Applied Filters
- Article
- Davidson, Bridget MHSc RDRemove filter
- Dietrich, Linda MEd RDRemove filter
- Canadian Journal of Dietetic Practice and ResearchRemove filter
Publication Date
Author
Access Type
1 - 3of3
Save this search
Please login to be able to save your searches and receive alerts for new content matching your search criteria.
Filters
You do not have any saved searches
- Paula M. Brauer PhD, RD,
- Lee Anne Sergeant BASc, RD,
- Bridget Davidson MHSc, RD,
- Rick Goy MSc, and
- Linda Dietrich MEd, RD
Purpose: Patients’ perceptions of preventive lifestyle in primary care practice were examined. Methods: Practice was assessed with a modified version of the Primary Care Assessment Survey (PCAS). This was mailed to random samples of patients twice, using practice mailing lists from three Ontario Family Health Networks (FHNs). Family Health Networks are physician-based group practices, with additional nurse-led telephone advisory services to provide care 24 hours a day, seven days a week. The PCAS questionnaire consisted of nine scales (ranging from 0 to 100). For preventive counselling, additional questions on diet and exercise counselling were included to determine how the physician delivered the intervention. Results: Of the 2184 survey questionnaires mailed to patients, 22% were undeliverable. The response rate was 62% at valid addresses (49% of all mailed questionnaires). Of the nine scales, scores (± standard deviation) for preventive counselling were lowest at 33 ± 25. In particular, rates of diet (37%) and exercise (24%) counselling were low in the FHNs. For most other aspects of primary care services, patients generally rated FHNs highly. The majority of patients advised about diet and exercise were given verbal advice or pamphlets. Conclusions: In these primary health care organizations, considerable room exists for increased preventive counselling, especially about diet and exercise.- Purpose: A modified Delphi process was used to identify key features of interdisciplinary nutrition services, including provider roles and responsibilities for Ontario Family Health Networks (FHNs), a family physician-based type of primary care. Methods: Twenty-three representatives from interested professional organizations, including three FHN demonstration sites, completed a modified Delphi process. Participants reviewed evidence from a systematic literature review, a patient survey, a costing analysis, and key informant interview results before undertaking the Delphi process. Statements describing various options for services were developed at an in-person meeting, which was followed by two rounds of e-mail questionnaires. Teleconference discussions were held between rounds. Results: An interdisciplinary model with differing and complementary roles for health care providers emerged from the process. Additional key features addressing screening for nutrition problems, health promotion and disease prevention, team collaboration, planning and evaluation, administrative support, access to care, and medical directives/delegated acts were identified. Under the proposed model, the registered dietitian is the team member responsible for managing all aspects of nutrition services, from needs assessment to program delivery, as well as for supporting all providers’ nutrition services. Conclusions: The proposed interdisciplinary nutrition services model merits evaluation of cost, effectiveness, applicability, and sustainability in team-based primary care service settings.
Estimation of Human Resource Needs And Cost of Adding Registered Dietitians To Primary Care Networks
- Julia Witt PhD,
- Paula Brauer PhD, RD,
- Linda Dietrich MEd, RD,
- Bridget Davidson MHSc, RD, and
- Steering Committee
Purpose: Information on human resources and costs is needed to plan for the addition of registered dietitian (RD) services to new models of primary health care (PHC). Estimates were developed, based on an analysis of an enhanced RD model of counselling and health promotion services in three Ontario Family Health Networks (FHNs). Methods: Both direct and indirect costs were averaged over the three FHNs. Costs and RD activities were tracked throughout 2005. The FHN staff completed two questionnaires addressing communication, case management, and satisfaction with RD services. Results: Actual and reported case management indicated that an estimated 1.3% to 2.4% of the 60,000 enrolled patients may require individual nutrition counselling in a year. If one full-time equivalent (FTE) RD can manage 380 new referrals, then one FTE RD is needed per 15,800 to 29,000 patients. The estimated direct costs of adding one FTE RD (including expenses and fixed costs) is $78,169 to $80,169, when the RD is an independent contractor. Conclusions: Additional studies are needed to develop better estimates of human resource needs and costs of interdisciplinary nutrition services in all PHC settings. These estimates should be based on population characteristics and direct and indirect costs for all models of nutrition services in PHC settings.