Preliminary content and construct validity of a new model to differentiate research skills from evidence-based practice skills: Core, Evidence Application, Research (CEAR) Model.

BACKGROUND: Research is the scientific basis for the profession of dietetics, as it must be located and applied in evidence-based practice (EBP). EBP is often presented as a foundational skill for research. CEAR - Core, Evidence Application, Research - is a newly proposed model that separates Research and Evidence Application skills into distinct domains, jointly supported by a set of Core skills, thus acknowledging that education and advancement in one domain neither requires nor precipitates education and advancement in the other. The goal was to investigate the content and construct validity of the new CEAR Model. METHODS: A cross-sectional online survey of randomly selected dietitians in the United States was used to collect CEAR domain scores, validated measures of research or EBP skills and self-reported characteristics. Exploratory factor analysis, Cronbach's α and Pearson correlation between various tools and CEAR domains were used to assess validity and reliability. Analysis of variance (ANOVA) and multiple linear regression between CEAR domains and participant characteristics were used to assess convergent and divergent validity. RESULTS: One hundred and fifty-four responses with a valid CEAR score were received and led to a three-factor solution, supporting the theorised differentiation of research from evidence application skills (content validity). Internal reliability for the CEAR Model overall and for each domain was high. The hypothesised correlations between existing research or EBP measurement tools and the relevant CEAR domains were found (construct validity). Known groups analysis demonstrated the expected differences in CEAR domain scores based on participant characteristics. CONCLUSIONS: The CEAR Model demonstrates preliminary validity and internal reliability. It adds to the current literature by acknowledging the separateness of evidence application skills from research skills.

Disability and COVID-19: Impact on Workers, Intersectionality With Race, and Inclusion Strategies.

This article discusses the impact of the COVID-19 pandemic on workers with disabilities. Given that most employment-related literature about COVID-19 does not include people with disabilities, an in-depth exploration of the impact of COVID-19 on this population is warranted. Additionally, this article discusses the unique issues this population is facing during the pandemic, including the intersectionality of disability, race, and economic disadvantage. Suggestions for supporting people with disabilities in counseling and career-related activities, both during the COVID-19 pandemic and postpandemic, are provided.

Characteristics and Drivers of the Registered Dietitian Nutritionist's Sustained Involvement in Clinical Research Activities: A Mixed Methods Study.

BACKGROUND: Research contributions by registered dietitian nutritionists (RDNs) are important for enhancing the use of nutrition-related evidence-based guidelines in dietetics practice. Involvement of RDNs in research activities has been studied previously, but little is known about the drivers (motivators) of sustaining research involvement by RDNs who work in clinical practice. OBJECTIVE: To identify key characteristics of established RDN clinician researchers and drivers that contributed to their sustained research involvement. DESIGN: We used a convergent parallel mixed methods study design utilizing the clinician career research trajectory as a framework. Research involvement was examined using the Practice-Based Dietitian Research Involvement Survey (PBDRIS). Workplace support was assessed using the Research Capacity and Culture (RCC) survey. Semistructured interviews were used to investigate key themes in established RDN clinician researchers. PARTICIPANTS/SETTING: We identified 450 RDNs involved with research activities in the United States through hand-searching clinically relevant nutrition journals and contacted them to participate in an online survey. A total of 29 RDNs met criteria and completed (6.4%) the quantitative survey, then a subsample (n=10) participated in semistructured interviews to explore drivers for continued research involvement. RESULTS: Research involvement scores (n=29) from the PBDRIS ranged from 60.0% to 97.5%, indicating involvement in higher-level research-related tasks by our sample participants. RCC results revealed the importance of workplace support and mentorship. Interviews with established RDN clinician researchers identified exposure, curiosity, and dedication as three overarching themes with eight subthemes driving continued research involvement. CONCLUSION: Based on the experiences of select RDN clinician researchers who have demonstrated success in sustaining their research involvement, we found that having an available mentor, support from their workplace environment, and personal drive were integral to their success.

A Pragmatic Guide to Establishing Clinical Decision Support Governance and Addressing Decision Support Fatigue: a Case Study.

There is limited guidance available in the literature for establishing clinical decision support (CDS) governance and improving CDS effectiveness in a pragmatic, resource-efficient manner. Here, we describe how University of Utah Health established enterprise CDS governance in 2015 leveraging existing resources. Key components of the governance include a multi-stakeholder CDS Committee that vets new requests and reviews existing content; a requirement that proposed CDS is actually desired by intended recipients; coordination with other governance bodies; basic data analytics to identify high-frequency, low-value CDS and monitor progress; active solicitation of user issues; the transition of alert and reminder content to other, more appropriate areas in the electronic health record; and the judicious use of experimental designs to guide decision-making regarding CDS effectiveness. In the three years since establishing this governance, new CDS has been continuously added while the overall burden of clinician-facing alerts and reminders has been reduced by 53.8%.

Applying social cognitive career theory to registered dietitian research involvement: a randomized controlled trial.

UNLABELLED: The purpose of this study was to measure the effect of a social cognitive career theory (SCCT)-based educational intervention combined with an evidence-based practice (EBP) continuing professional education (CPE) program (standard-plus group) as compared to the EBPCPE program alone (standard group) and a no-treatment control on research outcome constructs (research self-efficacy, research outcome expectations, research interest and research involvement) in dietitians. METHODS: This randomized controlled trial measured the effect of an online 14-week educational intervention, with measurements made pre- and post-intervention and at 3-month follow-up. A randomly selected list of registered dietitians (RDs), who reported clinical nutrition as their primary practice area, was obtained from the Commission on Dietetic Registration. Subjects (n=580) were randomly assigned to three study groups, and 47.2% (n=272) completed data collection. RESULTS: The treatment effect between the groups was significantly different for research self-efficacy (p<0.001) and research involvement (p=0.005), with positive effects observed in the standard-plus and standard groups. There were no significant effects for research outcome expectations and research interest. CONCLUSIONS: This is the first known application of SCCT to RD research involvement as a career-related behavioral outcome, and it demonstrated that a significant increase in research self-efficacy occurs following participation in an educational intervention on EBP.

Sexual victimization and health-risk behaviors: a prospective analysis of college women.

The present study utilizes the National College Health Risk Behavior Survey to examine the relationship between health-risk behaviors and sexual victimization among a sample of college women. A prospective design is utilized to examine the relationship between health-risk behaviors as measured at baseline and sexual victimization during a 3-month follow-up period. After controlling for age and parents' education, a history of adolescent sexual victimization was associated with the following health-risk behaviors as measured at pretest: increased likelihood of cigarette smoking, marijuana use, suicidal ideation, experience of physical violence within a dating relationship, use of diet pills and vomiting or laxatives to lose weight, multiple sexual partners, and early sexual intercourse. Prospectively, women's history of adolescent sexual victimization was the strongest predictor of sexual victimization during the 3-month follow-up. Implications of univariate associations between early sexual intercourse, suicidal ideation, and problematic weight loss behaviors and subsequent experience of sexual victimization are discussed.

A distance education in undergraduate dietetic education.

Distance education is an exploding phenomenon that allows people to pursue higher education on their own time, at a pace that meets their needs, in locations where there are no colleges and universities, or where there is not a desired program of study. This study examined the use of distance education in undergraduate dietetic education programs and the opportunities for obtaining an undergraduate degree in dietetics solely via distance education. A survey was sent to all directors (n = 279) of undergraduate programs accredited/approved by the Commission on Accreditation for Dietetics Education to determine the current status and projected future use of distance education in their institutions' on-campus programs. The survey had a 54% response rate. Approximately 32% (n = 150) of undergraduate dietetics programs offer distance education courses in some format. Institutions that offer nondietetics distance education courses were more likely to offer dietetics distance education courses. The most common distance education format utilized in dietetics was 100% Internet courses (48%). The most common distance education dietetics course offered was a basic or introductory nutrition course (31%). From the data of courses offered, or permitted to be transferred, it would not be possible for a student to complete an undergraduate degree in dietetics solely via distance education methodologies at the time this study was conducted.