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- Seabrook, Jamie A PhD10
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- Purpose: To identify key attributes of Canadian clinical registered dietitian (RD) jobs associated with high rates of turnover.Methods: Managers of clinical RDs in Canada were eligible to complete a survey on the topic of turnover in clinical RD positions. Specifically, key details were sought regarding positions with the highest and lowest turnover in each manager’s portfolio.Results: High turnover (HT) positions turned over an average of 4.0 times in a 5-year period in contrast to 0.3 times in low turnover (LT) positions. Resignation was the top reason for turnover in both HT and LT positions. HT and LT positions were of analogous full-time equivalent, had comparable caseloads, and served clients/patients with similar diagnoses including diabetes and neurological conditions.Conclusions: There is significant variation in the frequency of turnover across positions in clinical dietetics in Canada. What differentiates HT positions from LT positions remains unclear. More research is required to guide managers seeking to balance turnover and preclude uneven nutrition care quality across units and programs.
- Cindy Wei BSc,
- Justin B. Wagler BSc,
- Isabel B. Rodrigues MSc,
- Lora Giangregorio PhD,
- Heather Keller PhD,
- Lehana Thabane PhD, and
- Marina Mourtzakis PhD
Automated Self-Administered 24-hour Dietary Assessment (ASA24) is an economical method of estimating dietary intake as nutrient analysis is automated, but its use in older adults is limited. The purpose of this work was to guide dietitians and future researchers on how to use the ASA24 with older adults, considering potential barriers encountered and strategies used to support completion based on our experience using this tool in a pilot clinical trial. ASA24 was completed by phone interview with 39 older adults. Challenges included: recalling food intake in detail, recording frequent eating occasions and complicated recipes, and general problems with communication. Strategies to support collection included making morning phone calls and suggesting that seniors write down the food consumed. Phone interviews were acceptable to older adults, but sufficient time was required. Dietitians and future researchers can use these findings to obtain dietary intake data from this hard-to-reach group.- Myles W. O’Brien MSc, CSEP-CEP,
- Christopher A. Shields PhD,
- Margaret J. Dunbar MEd, CDE,
- Sandra J. Crowell MPA, and
- Jonathon R. Fowles PhD, CSEP-CEP
The purpose of this study was to assess the perceptions and practices around physical activity counselling and exercise prescription of dietitians in Nova Scotia. Dietitians (n = 95) across Nova Scotia completed an online self-reflection survey regarding their current physical activity and exercise (PAE) practices. Most (51%; n = 48) reported no previous PAE educational training. Dietitians infrequently prescribed exercise to their patients (16% ± 26% of appointments) or provided PAE referrals (17% ± 24%). Dietitians reported moderate confidence (57% ± 21%) performing PAE counselling and included PAE-related content in half of patient appointments (52% ± 31%). Almost all respondents (95%) identified interest in further PAE education or training. Open-ended responses also demonstrated the need for community-based exercise programs (28% of providers) and qualified exercise professionals to refer to (25%). Overall, dietitians report rarely providing patients with written exercise prescriptions or referrals to other professionals for PAE content but do frequently include PAE in patient appointments. Dietitians in Nova Scotia are well positioned to promote PAE, but more educational training and improved referral systems to qualified exercise professionals or community exercise programs is strongly desired. Exercise professionals and dietitians should concurrently advocate for these changes and collaborate to help more patients lead physically active lifestyles.- OPEN ACCESSHow does an ordinary dietitian have an extraordinary career? What is the most important asset that a dietitian has? Why is it important to take risks, be resilient, and challenge the status quo? In this article I answer these questions by sharing the highlights of my career and describing how I was socialized into the dietetics profession and ended up as the first female President of a Canadian university in Egypt.
- Rakhshan Kamran BSc (Hons), MD (c),
- Giulia Coletta BSc (Hons), MSc (c), and
- Janet M. Pritchard PhD, BSc
Purpose: The Social Cognitive Theory (SCT) suggests health behaviour can be modified by enhancing knowledge of health benefits and outcome expectations of changing behaviour, improving self-efficacy (confidence), and developing goals to overcome barriers to behaviour change. This study aimed to determine the impact of student-led nutrition workshops on participants’ confidence related to SCT constructs for making dietary choices that align with evidence-based nutrition recommendations.Methods: Level-4 Science students developed and delivered 9 workshops on nutrition recommendations for the prevention and management of age-related diseases. Participants attending the workshops completed pre- and post-surveys to assess SCT constructs. For each SCT construct, participants rated their confidence on a 10-point Likert scale. The number (%) of participants who rated their confidence as ≥8/10 on the pre- and post-surveys were compared using the χ2 test.Results: Sixty-three community members (60% female, mean ± SD age 71 ± 7 years) attended the workshops. The number of participants rating confidence as ≥8/10 for each SCT construct increased after the workshops (P < 0.05).Conclusion: Undergraduate students can positively influence community members’ confidence for making nutrition-related decisions. Involving students in interventions where SCT-structured workshops are used may help conserve health care resources and reach older adults who may not have access to dietitian services.- Purpose: To describe the energy (E), sodium, saturated fat, sugar, and fibre intakes of a sample of children attending regulated childcare (RCC) in Nova Scotia.Methods: Nutrient analyses from 79 food records were compiled and grouped by intakes in and outside of RCC, age, sex, location of the RCC (urban or rural), and nutrient intake data. Descriptive statistics and independent t tests were conducted.Results: Mean E and macronutrients were within recommended ranges and, for days attending RCC, 45%E was consumed in RCC. Saturated fat intake was 12%E on average. Mean sodium intake exceeded or approached the tolerable upper limit for 3-year olds (1726 mg/day) and 4–5-year olds (1770 mg/day), respectively. Total sugar was 27%E intake and significantly more sugar was consumed outside RCC and by boys compared to girls. Mean daily dietary fibre intake was below recommended levels (15 g/day).Conclusions: On average dietary intakes of children exceeded recommendations for sodium, saturated fat, and sugar with higher intakes outside RCC. The foods provided by RCC have a positive influence on children’s intakes, but given the pervasiveness of sugar and sodium in the food environment and the challenges of feeding children, support is needed for both RCC and families to encourage healthy eating behaviours for positive growth and development.
- Phillip Joy PhD,
- Lisa Goldberg PhD,
- Matthew Numer PhD,
- Sara Kirk PhD,
- Megan Aston PhD, and
- Laurene Rehman PhD
Our purpose in writing this Perspective in Practice is to create awareness about the role of compassion within dietetic practice, particularly the role of compassion for body image tensions. Nine self-identifying gay men were recruited to a photovoice research study that explored their beliefs, values, and practices relating to food and their bodies. Compassion was found as one way to navigate body images tensions. It is not the intent of this article to review all aspects of this research study but to use it as an example to illustrate compassion in dietetics. We suggest that our findings reveal the strength of using compassionate practice within the dietetic profession. In doing so, we call upon dietitians to incorporate compassion into their clinical and client care practices to foster health and healing for all communities, especially among those who struggle with body image tensions.- OPEN ACCESS
- Janice Sorensen PhD, MSc, RD,
- Heather Fletcher RD, BASc,
- Brenda Macdonald MAdEd, BSc, PDt,
- Leslie Whittington-Carter MHS, RD,
- Roseann Nasser MSc, RD, CNSC, FDC, and
- Leah Gramlich MD
Purpose: The study aimed to determine current practice, barriers, and enablers of foodservices in Canadian hospitals relative to guiding principles for best practice to prevent malnutrition.Methods: Foodservice managers completed a 55-item cross-sectional, online survey (closed- and open-ended questions).Results: Survey responses (n = 286) were from diverse hospitals in all Canadian regions; 56% acute care; 13% had foodservices contracted out; and 60% had a reporting structure combined with clinical nutrition. Predominantly, foodservice systems were 43% in-house versus 41% pre-prepared, 46% cook–serve food production, 64% meals assembled centrally (on-site), and 40% non-selective menus with limited opportunities for patient choice in advance or at meals. The “regular menu” (44%) was most commonly served as 3 meals, no snacks at specific times. Energy and protein-dense menus were available, but not widespread (9%). Daily energy targets ranged from 1200 to 2400 kcal and 32% of respondents viewed protein targets as important. The number of therapeutic diets varied from 2 to 150.Conclusions: Although hospital foodservice practices vary across Canada, the survey results demonstrate gaps in national evidence-based practices and an opportunity to formalize guiding principles. This work highlights the need for standards to improve practice through patient-centered, foodservice practices focused on addressing malnutrition. - This qualitative study explored the impressions of pregnant Canadian women toward Canada’s Food Guide (CFG) snapshot released in January 2019. Semi-structured interviews were conducted with 8 physically active pregnant women. Interviews were digitally recorded, transcribed verbatim, and analyzed using thematic analysis. Three themes emerged: (i) pregnancy changes what I eat; (ii) what is healthy to me? and (iii) a connection with people and food. Pregnancy was the primary factor influencing dietary changes, and messages in the snapshot reinforced some dietary behaviours that participants had already incorporated. Participants wanted information specific to pregnancy but were not aware of available resources pertaining to nutrition on existing websites. Dietitians and other health care professionals should take steps to raise awareness of and ensure wider dissemination of reliable resources on healthy eating during pregnancy including Canada’s Food Guide website.
- Purpose: The COVID-19 pandemic has impacted the lives of lesbian, gay, bi, trans, queer, and other groups (LGBTQ+) within Canada. This research aimed to explore the experiences of LGBTQ+ Canadians in relation to their nutritional needs, practices, and supports during the COVID-19 pandemic.Methods: The qualitative study was framed within a poststructuralism and queer theory paradigm and consisted of an online questionnaire. Participants were recruited and asked to complete open-ended questions. Responses were coded using thematic analysis.Results: Seventy participants completed the questionnaire. Data analysis resulted in 3 major themes, including (i) (dis)comforts of food and eating, (ii) shifting views of food and food practices, and (iii) what supports? The themes revealed that many LGBTQ+ individuals experienced stress and anxiety during the COVID-19 pandemic. It was a time in which their views and practices of food, cooking, and eating were changed. Nutritional supports were discussed in terms of family, friends, and partners.Conclusion: The findings highlight the complexity to the meanings people give to food, cooking, and eating during stressful times. It is recommended that dietitians familiarize themselves with the experiences of LGBTQ+ people, especially during times of global health emergencies to ensure equitable health care for LGBTQ+ communities.
- A concept analysis using the method of Walker and Avant was undertaken to clarify the concept of food insecurity in older adults in Canada and the United States. A literature review was undertaken to conduct a concept analysis of food insecurity in older people. Food insecurity is associated with multiple negative health outcomes and may be experienced differently by older adults as compared to younger adults. It is therefore important to understand the concept of food insecurity as is relates to older adults. Four defining attributes of food insecurity in older adults in Canada and the United States were identified: (i) inability to acquire or prepare enough food, (ii) compromising on food quality or preference, (iii) uncertainty or anxiety around the ability to acquire or prepare food, and (iv) socially unacceptable or non-normative practices. These attributes may allow for improved policies and programs aimed at addressing food insecurity in older adults by better meeting the needs of older individuals. Additional research into food insecurity as experienced by Canadian and American older adults could help to further clarify the concept.
- Jessica Martino MSc, RD (candidate),
- Corinne Eisenbraun MA, FDC,
- Brenda Hotson MSc, RD,
- Rhona M. Hanning PhD, RD, FDC,
- Elin Lövestam PhD, RD,
- Jessica R.L. Lieffers PhD, RD, and
- on Behalf of the International NCP/NCPT Implementation Study (INIS) Consortium
Purpose: The purpose of this paper is to understand Canadian dietitians’ use of the Nutrition Care Process (NCP) and terminology (NCPT) nationally and by province/territory as well as facilitators, barriers, and attitudes regarding the NCP/NCPT.Methods: Canadian dietitians were invited to complete an online survey (SurveyMonkey) on the NCP/NCPT from February to April 2017 through multiple channels. Data were analyzed using descriptive statistics and nonparametric tests.Results: Overall, there were 500 eligible respondents; the analysis focused on dietitians working in clinical care who were familiar with the NCP (n = 420). In total, 87.9% and 77.5% of respondents reported always/frequently using aspects of the NCP and NCPT in their practice, respectively. There were variations in use by province/territory (P < 0.001); use was more frequent in Alberta and Manitoba versus other provinces/territories. A main barrier to implementation was lack of time; main facilitators to implementation were peer support, management support, and required use of the NCP. The prevalence of many facilitators and barriers varied by province (P < 0.05). Attitudes regarding the NCP/NCPT were variable.Conclusions: Overall, most clinical care dietitians reported some type of use of the NCP/NCPT. There were provincial/territorial variations in use, barriers, and facilitators. These findings provide information to develop strategies to enhance use of the NCP/NCPT in Canada.- OPEN ACCESSDysphagia 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.
- Catherine Forgues RD, MSc,
- Julie Fortin BA,
- Cynthia Gagnon OT, PhD,
- Jean-Denis Brisson MD,
- Jean Mathieu MD, MSc,
- Bernard Brais MD, PhD, and
- Claudia Côté RD, MSc
Purpose: To document the nutritional risk in adults with oculopharyngeal muscular dystrophy (OPMD) and its association with oropharyngeal dysphagia.Methods: In this cross-sectional study, 33 adults with molecular confirmation of OPMD between 50 and 75 years old were recruited from the registry of a university-affiliated neuromuscular clinic. Nutritional risk was assessed with the French version of Seniors in the Community: Risk Evaluation for Eating and Nutrition II (SCREEN II), whereas the severity of dysphagia was assessed using the French-Canadian version of the Sydney Swallow Questionnaire. Anthropometric measurements were performed with standardized procedures.Results: SCREEN II scores showed high nutritional risk for 81.8% of OPMD participants with 6 factors contributing to nutritional risk in at least 50% of the sample. Pearson’s correlational analysis showed a significant moderate relationship between dysphagia and nutritional risk (r = −0.470; P = 0.006).Conclusion: To our knowledge, this study is the first to investigate the nutritional risk of adults with OPMD. Our results indicate that individuals with OPMD may be at high nutritional risk mostly associated with swallowing difficulty, in the absence of a low body mass index. The present study highlights the need for dietary counseling in OPMD.- Community gardens (CG) are areas of land where individuals or groups grow food in single or shared plots, typically in an urban setting, providing fresh produce, urban greening, and opportunities to socialize and improve the community. The purpose of this descriptive study was to introduce a CG laboratory (lab) as part of an introductory foods course within a nutrition program and explore how the lab influenced students’ learning and overall experiences. Forty-one students, 2 lab instructors, and 3 student volunteers who tended the CG participated in the survey. Survey analysis revealed 4 interrelated themes: (i) connection and exposure, (ii) food preparation, (iii) benefits of using local food, and (iv) explicit learning. Overall, the lab fostered multiple types of individual and relational learning involving the acquisition of course content and food literacy skills. The CG was valued by students as a curriculum component as well as opportunities for personal growth and development. With the growing importance of food systems knowledge to the profession, CG may act as a site for embodied forms of learning in nutrition programs.
- OPEN ACCESS
- Holly Schaafsma MScFN (c),
- Holly Laasanen PHEc, MScFN (c),
- Jasna Twynstra PhD, and
- Jamie A. Seabrook PhD
Despite the widespread use of statistical techniques in quantitative research, methodological flaws and inadequate statistical reporting persist. The objective of this study is to evaluate the quality of statistical reporting and procedures in all original, quantitative articles published in the Canadian Journal of Dietetic Practice and Research (CJDPR) from 2010 to 2019 using a checklist created by our research team. In total, 107 articles were independently evaluated by 2 raters. The hypothesis or objective(s) was clearly stated in 97.2% of the studies. Over half (51.4%) of the articles reported the study design and 57.9% adequately described the statistical techniques used. Only 21.2% of the studies that required a prestudy sample size calculation reported one. Of the 281 statistical tests conducted, 88.3% of them were correct. P values >0.05–0.10 were reported as “statistically significant” and/or a “trend” in 11.4% of studies. While this evaluation reveals both strengths and areas for improvement in the quality of statistical reporting in CJDPR, we encourage dietitians to pursue additional statistical training and/or seek the assistance of a statistician. Future research should consider validating this new checklist and using it to evaluate the statistical quality of studies published in other nutrition journals and disciplines. - Purpose: Postsecondary students who move to a new country to continue their education experience a drastic shift in food landscape, often resulting in unhealthy dietary adaptations.Methods: This mixed-method study explored the eating experiences and dietary patterns of 30 international students attending a Canadian university. Data were collected through focus groups that were analyzed thematically and dietary records analyzed for compliance with Canada’s Food Guide for Healthy Living (2007).Results: Results showed that many participants want to maintain home country food traditions, yet their new independent living status and novel food environments led to changes in dietary habits. Limited food skills, busy schedules, reduced access to familiar foods, and fast-food environments contributed to unhealthy eating patterns. These perceptions were reflected in the high consumption of “other”, less nutritious foods and low servings of fruits and vegetables, milk products and alternatives, and grain products.Conclusions: These findings show that international university students face dual challenges of transitioning into independent living without sufficient food skills and family supports, and exposure to unfamiliar and unhealthy food environments. Resources need to be developed for newly enrolled international students that emphasize food awareness, food skills, and healthy eating habits.
- Purpose: The present study examined differences in mental health and well-being between students with and without suspected food insecurity during their transition to university.Methods: We drew on existing data from 4 samples of first-year undergraduates enrolled at 3 large universities in 3 provinces (Alberta n = 199, Québec n = 299, and Ontario n = 461 and n = 510). Students completed online surveys assessing a wide range of health-related behaviours and indicators, and students were classified as food secure or insecure based on their responses to screening questions.Results: Mental health (depression, anxiety, low satisfaction with life) was consistently poorer in students classified as food insecure across all samples. The magnitude of mental health deficit was comparable to socioeconomic disadvantage associated with food insecurity.Conclusions: Students experiencing food insecurity are disproportionately launching their university careers with poorer mental health, revealing a critical point of intervention for these socioeconomically higher-risk students.
- Ana Carolina Leme PhD, RD,
- Dabrowka Muszynski MSc, RD,
- Julia A. Mirotta BASc, MSc,
- Nicholas Caroll BASc,
- Jaimie L. Hogan BASc, MSc,
- Kira Jewell MSc,
- Jessica Yu BASc,
- Regina Mara Fisberg PhD, RD,
- Alison M. Duncan PhD, RD,
- David W.L. MA PhD,
- Jess Haines PhD, RD, and
- On behalf of the Guelph Family Health Study
Purpose: To examine associations between preschoolers’ diet quality and parent and child socio-demographic variables.Methods: Cross-sectional analysis with 117 preschoolers. Parents reported socio-demographics and their children’s diet using 3-day food records. Diet quality was assessed using the Healthy Eating Index (HEI) 2015. Linear regression models were used to analyze associations between socio-demographics and HEI scores.Results: A total of 86% of children had an HEI-2015 score in the “needs improvement” category (51–80 out of a maximum of 100). Children’s overall HEI-2015 score was inversely associated with children’s age (β = −0.19, 95% CI −0.37, −0.02). Parental education was positively associated with children’s overall HEI score (β = 9.58, 95% CI 3.81, 15.35) and with scores for total fruit (β = 1.00, 95% CI 0.39, 1.76), vegetables (β = 1.11, 95% CI 0.03, 2.18), total protein (β = 1.06, 95% CI 0.28, 1.84), and seafood/plant protein (β = 1.67, 95% CI 0.43, 2.89) components. Children who identified as Caucasian (β = 4.29, 95% CI 2.46, 6.14), had a Caucasian parent (β = 3.01, 95% CI 0.78, 5.25), or parents who were born in Canada (β = 2.32, 95% CI 0.53, 4.11) had higher scores for dairy.Conclusion: Our results suggest that preschoolers’ diet quality needs improvement and that children’s diet quality varies by children’s age and parental education level.- Nutrition is important for prostate cancer (PCa) care as it may influence PCa progression and risk of comorbid diseases. The aim of this pilot study was to assess changes in knowledge and satisfaction in men with PCa following attendance at a nutrition education seminar. Fifty-two men with PCa attended nutrition education seminars instructed by a Registered Dietitian. Participants completed the Revised General Nutrition Knowledge Questionnaire (GNKQ-R) preseminar and 2 weeks postseminar, along with a satisfaction survey. Increased nutrition knowledge was observed through a significant (P = 0.023) improvement in mean scores of 71.6% (P < 0.005) preseminar compared with 79.3% (P < 0.005) postseminar on the GNKQ-R. Participants reported the seminar as a satisfactory method for meeting their diet information needs. Using thematic analysis 3 themes emerged: importance of diet information, desire for an integrative approach, and the value of group learning. This pilot study found that a group nutrition education seminar may be an effective and satisfactory approach to fulfilling the dietary information needs of this population. Group education may be an economically sustainable approach with potential application in other tumour sites or health conditions.