Nutrition literacy is a unique subset of health literacy, a leading predictor of poor health outcomes. Understanding a patient's nutrition literacy may help dietitians provide interventions tailored to a patient's nutrition knowledge weaknesses. While tools exist to evaluate nutrition literacy, it is unclear whether dietitians currently assess patients for nutrition literacy.
To examine nutrition literacy assessment among practicing outpatient dietitians, barriers to implementing a nutrition literacy survey into clinical practice, and possible solutions to these barriers.
Study Design, Settings, Participants
Semi-structured interviews, divided into four sampling frames, with dietitians (n = 28) from multiple outpatient settings were conducted across two Midwestern states. Similar interviews were conducted with outpatient clinic managers (n = 7), providing a wider viewpoint.
Questions addressed clinic work flow, assessing nutrition literacy, and barriers to implementing a survey into practice. All interviews were transcribed, coded, and analyzed by trained study personnel.
All dietitians stated they use no nutrition literacy assessment tools in clinical practice; subjective assessments are used. Barriers to survey implementation included time to complete the survey (79%/n = 22 of interviewees), logistics in administering the survey (75%/n = 21), patient motivation (75%/n = 21), literacy levels of patients (54%/n = 15), and clinic staff support (32/n = 9). Clinic managers stated barriers to survey implementation included patient motivation (86%/n = 6), devoting staff to a non-revenue generating task (71%/n = 5), logistics in administering the survey (71%/n = 5), and time to complete the survey (57%/n = 4). Solutions include survey administration prior to the patient's appointment (79% of dietitians/n = 22, 86% of managers/n = 6), motivating patients to complete the survey prior to their visit (29%/n = 8, 100%/n = 7), and reducing survey length (21%/n = 6, 43%/n = 3).
While multiple barriers to evaluating nutrition literacy in clinical settings exist, potential solutions to these barriers exist. Further research on the implementation of nutrition literacy assessment in the outpatient clinic setting is needed.