Undergraduate dietetics programs do not support training students in smoking cessation

Although tobacco use is the leading contributor to death and disability in the United States, allied health professionals often lack knowledge of smoking cessation techniques. The objective of this study was to identify the extent to which undergraduate dietetics programs (referred to as didactic programs in dietetics [DPD]) teach about tobacco and smoking cessation interventions and also DPD directors' opinions regarding tobacco and smoking cessation in dietetics education. All DPD directors in the United States (n=231) were sent a questionnaire to assess programs' and directors' demographics, courses that included tobacco and smoking cessation education, and directors' opinions pertaining to tobacco and smoking cessation education. The response rate was 49% (n=113). On average, DPD directors did not agree that tobacco and smoking cessation education should be a formal part of undergraduate dietetics programs and that it is not as important as other content areas required of dietetics students. Just 37% of directors believed that a dietitian's job responsibility included educating patients on smoking cessation. Only 7% of DPD directors had formal education on smoking cessation and tobacco use, but 53% had formal education on behavior modification. More than half of DPD programs (56%) did not offer any courses that provided tobacco and smoking cessation education. These results indicate that most undergraduate dietetics programs do not incorporate tobacco and smoking cessation education in their curricula. Dietetics and other allied health educators could consider including smoking cessation education in their curricula to ensure that future health professionals can contribute to Healthy People 2010 objectives related to smoking cessation.     

Faculty perspectives of health promotion in allied health curricula: results of a national survey

More knowledge and skills related to health promotion/disease prevention are being required of health professionals. Allied health graduates entering the workforce will need academic preparation in these areas. This study assessed faculty perspectives on the status of health promotion content in allied health programs by a survey of 524 program directors. A questionnaire gathered information about perception of importance, level of representation, and method of delivery of health promotion content. Response rate was 41%. The majority of participants thought this content area was important for their programs and was highly or moderately represented in their curricula. Level of representation was significantly associated with requirement for accreditation. Programs in the Northeast were more likely to think health promotion was important and those in the West were more likely to have it integrated into their curricula. The most common delivery modality was guest lecture. Allied health is adopting health promotion curricular content, but further study is needed to assess programs and faculty expertise and identify strategies to ensure greater consistency of delivering material.     

Perceived knowledge, attitudes, and practices of California registered dietitians regarding dietary supplements

A convenience sample of California registered dietitians (RDs) (n=253) completed a survey investigating the perceived knowledge, attitudes, and practices of RDs who had or had not received formal training in use of dietary supplements. We also examined whether differences existed between RDs registered before or after 1997, when the American Dietetic Association began requiring that dietetics curricula include basic knowledge of dietary supplements. Statistical analysis included analysis of variance and chi2 analysis. Among this sample of RDs from California, those registered before 1997 (n=194) were more likely (P<0.05) to agree that they are knowledgeable regarding supplement use, safety, interactions, and contraindications than those registered after 1997 (n=46), and were more likely (P<0.05) to assess client use. Among this sample of RDs from California, those reporting that they had received formal training in dietary supplements (n=145) were more likely (P<0.05) than those who had no formal training in supplement use (n=105) to agree that they are comfortable discussing supplements with the public; are knowledgeable regarding uses, safety, interactions, and contraindications of supplements; and assess client use. Providing RDs professional education opportunities on supplements continues to be warranted.     

A distance education in undergraduate dietetic education

Distance education is an exploding phenomenon that allows people to pursue higher education on their own time, at a pace that meets their needs, in locations where there are no colleges and universities, or where there is not a desired program of study. This study examined the use of distance education in undergraduate dietetic education programs and the opportunities for obtaining an undergraduate degree in dietetics solely via distance education. A survey was sent to all directors (n = 279) of undergraduate programs accredited/approved by the Commission on Accreditation for Dietetics Education to determine the current status and projected future use of distance education in their institutions' on-campus programs. The survey had a 54% response rate. Approximately 32% (n = 150) of undergraduate dietetics programs offer distance education courses in some format. Institutions that offer nondietetics distance education courses were more likely to offer dietetics distance education courses. The most common distance education format utilized in dietetics was 100% Internet courses (48%). The most common distance education dietetics course offered was a basic or introductory nutrition course (31%). From the data of courses offered, or permitted to be transferred, it would not be possible for a student to complete an undergraduate degree in dietetics solely via distance education methodologies at the time this study was conducted.     

Physicians ask for more problem-solving information to promote and support breastfeeding

Physicians (n=262) were surveyed about their breastfeeding promotion practices, knowledge, and areas in which they need more information in order to be more influential with patients in the initiation and duration of the process. Over half (51%) reported no or limited education in breastfeeding, whereas only 9% reported adequate education. A knowledge assessment indicated almost half (42%) did not know certain viruses can be transmitted through breast milk. There were also mixed responses to the need for vitamin D supplementation. Promotion practices included most (82%) thinking the physician has a primary role in the feeding decision, and most did discuss the benefits with patients; however, only 54% would recommend breastfeeding to a patient who had decided to bottle-feed. Problem-solving was the main area physicians reported needing more education. Partnerships with dietetics professionals may fill the gaps in the support needed to increase rates of breastfeeding.     

Cultural Competency Training and Evaluation Methods Across Dietetics Education: A Narrative Review

Developing cultural competence among credentialed nutrition and dietetics practitioners is critical to move toward eliminating disparities in health care. Despite emphasis put forth on culturally competent care by credentialed nutrition and dietetics practitioners, the types, methods, and outcomes of cultural competency training are lacking or inconsistent. In this narrative review, we evaluated studies detailing cultural competency training for content, modes of delivery, and learner outcomes. Main inclusion criteria were students in dietetics or credentialed nutrition and dietetics practitioners engaging in an educational intervention. Exclusion criteria were studies published before 2000 and not published in the English language. Ten studies were reviewed from four health science databases. Our aims were to quantify the literature on cultural competence training in dietetics education and describe the interventions to identify gaps within the field; thus, a quality assessment tool was not utilized. Data were extracted on learner type, number of participants, curriculum content, intervention type, learning outcomes, and outcome evaluation tool. Most studies employed interprofessional education (n=7) and/or service learning (n=6) as interventions types. Quantitative evaluation of learners in the studies reviewed indicated increased knowledge and skill (statistically significant; n=2), whereas qualitative evaluation of learners indicated themes, including curriculum satisfaction, gains in competence, and comfort working with diverse people. Methods of evaluation and delivery were inconsistent, making it difficult to draw larger conclusions about cultural competency training in dietetics. Cultural competence creates opportunities for growth and development of health professionals to serve diverse communities and work environments; future work should include standardizing evaluations of training, specifically to include both qualitative and quantitative methods.     

Teacher beliefs, professional preparation, and practices regarding exceptional students and sexuality education

Sexuality education, part of the comprehensive school health education component of a Coordinated School Health Program, interests many health educators as well as special education teachers. In this study, Florida special educators reported their beliefs about teaching sexuality education to educable mentally disabled students, the range of sexuality topics they teach, and their professional preparation in sexuality education. Respondents (n = 494) completed a mailed instrument that included the 36 sexuality content areas identified by the Sexuality Information and Education Council of the United States. Respondents believed strongly that many of the sexuality topics and content areas should be taught to educable mentally disabled students. However, most reported delivering only a modest amount of sexuality education, and they rated their professional preparation as inadequate. Regression analyses documented that respondents' beliefs predicted the topics they actually taught within 5 of the 6 key concepts. This study supports collaboration between health educators and special education teachers to adapt existing sexuality curricula for students with special needs, improve professional preparation of special education teachers to teach sexuality education, and to more effectively implement comprehensive school health education through the Coordinated School Health Program model to special education students.     

Nondiet Weight-Neutral Curricula Limited in Current Accredited US Dietetic Programs

ObjectiveDetermine awareness and prevalence of, and interest in nondiet weight-neutral (NDWN) focused curriculum and factors associated with the presence in accredited dietetic programs throughout the US.MethodsOnline cross-sectional survey sent to directors of US Coordinated Programs (n = 60) and Didactic Programs in Dietetics (n = 214).Results116 programs (42%) responded, 95% reported knowledge of NDWN approaches to weight management like Health at Every Size. Most schools (72%) included NDWN in their curriculum, mostly in a single lecture (53%). Most respondents (74%) reported interest in an NDWN curriculum. Common factors for not including NDWN were: lack of trained and knowledgeable staff (35%) and insufficient space in the curriculum to incorporate additional topics (35%).Conclusions and ImplicationsMost knew of NDWN approaches and included in curricula but only as 1 lecture. Faculty training and curriculum flexibility may help support the increased incorporation of NDWN approaches.     

Community-Level Successes and Challenges to Implementing Adolescent Sex Education Programs

Best practices for adolescent sex education recommend science-based approaches. However, little is known about the capacity and needs of organizations who implement sex education programs on the local level. The purpose of this research was to describe successes and challenges of community organizations in implementing science-based sex education. Using qualitative methods, we interviewed program directors and educators in 17 state-funded adolescent pregnancy prevention/sex education programs as part of a larger mixed methods evaluation. Semi-structured interviews focused on success and challenges faced in implementing science-based approaches to program design, implementation and evaluation. Interviews were audio-recorded, transcribed and analyzed using a thematic approach. Grantees included a range of programs, from short programs on puberty and HIV for late elementary students, to skills-based curricular sex education programs for high schools, to year-long youth development programs. Key aspects of curricular choice included meeting the needs of the population, and working within time constraints of schools and other community partners. Populations presenting specific challenges included rural youth, youth in juvenile justice facilities, and working with Indiana’s growing Latino population. Programs self-developing curricula described challenges related to assessment and evaluation of impact. Programs using commercial curricula described challenges related to curricular selection and adaptation, in particularly shortening curricula, and adapting to different cultural or social groups. A remarkable degree of innovation was observed. The use of qualitative methods permitted the identification of key challenges and successes in a state-sponsored small grants program. Information can be used to enhance program capacity and quality.     

A success of a genetics educational intervention for nursing and dietetic students: A model for incorporating genetics into nursing and allied health curricula

Allied health care professionals and nurses provide genetic-related client services, such as eliciting family medical history information and discussing the genetic component of health conditions. However, these professionals report a lack of confidence in their ability to perform genetic services and have little formal education in genetics. A barrier to incorporating genetics into allied health curricula includes the limited flexibility to expand curricula. This barrier was addressed by incorporating a Web-based tutorial on basic genetics and a lecture on the genetics of diabetes into preexisting undergraduate nutrition courses for nursing and dietetic students. The vast majority of students enrolled in these required courses participated in the intervention. Most participants agreed that genetics is important to their future career. Following the intervention, students' knowledge of genetics and confidence in their ability to provide genetic-related services increased significantly. Despite the short-term success and positive student evaluations, a single educational intervention does not appear to be sufficient for students to become proficient in performing the recommended genetic competencies for all health care professionals. Recommendations and resources for incorporating genetics into allied health curricula are included.     

Assessing interdisciplinary education in U.S. dental hygiene programs

This study was done to examine the role of interdisciplinary education in dental hygiene curricula, identify factors associated with its implementation, explore the perceptions of dental hygiene educators related to interdisciplinary education, and explore these educators' perception of its validity and barriers to implementation. A 36-item questionnaire mailed to directors of all 216 dental hygiene programs in the United States elicited program demographics and information about participation in clinical and didactic interdisciplinary educational experience as well as attitudes regarding such experiences. The response rate was 63% (n = 136). Of the 136 respondents, 31% (n = 69) indicated that the dental hygiene curricula at their institutions included interdisciplinary activities; 15% (n = 33) indicated participation in both clinical and didactic interdisciplinary course work. Student participation was minimal, with most interdisciplinary activities taking place in didactic course work, but 74% (n = 160) of the respondents felt their students should be participating in interdisciplinary educational experiences. Chi-square analysis identified no consistent association among interdisciplinary activity variables. Many respondents felt that interdisciplinary educational experiences would benefit their students, but very few had incorporated them into their curricula, citing lack of resources and time as reasons. In addition, the term interdisciplinary was interpreted variably.     

Model for multicultural nutrition counseling competencies

A model for multicultural nutrition counseling competencies for registered dietitians was developed and tested. Six hundred four registered dietitians who were members of The American Dietetic Association Public Health Nutrition Practice Group or directors of dietetic internships and didactic programs in dietetics were selected by a stratified random sample method and were mailed a survey. Respondents rated each of 46 competencies using a Likert scale to delineate how essential each competency will be for entry-level dietitians in the next 10 years. Of the 60% who responded (n=363), 94.4% met the study selection criteria. Most were white (85.7%), spoke English as their primary language (96.8%), and had a master's degree (64.4%). Many (37.9%) worked in community/public health facilities or organizations, and 50.4% provided nutrition counseling or education to clients culturally different from themselves. Exploratory principal components analysis extracted 3 factors with 28 competencies loading on them: multicultural nutrition counseling skills, multicultural awareness, and multicultural food and nutrition knowledge. Subjects responded similarly whether or not they provided nutrition counseling to culturally different clients. Secondary analysis revealed no significant interaction or differences between how bilingual dietitians and those of color scored items in the 3 factors. The resulting model is a guideline that can be used by educators to enhance dietetics education and training and by public health nutritionists as a basis for self-evaluation and selection of continuing education opportunities to enhance their multicultural nutrition counseling competence.     

Management training in long-term care

The education of health care administrators faces its most dramatic change since the inception of the field. Recent discussions at the national level call for major overhaul of curricula and teaching modalities, including moving education to position students for evidence-based practice. This paper presents recommendations for incorporating training about chronic and long-term care into health care management curricula. It asserts that all health care management students should have a basic knowledge of the fundamental policy, operating, and financing principles of long-term care. The majority of people using the health care delivery system today, and increasingly in the future, suffer from chronic conditions. Long-term care services, although less expansive in structure, far outnumber acute care services and health plans. They will grow in the future to meet the portending demand. To maximize job opportunities and to optimize performance in any job, health care administrators need to know about the long-term care delivery system. This paper delineates critical topics pertaining to long-term care, organized according to 11 fundamental management areas in which the field is developing core competencies. The contents were derived from a year-long process of asking stakeholders in the various facets of long-term care what topics they thought were essential for administrators to know. The topics delineated in this document represent the consensus about essential knowledge that all health care administrators should have about long-term care, whether specializing in long-term care or following a more general management career. The education of health care administrators faces its most dramatic change since the inception ofthe field. Recent discussions at the national level call for major overhaul of curricula and teaching modalities, including moving education to position students to perform according to evidence-based practice. It is thus timely to consider content, as well as educational format. This paper presents recommendations for incorporating training about chronic and long-term care into health care administration curricula. It asserts that all health care administration students should have a basic knowledge of the fundamental policy, operating, and financing principles of long-term care.     

Assistive technology curriculum structure and content in professional preparation service provider training programs

Assistive technology (AT) and AT services enable children and youth with disabilities and special health care needs to participate in society and are increasingly a part of service provider practice. It is not clear how professional preparation programs are meeting the challenge of preparing service providers to provide AT/AT services. An electronic survey was sent to the program directors for occupational therapy, physical therapy, special education, and speech-language pathology programs in the United States (n = 959) to determine the extent to which AT/AT services were included in the curriculum. The results (n = 153) showed that nearly all of the programs that responded covered AT/AT services in their curriculum, used similar types of faculty and teaching method patterns, and were generally satisfied with the amount of time they spent on the subject. The programs differed, however, in terms of the time spent and emphasis of content specific to their program type. Gaps existed in the extent to which programs covered the influence of culture on the use of AT and addressing the requirement to discuss AT/AT services at every Individualized Education Program meeting. These gaps and emphasis on specific topics within program types indicate that service providers may leave programs with a narrow scope of knowledge about AT/AT services. Information from this survey suggests that to promote contemporary practice in the areas of AT/AT services, entry-level curricula should be enriched or expanded to comprehensively present AT information instruction in this growing service area.     

Changes after taking a college basic nutrition course

A food and nutrition questionnaire was administered to students in a college basic nutrition course (basic nutrition students) and to others in unrelated general studies classes (control students) at the beginning and end of the semester to determine changes other than in academic knowledge of nutrition. Analysis with chi square (p less than .05) compared pre-semester responses (no. = 279) and post-semester responses (no. = 218) with those of 24 senior dietetics students (dietetics majors). After completing the course, all basic nutrition students responded that they had learned a lot about nutrition, and 45% indicated that they had made dietary changes because of this learning. Changes included increased confidence in the adequacy of their diets, decreased supplement use, and reduced fat content of milk usually consumed. Some misunderstandings of carbohydrates in foods were not improved. The similarity of responses by basic nutrition and control students to the pre-semester questionnaire suggests that enrollees in a basic nutrition class may be representative of the general student body in needs for nutrition education. The basic class for non-nutrition majors can effect changes in dietary practices; their nutrition education needs may be used to plan nutrition education of the general student population.