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Barriers
to good nutrient intakes during pregnancy: A qualitative analysis
Andrea Begley
Abstract
Objective: To identify barriers to initiating and maintaining die-
tary change for pregnancy.
Design: A descriptive qualitative study using focus groups.
Subjects: Ninety women of child-bearing age who were plan-
ning a pregnancy or currently pregnant.
Setting: Women were recruited from antenatal classes, infant
health clinics, community groups and articles in community
newspapers in two health service regions in Perth, Western Aus-
tralia between August 1999 and April 2000.
Main outcomes measures: Barriers identified by participants to
good nutrition for pregnancy.
Analysis: Transcripts were analysed for common themes using
the QSR.NUD*IST program.
Results: The five barriers identified were: nutrition which was
just one of a range of health issues women were dealing with
when pregnant; a lack of knowledge and advice received on
what are good nutrient intakes for pregnancy; the promotion of
listeria awareness was seen as giving food a negative connota-
tion; general practitioners (GPs) were identified as lacking
nutrition knowledge and having limited time to discuss nutrition;
and l?rinted educational materials did not contain sufficient
detail.
Conclusions: There is a lack of consistent educational and pro-
motional efforts for general nutrition in pregnancy, particularly
from GPs. There is a need to design and implement effective and
consistent strategies to improve nutrient intakes during preg-
nancy to meet public health nutrition objectives in Australia. The
use of focus groups provides important insights into the nutri-
tion-related beliefs and attitudes of pregnant women for the
design of such efforts. (Nutr Diet 2002;59:175--80)
Key words: pregnancy, nutrition education, barriers, qualitative
analysis
Dietitians’
knowledge and perceptions of changes to food labelling in Australia
Danielle Lidgard and Heather Yeatman
Abstract
Objectives: To determine dietitians' knowledge and perceptions
of the nutrition-related labelling requirements of the new Food
Standards Code for Australia and New Zealand.
Design: A 20-minute telephone survey assessed dietitians'
knowledge and perceptions of the new requirements for nutri-
tion-related information on food labels.
Subjects: Clinical, community, private practice and industry-
based dietitians.
Setting: Study participants included all dietitians working in
a
region of NSW, together with a purposive sample of dietitians
from speciality areas of dietetics from outside this region.
Main outcome measures: Knowledge questions were assessed
for correct answers, attitudes were assessed using a six-point
scale.
Statistical analysis: No statistical analysis other than frequen-
cies were reported because of the small sample size.
Results: Of the 42 dietitians eligible to participate in the tele-
phone survey, 39 agreed and participated. Just over half (23 of
39) of the participants said they had received information on the
new Food Standards Code. Having had access to the new code
did not equate to dietitians knowing details of the code (mean
knowledge score 1.85 of 6, highest score 4 of 6). However, over-
all the surveyed dietitians supported the changes to nutrition
labelling. Most had favourable attitudes to changes including the
mandatory nutrition information panel detailing seven nutrients,
percent of key ingredients and warning and advisory statements.
Conclusion: Dietitians lack knowledge of the labelling require-
ments in the new Food Standards Code and hence are limited in
their capacity to assist communities or clients make more
informed food choices through better use of food labels. (Nutr
Diet 2002;59:181-6)
Key words: food labelling, knowledge, attitudes, practice,
dietetics, patient education, telephone survey
Nutrient
intakes of young children: Implications for long-day child-care nutrition
recommendations
Barbara C. Radcliffe, Clare V. Cameron and Peter D. Baade
Abstract
Objective: To develop nutrition recommendations for food pro-
vided during long-day child-care hours, expressed in terms of a
percentage of recommended dietary intakes (RDls) for nutrients.
Design: Secondary analyses of nutrient intake data from the
Australian Bureau of Statistics' 1995 National Nutrition Survey.
Total daily intakes and intakes from lunch and daytime snacks
(i.e. long-day child-care hours) were examined.
Subjects: Children aged two to five years (n = 793).
Setting: Males and females from all Australian states and
territories.
Main outcome measures: The proportion of the mean total
daily nutrient intake consumed during long-day child-care hours
in quantitative amounts and in percentage RDI.
Results: The mean daily intakes of energy, vitamin A, thiamin,
niacin, zinc, iron and calcium were all above 100% RD!. On
average, young children derived 40 to 51 % of total 24-hour
nutrient intake and approximately 43 to 107% of RDI for the
nutrients examined from lunch and snacks. Iron was the only
nutrient with a mean intake less than 50% of the RDI for lunch
and day-time snacks. However, the total mean daily intake
exceeded the RDI.
Conclusion or application: The recommendation that 'at least
50% of the RD! for nutrients be provided to children during
long-day child-care' is consistent with children's current eating
patterns. Further research, legislation, policy development,
resources and training will be required to implement this recom-
mendation. (Nutr Diet 2002;59:187-90)
Key words: child-care, nutrient intake, nutrition
recommendations
University-initiated
strategies to increase supervisory capacity and benefits associated with
dietetic student supervision— perceptions of dietetic placement sites
Roger Hughes
Abstract
Objective: To assess the attitudes of staff involved in dietetic
student professional placement on the utility of a range of uni-
versity initiatives to increase supervisory capacity.
Design: Cross-sectional survey using a mailed questionnaire.
Subjects: Managers and dietitians participating in the supervi-
sion of student dietitian placements in the Griffith University
program.
Setting: Nutrition and dietetic practice settings.
Main outcome measure: Attitudes and utility ratings ofuniver-
sity-initiated support strategies from dietitians involved in
student dietitian placement programs.
Statistical analysis: Descriptive analysis to calculate response
frequencies.
Results: Completed questionnaires were received from 14 man-
agers (70% response rate) and 28 supervising dietitians (-56%
response rate) from a total of 20 Griffith University placement
sites. Direct allocation of a placement honorarium received the
highest utility rating among supervisors followed by formal
training in supervision provided by the university. There was
general agreement that student placements increase overall stress
among staff and increase staff workloads but a similar agreement
that student supervision adds to job satisfaction and encourages
reflective practice and further learning by staff. The majority of
respondents reported that the benefits of student supervision out-
weighed the costs.
Conclusions: There is strong support for university-initiated
investments in strategies that focus on increasing the capacity of
placement sites and optimise the benefits associated with student
supervision. Further study to economically evaluate costs and
benefits of this important aspect of development of the dietetic
workforce is required to make the most effective use of these
investments. (Nutr Diet 2002;59:191-4)
Key words: professional placement, nutrition and dietetics,
education, student dietitians, supervisory capacity
The
development and preliminary testing of an invoice-based menu assessment
tool for long-day child-care centres
Christina M. Pollard, Janette M. Lewis, Janine Barkess and
Ana Toquero
Abstract
An educational Menu Assessment and Planning
Guide (Guide) was developed for long-day child-care centre
staff to determine whether their menus provided 50% of the Rec-
ommended Dietary Intake (RDI) of nutrients. Menu assessment
was based on the amount of food purchased from recommended
food groups. To test the ability of the Guide to estimate nutrients
provided from a menu, measurement characteristics were com-
pared with weighed food record analysis. A pilot study was
conducted in two long-day child-care centres over ten days.
Although the nutrient analysis using the Guide underestimated
most nutrients compared to that measured by weight of all foods
provided, it was demonstrated that the tool could be useful for
cooks to assess the amount of food required to provide 50% of
nutrients for children attending long-day care. Further testing
would be required to validate the preliminary fmdings. (Nutr
Diet 2002;59:195-200)
Key words: menu assessment, food provision, invoice analysis,
child-care, long-day care
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Nutrition & Dietetics, Volume 59, Number 3, September 2002