PURPOSE: The purposes of this research were to (1) identify factors that contribute to the barriers to dietary adherence in individuals with diabetes identified in a 1998 study and (2) obtain recommendations from registered dietitians for strategies to overcome these barriers. METHODS: A 10-item, open-ended telephone questionnaire was used to obtain information. The sample included 75 registered dietitians who participated in a previous survey to identify barriers and agreed to a follow-up telephone interview. RESULTS: Of the 75 participants, 28% reported spending 5 hours or less per week counseling individuals with diabetes, 64% spent between 6 and 30 hours, and 8% spent more than 31 hours per week. Almost half of the participants (47%) were certified diabetes educators. Factors identified as the greatest contributors to the barriers being evaluated included lack of time, lack of symptoms, lack of education (including follow-up), poor self-esteem/lack of empowerment, and misinformation from family/peers/others with diabetes. The primary recommendations for overcoming each of these barriers included individualizing meal plans and planning ahead, teaching about complications, and setting obtainable goals. CONCLUSIONS: The registered dietitians who were surveyed emphasized the importance of individualizing dietary counseling.

Attitude of Health Personnel↗

PubMedDate not supplied

Motivational strategies used by dietitians to counsel individuals with diabetes.

The purposes of this study were to determine the use and perceived effectiveness of motivational strategies used by dietitians and to evaluate dietitians' perceptions of barriers to client compliance. A three-part questionnaire with 32 motivational strategies, 16 barriers to adherence, and demographic information was designed and mailed to 862 members of the American Dietetic Association's Diabetes Care and Education Dietetic Practice Group. Statistical analyses included frequency distributions, chi-square analysis, and factor analysis. Only 13 of the 32 motivational strategies were used frequently by 50% or more of the dietitians. The main strategy based on perceived effectiveness was "Tailor the diet to the client's lifestyle." Strategies perceived as effective also were used frequently by a majority of the dietitians. There were differences in use of strategies based on practice setting, CDE certification, and education level. The most significant barrier to adherence was "Complications with lifestyle/competing demands." Factor analysis revealed nine factors for motivational strategies and five factors for barriers to adherence.

Attitude of Health Personnel↗