Are primary care providers' nutrition care and food insecurity screening practices associated with their perceptions of team-based care?

diet therapy food insecurity patient care team preventive care primary health care referral and consultation

Journal

Family practice
ISSN: 1460-2229
Titre abrégé: Fam Pract
Pays: England
ID NLM: 8500875

Informations de publication

Date de publication:
24 09 2022
Historique:
pubmed: 25 3 2022
medline: 28 9 2022
entrez: 24 3 2022
Statut: ppublish

Résumé

Screening for food insecurity (FI) and providing nutrition care are important management strategies for chronic diseases, but rates are low. Aspects of team-based care and providers' nutrition competence may help inform interventions to improve these services. The objectives of this study were to describe US primary care providers' FI screening and nutrition care practices (counselling, referrals, and time spent counselling) and test for associations with scored measures of their perceptions of team-based care (care continuity, patient-centredness, coordination with external providers and resources) and nutrition competence (confidence counselling and attitudes towards nutrition). Cross-sectional online survey data of primary care providers were described and analysed for associations using Wilcoxon rank sum tests. Of provider respondents (N = 92), 35% (n = 32) worked in clinics that screen for FI and had higher team perceptions (P = 0.006) versus those who do not. Those who reported counselling >30% patients about nutrition (57%, n = 52) and referring >10% patients to nutrition professionals (24%, n = 22) had significantly better attitudes towards nutrition (P = 0.013 and P = 0.04, respectively) compared with those with lower counselling and referral rates. Half (n = 46) of the providers reported spending >3-min counselling each patient about nutrition and had higher patient-centred care (P = 0.004) and nutrition competence (P < 0.001) compared with those who spent less time counselling. Providers in clinics that screen for FI had higher overall perceptions of team-based care, but their nutrition competence was not significantly different. Meanwhile, reported more time counselling was associated with a culture of patient-centredness. Promoting team-based care may be a mechanism for improving FI screening and nutrition care.

Sections du résumé

BACKGROUND
Screening for food insecurity (FI) and providing nutrition care are important management strategies for chronic diseases, but rates are low. Aspects of team-based care and providers' nutrition competence may help inform interventions to improve these services. The objectives of this study were to describe US primary care providers' FI screening and nutrition care practices (counselling, referrals, and time spent counselling) and test for associations with scored measures of their perceptions of team-based care (care continuity, patient-centredness, coordination with external providers and resources) and nutrition competence (confidence counselling and attitudes towards nutrition).
METHODS
Cross-sectional online survey data of primary care providers were described and analysed for associations using Wilcoxon rank sum tests.
RESULTS
Of provider respondents (N = 92), 35% (n = 32) worked in clinics that screen for FI and had higher team perceptions (P = 0.006) versus those who do not. Those who reported counselling >30% patients about nutrition (57%, n = 52) and referring >10% patients to nutrition professionals (24%, n = 22) had significantly better attitudes towards nutrition (P = 0.013 and P = 0.04, respectively) compared with those with lower counselling and referral rates. Half (n = 46) of the providers reported spending >3-min counselling each patient about nutrition and had higher patient-centred care (P = 0.004) and nutrition competence (P < 0.001) compared with those who spent less time counselling.
CONCLUSION
Providers in clinics that screen for FI had higher overall perceptions of team-based care, but their nutrition competence was not significantly different. Meanwhile, reported more time counselling was associated with a culture of patient-centredness. Promoting team-based care may be a mechanism for improving FI screening and nutrition care.

Identifiants

pubmed: 35325099
pii: 6553105
doi: 10.1093/fampra/cmac017
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

860-867

Informations de copyright

© The Author(s) 2022. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Auteurs

April R Williams (AR)

Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA, USA.

Anika L Hines (AL)

Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA, USA.

Alan W Dow (AW)

School of Medicine, IPE Center, Virginia Commonwealth University, Richmond, VA, USA.

Roy T Sabo (RT)

Department of Biostatistics, Virginia Commonwealth University, Richmond, VA, USA.
C. Kenneth and Dianne Wright Center for Clinical and Translational Research, Virginia Commonwealth University, Richmond, VA, USA.

Maria D Thomson (MD)

Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA, USA.

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