Nutrition programmes for individuals living with disadvantage in supported residential settings: a scoping review.

OBJECTIVE: Health inequities such as chronic disease are significantly higher among individuals living with disadvantage compared with the general population and many are reported to be attributable to preventable dietary risk factors. This study provides an overview of the current nutrition interventions for individuals living with extreme disadvantage, in supported residential settings, to develop insights into the development and implementation of policies and practices to promote long-term nutritional health and well-being. DESIGN: A scoping review searched Scopus, ProQuest, CINAHL Plus, MEDLINE, and Web of Science databases using the terms 'resident', 'nutrition', 'disadvantage', 'intervention' and their synonyms, with particular emphasis on interventions in residential settings. SETTING: Residential services providing nutrition provision and support. PARTICIPANTS: People experiencing extreme disadvantage. RESULTS: From 5262 articles, seven were included in final synthesis. Most interventions focused on building food literacy knowledge and skills. Study designs and outcome measures varied; however, all reported descriptive improvements in behaviour and motivation. In addition to food literacy, it was suggested that interventions need to address behaviour and motivations, programme sustainability, long-term social, physical and economic barriers and provide support for participants during transition into independent living. Socio-economic issues remain key barriers to long-term health and well-being. CONCLUSIONS: In addition to food literacy education, future research and interventions should consider utilising an academic-community partnership, addressing nutrition-related mental health challenges, motivation and behaviour change and a phased approach to improve support for individuals transitioning into independent living.

Whole Grains and Consumer Understanding: Investigating Consumers' Identification, Knowledge and Attitudes to Whole Grains.

Whole grains may assist in reducing risk of non-communicable disease, but consumption is limited in many countries. In Australia, the reasons for poor consumption are not well understood. The aim of this study was to investigate consumers' knowledge, attitudes and identification of whole grains, incorporating an exploration of factors influencing consumption, promotion and provision. An online semi-structured questionnaire was used to gather responses from 735 participants (61% complete responses). Although 92% of respondents consumed grains, only 8% reported an intake consistent with age and gender recommendations. Refined pasta and rice were the most frequently purchased grain foods followed by wholemeal/whole grain bread. Of whole grain foods, bread and breakfast cereals were consumed more frequently. However, overall, participants did not prioritise consumption of whole grains. Despite this, 93% of participants had seen food packaging information drawing attention to whole grain content, with a high proportion describing whole grain as less processed (72%) or high in dietary fibre (67%). Two-thirds were aware of health benefits but stated that if they had further information, they would be more likely to swap to whole grain. Further education, increasing exposure, accessibility and extensive promotion of whole grain health benefits are required to facilitate whole grain consumption. Furthermore, removing the negative stigma associated with carbohydrate foods, including grains, will be necessary to improve consumption.

Moderation of a foodservice assessment artefact in nutrition and dietetics programs.

AIM: Foodservice is a key component of dietetics education and practice internationally yet benchmarks for competency are limited. This study sought to review and moderate an assessment artefact of foodservice work integrated learning (WIL) to develop a shared understanding of one tool which may be used in a suite of evidence to demonstrate competence. METHODS: The foodservice curricula and assessment artefacts were described for the foodservice program at each of four participating universities. An assessment artefact from WIL, the report, was identified as an indicator of foodservice competence common to each program. Each university provided four purposively sampled WIL reports, assessed in duplicate by two academics from other participating universities using the corresponding university assessment rubric. Collated assessment results, along with the original assessment, were presented back to assessors. A semi-structured group discussion explored variations in assessment results, factors influencing decisions, and potential changes needed for assessment documentation. RESULTS: There was variation in assessment outcomes between independent assessors. In some instances assessors did not consistently deliver the same assessment outcome, nor rank students in sequential order of performance. This variation was less where an absolute ranking of satisfactory/unsatisfactory was applied. The assessor discussion revealed three key concepts: importance of understanding the project scope; challenges which influence assessment decision making; importance of understanding the broader program of assessment. CONCLUSIONS: Assessment inconsistencies emphasise the importance of multiple assessors and assessment artefacts across a programmatic assessment model, and the need for a clear understanding of competence in nutrition and dietetics.

Dietetics students' construction of competence through assessment and placement experiences.

AIM: Competency standards are widely adopted as a framework to describe standards of performance required in the workplace. Little is known, however, about how students construct competence. This qualitative study aimed to explore how dietetics students ready to graduate construct the concept of competence and the role of assessment in developing professional competence. METHODS: A qualitative description was used to gather data from a convenience sample of students ready to graduate from universities with accredited dietetics programs across Australia (10 out of 15 at the time of the study). A total of 11 focus groups were conducted to explore perspectives of competence and experiences of 'competency-based' assessment. Data were audio-recorded, transcribed and analysed using a thematic analysis approach. RESULTS: A total of 81 (n = 81) participants across 10 universities representing 22% of total students participated in the focus groups. Themes revealed that: (i) there is no shared understanding of competence; (ii) current work placement experiences may not reflect current standards or workforce needs; (iii) assessment approaches may not fully support the development of competence; and (iv) the competent performance of supervising dietitians/clinical educators in the workplace influences the construction of competence. CONCLUSIONS: There is a need to work towards a shared understanding of dietetic entry-level competence in the profession. 'Work-based' learning experiences may need to be modified to ensure students meet current competency standards. Practitioners involved in student supervision need to acknowledge the influential role they have in the development of the future workforce.