Intuitive eating and health at every size in community settings: dietitian's perceptions of practice barriers
Date
Authors
Larkey, Rachel
Quatrimoni, Paula A.
Fuster, Melissa
Version
Published version
OA Version
Citation
R. Larkey, P. Quatrimoni, M. Fuster. "Intuitive eating and Health at Every Size in community settings: Dietitian's perceptions of practice barriers." Critical Dietetics, Volume 5, Issue 2, pp. 53 - 64. https://doi.org/10.32920/cd.v5i2.1402
Abstract
Intuitive Eating (IE) and Health at Every Size (HAES) are health promotion paradigms used by dietitians in private practice more commonly than in community-based practice where more diverse and vulnerable populations are served. The primary objective of this study was to examine the perceived barriers and facilitators that dietitians encounter when using IE and HAES in community nutrition practice settings. This phenomenological, qualitative study applied a grounded theory analysis to identify emergent themes from transcripts of semi-structured interviews with 27 dietitians working in community settings in the United States. Dietitians reported the following perceived barriers to the use of IE/HAES: diet culture which was often expressed as inconsistent messages patients receive from the media and other professionals that conflict with nutrition providers’ messages; legislative restrictions and weight-centric administrative policies; and personal beliefs of clients and colleagues concerning weight and health. Dietitians reported occupational autonomy as a salient factor facilitating the use of IE/HAES in community practice and identified the need for shifts in attitudes about weight and its relation to health achieved through research and dissemination of information on weight-inclusive practices. Collectively, respondents experienced more systemic barriers than individual barriers and identified several macro-level facilitators that remain elusive. The unique experiences of RDNs in community practice provide a roadmap for ongoing research to establish the evidence base for best practices, inform education and training, and achieve cultural shifts that move towards weight-inclusive practice in this setting. More research is needed to explore the generalizability of these experiences.
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License
Open access. Author retains: (i) the rights to reproduce, to distribute, to publicly perform, and to publicly display the Article in any medium for non-commercial purposes; (ii) the right to prepare derivative works from the Article; and (iii) the right to authorize others to make any non-commercial use of the Article so long as Author receives credit as author and the journal in which the Article has been published is cited as the source of first publication of the Article. For example, Author may make and distribute copies in the course of teaching and research and may post the Article on personal or institutional Web sites and in other open-access digital repositories. (http://www.sparc.arl.org/resources/authors/addendum-2007)