THE ROLE OF DIETITIANS TOWARDS ALTERNATIVE HEALTH PRACTICES

Two research questions guided this study: How are alternative health practices affecting dietitians' practice? What should dietitians' roles be in actively confronting alternative health practices that convey nutrition misinformation and quackery?
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\nQuantitative and qualitative methods of data collection were used. A self-administered questionnaire was administered to all members of the Saskatchewan Dietetic Association. Data was obtained to answer three subsidiary questions pertaining to the first research question: i) how often and (ii) on which types of AHP dietitians were consulted, and (iii) which resources dietitians accessed when they were consulted on AHP. The questionnaire also collected information about demographics. Qualitative
\nresearch methodology using both focus groups and telephone interviews, were then used to explore dietitians' practice towards AHP and what role dietitians should take in dealing with issues and/or challenges presented by AHP. All dietitians who were contacted in Regina, Saskatoon, Prince Albert, Melfort, Moose Jaw, were invited to participate in focus groups between May and June, 1997. A Reflexive journal, member checking, debriefing sessions, and an audit of the study, were used to increase trustworthiness of or validate the data collected.
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\nThe questionnaire response rate was 53%. Seventy-five percent (n=68) of respondents worked in the nutrition/dietetic field and were generally consulted one to nine times on specific AHP during February 1996 to February 1997. Both questionnaire respondents and focus group/telephone interview participants indicated they were consulted more frequently on high protein products, herbal remedies, and products sold by multilevel marketing companies. Other dietitians, pharmacists, and the book The Honest Herbal by Varro Tyler, were the resources most accessed by dietitians.
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\nParticipants in the first set of focus groups/telephone interviews described three main themes. 1) Participants felt alternative health practices were readily available, for example, unconventional practitioners, multilevel marketing companies, and health food stores are available in Saskatchewan. 2) How participants were consulted and by whom. Participants were consulted when clients asked them unsolicited questions about AHP but more often, participants discovered clients' use of AHP during nutrition consultations. More frequently, participants felt they were not consulted about AHP.
\nParticipants were consulted most often by seniors, competitive and noncompetitive athletes, women, and people with degenerative, debilitating, or terminal diseases, affected how often dietitians were consulted. 3) Participants dealt with alternative health practices in a variety of ways. They educated clients, used methods of persuasion, gained knowledge about AHP in response to questions asked, accessed credible sources of information, used professional ethics, were open-minded, encouraged clients to focus on their diet, established rapport and open-communication, and took time to listen and empathize with clients.
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\nThe second set of focus groups/telephone interviews emerged five main themes. Participants felt that dietitians should be open-minded, share information, and continue to educate the public. They had differences of opinion about whether or not dietitians should be more visible. Suggestions were also made about what type of partnerships dietitians could form.
\nThe information gathered from this study could be used by several nutrition/dietetic professionals such as practicing dietitians, university faculty members and internship coordinators. When planning programs, faculty members and internship coordinators can incorporate information from this study into their programs. Also, these results may help dietitians either improve communication with clients about alternative health practices or be more effective in dealing with the issue of alternative health practices. If continuing education resources were developed and further research pursued, this study could provide a basis for choosing alternative health practices and areas of research.

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