The Client's Goals Are My Primary Responsibility: A Qualitative Study Examining Dietitians' Perceptions of the Barriers and Facilitators to Incorporating Environmentally Sustainable Food Systems in Clinical and Food Services Practice Within Healthcare Settings
Notice bibliographique
Résumé
INTRODUCTION: Current industrial food systems are not sustainable; they threaten future generations and cause rapid environmental degradation. Shifts to more sustainable food systems (SFS) and associated dietary practices can help reduce the carbon footprint and promote environmental sustainability. Dietitians working in healthcare settings can promote SFS initiatives. This study explored dietitians' SFS practices and their perceptions of the barriers and facilitators within healthcare settings. METHODS: This study analyzed secondary data from a survey of dietitians in Canada, the United Kingdom (UK), Australia, and the United States (US). A convenience sample of dietitians was recruited through national dietetic associations, professional networks, social media, listservs and snowball sampling. Responses were isolated for dietitians working in clinical and food services practice areas and analyzed thematically. The socio-ecological framework was used to understand areas where dietitians have influence within healthcare settings. RESULTS: Three main themes were identified where clinical and food services dietitians (n = 111) are incorporating SFS into practice in healthcare settings: education, communication, and workplace-related activities. Key barriers included operational and organizational factors (competing priorities), external factors (rising food costs), practice area constraints (limited role clarity), and concern for the client-practitioner relationship (CPR). The CPR tension theme emerged as a challenge for clinical dietitians in incorporating SFS into patient counselling. Facilitators included organizational factors (leadership), research and educational resources, personal factors (interest), and practical tools and resources (national food guides). CONCLUSION: This study underscores the important work that dietitians are already doing across countries with different yet comparable dietetic professions and health systems. Recognizing that the barriers and facilitators identified in this study will vary between nations, institutions and practitioners, four areas of consideration were suggested, including expanding the client-practitioner relationship to include planetary health; learning from what dietetics and nutrition professionals are doing in other countries; advocating for policy and organizational changes within healthcare, and communicating in the 'cost language' of decision-makers. This study identified that there may be gaps for some dietitians in understanding client-centredness in the context of planetary health. This study highlights the need for further research to support more formalized approaches to the incorporation of SFS and planetary health considerations across all dietetic practice areas.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,016 | 0,022 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,001 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,012 | 0,008 |
| Communication savante | 0,004 | 0,003 |
| Science ouverte | 0,002 | 0,005 |
| Intégrité de la recherche | 0,002 | 0,004 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».