The ADA's research priorities contribute to a bright future for dietetics professionals

The ADA research philosophy is that research is the foundation of the profession, providing the basis for practice, education, and policy (6) and (7). Evidence-based practice and the development of nutrition care guidelines presume that the body of research is adequate and continually addresses key questions related to provision of nutrition care (13). Key characteristics of a viable profession and strategies for success include the continual infusion of ideas and effective use of research in evidence-based practice (5) and (14). Involvement of all the members of the profession is essential to the continued dynamic nature of dietetics. It is necessary to ensure that ADA members, ADA organizational units, and external funding organizations address the most important research. The Research Committee is exploring how to measure progress toward the research priorities and determine how to update the priorities on an ongoing basis to reflect the current research needs of the dietetics profession.ADA Priorities for Research

• Prevention and Treatment of Obesity and Associated Chronic Diseases

• Effective Nutrition and Lifestyle Change Interventions

• Translation of Research into Nutrition Interventions and Programs

• Effective Nutrition Indicators and Outcome Measures

• Dietetics Education and Retention

• Delivery of and Payment for Dietetic Services

• Access to Safe and Secure Food Supply

• Customer Satisfaction

• Nutrients and Gene Expression

(For specific research objectives under each priority area, see full text at www.eatright.org/Public/index_9916.cfm)(2)     

Views of the dietetics profession on communication skills for behaviour change in dietetics

Background: There is strong evidence to suggest that the communication skills of the practitioner are an important factor in helping people to change health‐related behaviour (Najavits & Weiss, 1994; Stewart et al., 2003). Despite this, many UK dietitians perceive their pre‐registration training in communication skills to be inadequate (Rapoport & Nicholson Perry, 2000). Many new courses have recently been approved by the Health Professions Council, and the British Dietetic Association (BDA) has recently undertaking a curriculum review for dietetic training. This study aimed to explore the current views of the dietetic profession in relation to their training in this area. Methods: A cross sectional survey was completed in October 2007. All BDA members (n = 6013) were sent a questionnaire to ascertain their views on communication skills for behaviour change in dietetic practice and relevant training. The questionnaire had been piloted on dietetic colleagues and comments received from an expert on communication skills for behaviour change. Approval was obtained from the University of Nottingham Medical School Research Ethics Committee. Results: There were 1158 respondents (19% response rate) of whom 418 (36%) had qualified since 2000. All countries within the UK and a wide variety of specialist areas were represented. Some communication skills training had been completed by 89% of respondents. Communication skills were rated as either ‘very’ or ‘extremely’ important by 96% respondents. There was no difference between those who had qualified before the year 2000 and those who had qualified since. Respondents agreed that implementing communication skills had led to improvements in their relationships with patients (70%), job satisfaction (59%) and confidence in client interviews (69%). However, 21% felt time keeping in client interviews was worse. Time was also identified as a barrier to putting learning into practice (19%). The majority of respondents (89%) felt they would benefit from further training. Discussion: The results must be viewed in light of the relatively low response rate. However, respondents clearly endorsed the importance of good communication skills in practice and had personally experienced positive outcomes because of their use. Despite their positive attitude, the practice of good communication was felt to have had a negative effect on time‐keeping. Unsurprisingly, the majority of participants wanted further training. Conclusions: The negative effect of introducing changes of practice to improve communication skills upon time‐keeping was a major concern for BDA members. Further research and training is required to support the implementation of improved communication skills within the recognized time constraints of dietetic practice. References Najavits, L.M. & Weiss, R.D. (1994) Variations in therapist effectiveness in the treatment of patients with substance use disorders: an empirical review. Addiction 89, 679–688. Rapoport, L. & Nicholson Perry, K. (2000) Do dietitians feel they have had adequate training in behaviour change methods. J. Hum. Nutr. Diet. 13, 287–298. Stewart, M. et al. (2003) Patient centred medicine: Transforming the clinical method, 2nd edn. Oxford: Radcliffe Medical Press.     

Medicare reform: what it means to the future of dietetics

A considerable amount of work will be required to fully implement these provisions. New guides for practice and evidence-based practices will have to be developed and implemented. However, the demand for the services of ADA members should significantly increase as this bill and the regulations go into effect.Expansion of the MNT benefits within Medicare was the result of many years of hard work by ADA members in educating Congress about the benefits of dietitian services. Enactment of these benefits is a milestone that should not pass unnoticed. Increasingly, dietitian services are being seen as an essential element of any comprehensive health plan. This has long been the goal of the ADA and its members. In reaching that goal, the ADA and its members have reason to celebrate before getting down to the tremendous work that will be required to successfully meet the challenges of implementing the new benefits.     

Training health professionals: a multidisciplinary team approach in a university-based weight-loss program

In a university-based weight-loss program for preadolescent girls, a multidisciplinary team delivered the intervention. The team included a nurse/health educator, an exercise physiologist, a psychologist, five dietitians, and 17 dietetics, nursing, and medical students, The six-month program provided 12 educational sessions in nutrition, stress management, behavior modification, and exercise. Concurrent sessions for parents addressed comparable educational topics and parenting skills. Dietitians and student research assistants (n = 19) were surveyed regarding their participation on a multidisciplinary team and their acquisition of new knowledge/skills. The survey included both open-ended questions and Likert-type statements. Results indicate that participation enhanced knowledge of nutrition counseling/education (chi = 1.6) as well as appreciation for research (chi = 1.8) and for the multidisciplinary team approach (chi = 1.7). Qualitative data reinforce the benefits of the multidisciplinary experience and multiskill training. Exercise, stress management, parenting skills, and psychological techniques were perceived as important skills to develop for professional careers.     

Ensuring public health professionals go the distance: a case study from an online data skills course.

Distance learning methodologies provide an effective and economical means for professional staff to advance their skills while continuing to meet their extensive work-related responsibilities. However, motivating professionals to engage in training opportunities that do not include the customary features of a trip out of town and time away from the office is a challenge for distance training initiatives aimed at the public health workforce. This article describes the implementation of several features designed to motivate public health professionals to participate in an online analytic skills course.     

Coordinated school health program and dietetics professionals: partners in promoting healthful eating

Although research indicates that school meal programs contribute to improved academic performance and healthier eating behaviors for students who participate, fewer than 60% of students choose the National School Lunch Program or School Breakfast Program. School meal programs have a difficult time competing with foods that are marketed to young people through sophisticated advertising campaigns. Youth's preferences for fast foods, soft drinks, and salty snacks; mixed messages sent by school personnel; school food preparation and serving space limitations; inadequate meal periods; and lack of education standards for school foodservice directors challenge school meal programs as well. A coordinated school health program offers a framework for meeting these challenges and provides children and adolescents with the knowledge and skills necessary for healthful eating. This article identifies challenges facing school foodservice directors in delivering healthful meals and acquaints dietetics professionals with the coordinated school health program to be used as a tool for addressing unhealthful weight gain and promoting healthful eating.     

Creating images of the future: a simulation game for dietetics students

A learning activity was developed for senior dietetics students to prepare them to respond to a changing future. It combined two methods commonly used to study the future--scenarios and simulation games. The simulation game asked the players to make career choices in accordance with specified scenarios in the areas of politics, economics, health care, foodservice systems, education, and technology. Scenarios could change throughout the game, either by chance or the choice of the players. Major factors affecting individual life-styles, such as acquiring a partner or children, were included. Each player made career choices at 5-year intervals, as he or she moved through life from the present age to age 65. At each age interval, the players discussed the options created by the scenarios in relation to the availability of career choices. Student and instructor response to the activity has been favorable.