Background on Provider Education
What are provider education strategies?
- Interventions that enhance health care providers’ knowledge and skills related to counseling patients or clients about nutrition through information and education.
- This type of intervention is geared towards health care providers working in clinical settings including physicians, nurses, dentists, dieticians, etc.
- These interventions train qualified health care providers to counsel or provide advice to individuals in order to encourage them to adopt a balanced eating pattern. This training offers health care providers access to information and resources about:
- the benefits of consuming nutrient-dense foods and beverages (e.g., fruits, vegetables, juices, whole grains, milk) from the basic food groups;
- how to improve culturally competent communication between individuals and health care providers;
- the health risks of consuming too many calories and too much saturated and trans fats, cholesterol, added sugars, salt, and alcohol; and
- ways to change individuals’ eating patterns by increasing support (e.g., physician recommendations for what and how much to eat or drink, recipes for nutritious meals and snacks) and reducing barriers (e.g., low-cost foods or beverages, ways to modify existing favorite recipes).
How can provider education impact nutrition related behaviors?
- Health care providers are a primary and respected source of health information. Many individuals and families seek out the advice of health care providers to maintain their health and quality of life on a regular basis. Therefore, health care providers are ideally suited to have an ongoing influence on individuals’ decisions to adopt a balanced eating pattern and consume nutrient-dense foods and beverages.
What are provider reminder strategies and how can they be used in nutrition interventions?
- Provider reminder interventions can be developed as part of provider training. Provider reminder interventions give cues or prompts to providers to increase the likelihood that they will discuss nutrition-related information with individuals. Provider reminder interventions utilize various strategies to prompt providers to discuss nutrition with individuals, including changes to the individual’s chart (e.g., stickers, colored folders), changes in the physical environment (e.g., posters in exam rooms, or personal prompts (e.g., laminated pocket sized information sheets).
What types of settings are appropriate for provider education strategies?
- Provider education interventions are usually offered to health care providers in traditional public or private health care settings, including a provider’s office, hospital, health department, or assisted living facility. However, health care providers with or without specialized medical training can participate in provider education interventions training for non-traditional settings, including communities (e.g., mobile clinics), schools (e.g., school nurses), worksites (e.g., health screening), faith-based settings (e.g., health ministry), or individuals’ homes.
Where are opportunities for interventions in during patient visits?
- As part of their interaction with individuals, health care providers typically include the following:
- An assessment of an individual’s health, nutrition, and readiness to make behavior changes. This assessment enables the provider to provide personally relevant information to the individual about their health and nutrition needs. For example, it may be used to increase knowledge or awareness of nutrient-dense foods and beverages, change attitudes about calorie intake or portion sizes, teach skills for preparing balanced meals, or provide social support limiting the intake of alcohol.
- An opportunity for the individual to ask questions or clarify what they have been told. This exchange with the provider can help to ensure that the individual understands the information and recommendations that they have been provided.
- Referrals and resources within the community to assist the individual in following dietary guidelines. For example, the provider can give the individual a shopping list of nutrient-dense foods and beverages, phone numbers for cooking classes in the community, or a list of restaurants that offer healthy options on their menu.
- Subsequent interactions between the provider and individual, including a reassessment of the individual’s health and nutrition as well as a discussion of challenges, benefits, and advice for maintaining a balanced eating pattern over time.
What are the best methods for educating health care providers?
- Provider education training works best if it is hands-on and practical. This may include discussions among health care providers about how to counsel or provide advice to specific individuals (e.g., those with special health care needs, those who show no change over time), how to respond to individual barriers to eating nutrient-dense foods (e.g., family traditions involving food or beverages, access to grocery stores, cost of foods and beverages), how to reach high risk populations, how to work in different settings, and how to integrate effective practice strategies into different practice styles.
- Previous studies also suggest the need to consider longitudinal education strategies, employing a dietitian or nutritionist, tailoring provider education about nutrition to specific conditions (e.g., hypertension, diabetes, high cholesterol, pregnancy), training on community and policy influences on nutrition behavior in addition to the more traditional focus on individual services, and improved methods for patient tracking, repeat testing, and dietitian referral. Interventions should be accomplishable in a quick and succinct manner.
What are the barriers to implementing provider education interventions?
- It is difficult to understand the effectiveness of these interventions because the interaction between the provider and individual is unique for each individual, short in duration (less than 5 minutes), may involve recommendations for multiple behaviors at once (e.g., eat healthy, be active and quit smoking), or may lack institutional support for sharing this type of information during a visit (e.g., policies, procedures, training, or incentives).