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At least 19 recordsLinked to original sources
PubMed2026

Understanding and Usefulness of Effect Size and Certainty of Evidence: A Cross-Sectional Survey of Evidence-Based Practice Competencies Among US Registered Dietitians.

INTRODUCTION: Understanding of absolute and relative effect estimates, and determining effect size and certainty of evidence corresponding to effect estimates, represent fundamental evidence-based practice competencies that promote informed clinical decision-making. While research has been conducted in the medical profession, based on our literature review there is no published research on these competencies in the nutrition and dietetics profession. METHODS: Among registered dietitians, our main objectives were to assess (1) their understanding and perceived usefulness of three absolute and two relative effect estimate approaches to determine effect size, (2) their perceived usefulness of certainty of evidence, and (3) factors influencing their understanding and perceived usefulness. We conducted a web-based, cross-sectional survey by recruiting dietitians from the Academy of Nutrition and Dietetics (United States). Participants received effect estimates based on hypothetical dietary interventions vs. usual diet for reducing myocardial infarction risk. RESULTS: Of the 11,050 dietitians who received the survey link, 210 participated, and only completers (n = 114) were included in our analysis. Participants demonstrated a similar understanding of the relative (27.6%) and absolute (27.5%) effect estimates, with Risk Difference being the best understood approach and Number Needed to Treat being the least (30.7% vs. 24.6% correct responses). While perceived usefulness scores were similar between five approaches, they were highest when data was presented as Relative Risk [mean (SD): 4.82 (1.50)]. Dietitians rated the usefulness of certainty of evidence favorably [mean (SD): 5.07 (1.83), on a 7-point scale], and no factors were associated with correct understanding. CONCLUSION: Dietitians may have limited understanding of effect size thresholds presented in our survey, a finding mostly consistent with surveys of other health professionals. To optimize informed decision-making between dietitians and clients, dietetic programs and continuing education platforms should consider additional training on effect estimate approaches (relative and absolute), and determining effect sizes and certainty of evidence for effect estimates.

Clinical nutrition↗
PubMed1979

The consultant dietitian in nursing homes. I. Methodology and general information.

The functions of the consultant dietitian and the foodservice supervisor were studied by surveying dietitians consulting in nursing homes and the administrators of each dietitian's nursing home accounts. Data were available from consultants and administrators in 297 nursing homes in a twelve-state, midwestern region. Almost 60% of the homes had employed a consultant for three to eight years, and nearly half had employed the present consultant for the same length of time. Generally, the dietitians made one to three visits to the homes a month, for a total of 3 to 12 hr. The administrators listed personnel, cost of department operation, and facilities as problem areas in foodservice. Dietitians reported greater concern than did administrators in all of the rated problem areas except cost. Problem ratings of the two groups reflected differences in interest and expertise.

Consultants↗
PubMed1979

Strategies for nutritional counseling. Dietitians' attitudes and practice.

Responses to a questionnaire distributed to forty-four Midwest dietitians during the development of a program to train dietitians in patient counseling strategies are summarized. Dietitians rated forty-five strategies, divided into five broad categories: Instructional, motivational, behavioral, educational diagnosis, and assessment of compliance. Questions about each strategy included reported use, perceived benefits, and perceived barriers to implementation. Six nutritional consultants rated the relative innovativeness of the strategies. The results provide evidence that strategies currently being developed for training dietitians are compatible with dietetic practice, are often viewed favorably by practitioners, and are "teachable" to nutritionists.

Attitude of Health Personnel↗
PubMed1979

Dietitians' effectiveness and patient compliance with dietary regimens. A pilot study.

Demonstration of dietitians' effectiveness is a necessary prerequisite in documenting the cost-effectiveness of untritional care. In this report, a framework for the study of dietitians' effectiveness and patient compliance with dietary regimens is developed, and the results of a pilot study are presented. Personal, attitudinal, and situational variables that affect adherence to diets were investigated. Findings suggest that (a) disclosure of patient non-compliance varies, depending on the type of question asked and the sequence of questions in an interview; and (b) dietitians with higher "Orientations to Social Influence" use more influence strategies, involve patients in counseling sessions more, and tend to have patients with more appropriate health attitudes and behaviors.

Adolescent↗
PubMed1979

Home health care: the dietitian's role.

Nutritional services are an important part of the home care program. Medicare, Medicaid, and other third-party mechanisms do not reimburse providers for such services, even though the cost for home care is lower than for institutional care. Recognizing the need for nutritional services, the Veterans Administration has included the dietitian as a member of the home care team. Skills and guidelines developed by The American Dietetic Association for home and ambulatory care were adapted and utilized in developing a dietetic home care procedure which helps to avoid institutional care and provides a better quality of life at home. Nutritional services should be an integral part of all home health care programs. Because most home care programs do not have funds for a dietitian's service, legislative and/or regulatory action is needed to provide reimbursement for nutritional home care services.

Adult↗
PubMed1979

Professionalization and the dietitian.

Professionalization as a process is reviewed and characteristics an occupation acquires as it becomes professionalized are outlined. Those attributes include founding a professional association with membership requirements to exclude the unqualified; control of education and admission to the profession by current members, frequently working through the professional organization; possible licensure or certification as a prerequisite to practice; a name change to provide enhanced status or prestige; and elaboration of an altruistic, service-oriented code of ethics. Relevant developments in dietetics and the history of The American Dietetic Association are then compared with this model. Advances have been and continue to be made in the above areas as the professionalization of dietetics and the dietitian progresses.

Accreditation↗
PubMed1979

Quality and standards--the dietitian's heritage. 16th Lenna Frances Cooper Memorial Lecture.

Since 1917, when The American Dietetic Association was founded, dietitians have been charged with accountability for defining and maintaining quality and standards related to food. This heritage continues to be a challenge to the profession. With current methods of food production, processing, preparation, and distribution, and varied and changing consumer preferences and demands, the need for monitoring the effect of these changes on quality as it relates to improving the nutrition of people is critical. Quality must be defined with regard for values and goals for individual situations and under varying circumstances. Standards by which that specific quality can be measured need to be described. Tian's heritage" their "hallmark" of quality.

Dietetics↗
PubMed1979

The consultant dietitian in nursing homes. II. Functions and change effectiveness.

Data are reported on functions and effectiveness of consultant dietitians in nursing homes. Key responsibilities of the consultants included: Planning and writing menus, in-service training, nutritional assessment, and discussing diets with physicians. Activities performed on each visit to the nursing home were resident visitation and dietary consultation, nutritional assessment, communication with other departments, and checking foodservice and sanitation procedures. Most important activities of the consultant, as perceived by the administrators, were in three functional areas: Menu planning, modified diets, and education and training. Administrators indicated that the most significant change brought about by consultants involved modified diets, menus, sanitation, and communication between the foodservice department and other departments and with the administration.

Consultants↗
PubMedDate not supplied

[The dietitian's role].

Explore the source record for details and available documents.

Cancer Care Facilities↗
PubMed1977

Dietary control of hyperlipidaemia. Dietitians in the EEC: 2. Republic of Ireland.

One hundred and ten adult out-patients entered a prospective study of the effect of dietary control of hyperlipidaemia. Seventy-nine were male and 31 female. Eighty-four patients had primary type II and 26 had primary type IV hyperlipidaemia. Cases of secondary hyperlipidaemia were excluded. Patients with type II hyperlipidaemia were treated with a diet low in saturated fat and cholesterol, with substitution of polyunsaturated fats. Additional carbohydrate and alcohol restriction was applied to patients with type IV hyperlipidaemia. Calorie restriction was prescribed for overweight patients. In type II patients, mean serum cholesterol fell from 322 to 286 mg per 100 ml, and weight from 159 to 152 lb over the first six months of treatment. In type IV patients cholesterol fell from 328 to 281 mg per 100 ml, triglycerides from 389 to 241 mg per 100 ml and weight from 166 to 156 lb over the same period. All reductions were statistically significant at the 1 per cent level. No statistical correlation was observed between reduction of weight and reduction in lipid levels. Over a three-year follow-up period no tendancy for lipid levels or weight to 'rebound' was noted. It is concluded that diet can produce a significant reduction in plasma lipid levels over six months in some hyperlipidaemic patients. Further follow-up is continuing to determine whether this effect can be maintained over the longterm.

Adult↗