, and
- Rosanna Sheppard RN, BScN
The term food literacy is emergent, and as a result the literature reflects a great variety of definitions. Simultaneously, new research and food literacy programming is being developed without an agreed upon definition of what food literacy is and how food skills, food security, and health literacy may fit with the definition. We undertook a scoping review and conceptual analysis to identify how the term is understood and to determine shared components of definitions. We found that although most definitions included a nutrition and food skills component, there was great variation in how the ability to access, process, and enjoy food was affected by our complex food system. We propose a definition of food literacy that includes the positive relationship built through social, cultural, and environmental experiences with food enabling people to make decisions that support health. We offer a framework that situates food literacy at the intersection between community food security and food skills, and we assert that behaviours and skills cannot be separated from their environmental or social context. The proposed definition and framework are intended to be guiding templates for academics and practitioners to position their work in education and advocacy, bringing together separate spheres for collective action.- Steven T. Johnson PhD,
- Stephen M. Cornish PhD,
- Ellina Lytvyak MD, PhD,
- Lorian M. Taylor RD, MPH, PhD,
- Gordon Bell PhD,
- Jeff Vallance PhD,
- Shawn Fraser PhD, and
- Terra Murray PhD
The aim of this cross-sectional study was to survey exercise specialists about nutrition counselling practices, their own dietary practices, and to identify potential relationships. An electronic survey was used to examine characteristics and strategies used for assessing and promoting healthy eating to clients. Exercise specialists (n = 94) were recruited through a public registry and through targeted advertising on 2 professional websites in Alberta, Canada. Eighty-five percent of respondents promoted healthy eating to clients. Confidence in assessing and promoting healthy eating was moderate to low. Those with more than 6 years of professional experience reported higher confidence compared with those with less than 1 year of experience in assessing healthy eating (P < 0.05) and promoting healthy eating (P < 0.01). Confidence was higher among those with more professional experience but who did not meet Canada's Food Guide recommendations (P < 0.05). Professional experience, personal dietary practices, and confidence are important characteristics when considering the assessment and promotion of healthy eating by exercise specialists. Promoting collaborative relationships between registered dietitians and exercise specialists would likely benefit exercise specialists when they are assessing and promoting healthy eating among their clients.- Bohdan L. Luhovyy PhD,
- Rebecca C. Mollard PhD,
- Shirin Panahi PhD,
- Maria Fernanda Nunez MSc,
- France Cho PhD, and
- G. Harvey Anderson PhD
The high prevalence of obesity and its metabolic co-morbidities require dietitians to promote lifestyle modifications that can be effectively implemented into practice and are feasible for customers to adhere to. The objective of this study was to determine the effect of commercially available ready-to-eat canned navy beans added to the habitual diet on risk factors associated with obesity. Fourteen overweight and obese adults consumed 5 cups of canned navy beans per week for 4 weeks. The study results demonstrated that bean consumption results in reduced waist circumference in females by 2.5 cm and males by 2.1 cm (P < 0.001). The effect of beans on pulse rate, total cholesterol (TC), and low-density lipoprotein cholesterol (LDL) were sex dependent (P < 0.05). In males, pulse rate, TC, and LDL were decreased by 6.5%, 11.5%, and 18%, respectively. In females, pulse rate increased by 9.6%, and TC and LDL were relatively unchanged. There was a trend for a decreased glucose AUC (P = 0.06) in response to a glucose load. This study demonstrates that consuming 5 cups per week of ready-to-eat canned navy beans for 4 weeks reduces metabolic risk factors associated with obesity and therefore can be used as a tool in dietetic practice.- The study evaluated the impact of a pilot “protected mealtime” program on meal experience and care of hospitalized acute care patients. A 4-month pilot protected mealtime program was implemented on a 35-bed acute, older adult ward. A pre- and post-observational audit was implemented to examine interruptions during lunch, food intake, hand hygiene, and positioning practices on the ward. A staff questionnaire was administered to gain the opinions of health care team members about the protected mealtime program. The observational audit showed a significant decrease in the number of total interruptions (Z = −2.496, P = 0.013, r = −0.42). Hand hygiene practices improved and no effect was found on mealtime patient positioning at mealtimes. Staff questionnaire responses indicated positive changes to the patients’ mealtime experiences. The protected mealtime program appeared to improve patient mealtime experiences and patient care. Enabling patients to eat their meals uninterrupted will assist in ensuring that patients in hospital are adequately nourished.
- Micronutrient (vitamin and mineral) deficiencies may exacerbate prevalent health conditions occurring in long-term care (LTC) residents, and current food provision may potentiate this problem. A micronutrient-focused, food-first approach to menu planning may address this gap by emphasizing nutrient-dense foods. The objectives were to determine if: (i) selected LTC menus met micronutrient and Canada's Food Guide (CFG) recommendations, and (ii) recommendations can be met through food alone with strategic menu planning. Regular, nontherapeutic menus (week 1, all meals) from diverse LTC homes (n = 5) across Canada were analyzed for micronutrient content using Food Processor and CFG servings. Site dietitians confirmed menu analyses. Five super-menus were created and analyzed for comparison. The nutrient content of the menus varied significantly across homes. Micronutrients of greatest concern were (mean ± SD) vitamin D (8.90 ± 5.29 µg/d) and vitamin E (5.13 ± 1.74 mg/d). Folate, magnesium, and potassium were also below recommendations. Super-menus of equal food volume met recommendations for all micronutrients except vitamin D (56%), vitamin E (84%), and potassium (85%). Meeting most micronutrient recommendations is possible with creative and deliberate menu planning. Knowledge translation of best practices is needed.
- The Good Food Box (GFB) is a program that offers fresh produce to community members. The implementation of a GFB pilot project targeting the elderly in Côte Saint-Luc (CSL) is described. Feasibility is evaluated in terms of partnerships necessary to realize the project and suitability of the GFB among seniors. Outcomes, lessons learned, and future directions are also discussed. GFBs were delivered biweekly for 10 weeks to 14 participants over the age of 65 years. Baseline and final surveys were administered to assess user satisfaction and effects of the project. Overall, participants were satisfied, finding the location convenient and the produce to be of excellent quality. Respondents also indicated an increased quantity of fresh fruits and vegetables in their home and an enhanced connection with the community. Many participants commented on excessive quantity and difficulty preparing certain products, demonstrating that the GFB may not be practical for all seniors. Smaller quantities and volunteer assistance could improve the program. Following the successful pilot project, the GFB was expanded to all members of the CSL community. Using the GFB as a major source of fresh produce will positively impact the health and quality of life for those who reside within the community.
- Purpose: There is concern about the nutritional quality of processed gluten-free (GF) products. The aim was to investigate the nutrient composition and cost of processed GF products compared with similar regular products.Methods: Product size, price, caloric value, and macro- and micronutrient composition were compared between foods labeled “Gluten-free” and comparable regular products in 5 grocery stores in 3 Canadian cities. Data were calculated per 100 g of product.Results: A total of 131 products were studied (71 GF, 60 regular). Overall, calories were comparable between GF and regular foods. However, fat content of GF breads was higher (mean 7.7 vs. 3.6 g, P = 0.003), whereas protein was lower (mean 5.0 vs. 8.0 g, P = 0.001). Mean carbohydrate content of GF pasta was higher (78 vs. 74 g, P = 0.001), whereas protein (7.5 vs. 13.3 g, P < 0.001), fibre (3.3 vs. 5.8 g, P = 0.048), iron (9% vs. 25%DV, P < 0.001), and folate content (5% vs. 95%DV, P < 0.001) were lower. Mean price of GF products was $1.99 versus $1.23 for regular products (P < 0.001).Conclusions: Some commonly consumed packaged GF foods are higher in fat and carbohydrates and lower in protein, iron, and folate compared with regular products. GF products are more expensive. Dietitians should counsel patients on the GF diet regarding its nutritional and financial impact.
- A Nutrition Screening Form (NSF) was designed to identify lifestyle risk factors that negatively impact fertility and to provide a descriptive profile of 300 female infertility patients in a private urban infertility clinic. The NSF was mailed to all new patients prior to the initial physician's visit and self-reported data were assessed using specific criteria to determine if a nutrition referral was warranted. This observational study revealed that 43% of the women had a body mass index (BMI) <20 or ≥25 kg/m2, known risks for infertility. Almost half reported a history of “dieting” and unrealistic weight goals potentially limiting energy and essential nutrients. A high number reported eating disorders, vegetarianism, low fat or low cholesterol diets, and dietary supplement use. Fourteen percent appeared not to supplement with folic acid, 13% rated exercise as “extremely” or “very active”, and 28% reported a “high” perceived level of stress. This preliminary research demonstrated that a NSF can be a useful tool to identify nutrition-related lifestyle factors that may negatively impact fertility and identified weight, BMI, diet, exercise, and stress as modifiable risk factors deserving future research. NSF information can help increase awareness among health professionals and patients about the important link between nutrition, fertility, and successful reproductive outcomes.
- Allison Proudfoot MAN,
- Daphne Lordly DEd, PDt, FDC,
- Barb Anderson PDt, FDC, and
- Doris Gillis PhD, PDt
With the aim of enhancing dietetics education in Nova Scotia, key stakeholders were engaged in identifying current practice issues along with opportunities for collaboration to address them. A survey containing five open-ended questions was distributed by email to a purposive sample of 24 participants affiliated with three universities with dietetics programs. Participants fell into five categories: internship coordinators, dietetics educators, recent internship graduates, current interns, and prospective interns. The response rate was 58%. Data were thematically analyzed through a process of constant comparison. Primary themes emerged, which reflected survey participants’ concerns about three current practice issues: province-wide standards, internship placement availability, and the overall educational experience. Additional comments suggested that overall dietetic educational experiences could be improved if relevant clinical experiences were offered and preceptor workloads were accommodated. The creation of province-wide standards for assessing interns’ level of competency was perceived to offer multiple benefits, including decreased preceptor workloads. Participants believed that collaborative actions might increase internship placements and improve the overall dietetic internship experience for interns and preceptors.