K.N. Wolf

Clinical Nutrition Managers have Access to Sources of Empowerment

OBJECTIVE To ascertain perceived access of dietitians to power in the workplace. DESIGN The conceptual framework was Kanters theory of organizational power. The Conditions for Work Effectiveness Questionnaire was used to measure perceived access to sources of power: information, support, resources, and opportunities. Demographic data were collected to identify factors that may enhance empowerment. SUBJECTS/SETTINGS The questionnaire was sent to a random sample of 348 dietitians chosen from members of the Clinical Nutrition Management dietetic practice group of the American Dietetic Association. Blank questionnaires were returned by 99 (28.4%) people not working as clinical nutrition managers, which left 249 in the sample. STATISTICAL ANALYSES Descriptive statistics were used to organize and summarize data. One-way analysis of variance and t tests were performed to identify differences in responses based on levels of education, work setting, and information technology skills. RESULTS Usable questionnaires were received from 178 people (71.5%). On a 5-point scale, scores for access to information (mean +/- standard deviation [SD] = 3.8 +/- 0.7), opportunity (mean +/- SD = 3.6 +/- 0.7), support (mean +/- SD = 3.2 +/- 0.9), and resources (mean +/- SD = 3.1 +/- 0.8) demonstrated that clinical nutrition managers perceived themselves as having substantial access to sources of empowerment. Those having higher levels of education, working in larger hospitals, having better-developed information technology skills, and using information technology more frequently had statistically significant higher empowerment scores (P = < or = .05) than contrasting groups in each category. APPLICATIONS/CONCLUSION Clinical nutrition managers are empowered and able to assume leadership roles in todays health care settings. Their power may be enhanced by asserting more pressure to gain greater access to sources of power: support, information, resources, and opportunities.

Health behaviors and perceptions of cancer survivors harvesting at an urban garden.

OBJECTIVES To gather information about perceptions of personal health behavior change in cancer survivors following participation in an urban gardening program. METHODS This qualitative study used focus groups of adult cancer survivors with an open-ended question thread format. Data were transcribed and analyzed by identifying, coding, and categorizing primary patterns/themes. RESULTS Four overarching themes were identified: (1) greater dietary intake of produce; (2) improved mental and physical health; (3) enhanced sense of community and social support; and (4) challenges to long-term maintenance. CONCLUSIONS Perceptions of positive behavior changes associated with harvesting at an urban garden targeting cancer survivors may inform future community and health promotion interventions aimed at improving adherence to evidence-based lifestyle behavior guidelines for cancer survivorship.

Dietitians Roles in the Interdisciplinary Health Care Team

Abstract The role of the dietitian is evolving as contemporary health care systems change. In particular, the increasing usage of interdisciplinary and transdisciplinary teams for health care delivery is providing opportunities for dietitians to expand current roles. Dietitians must strategize and position themselves to continue to be an influential presence on these teams. To assess present roles, potential barriers to these roles, and potential strategies for success in these roles, eight focus groups were conducted at the 1997 Annual Meeting of the American Dietetic Association. A total of 41 dietitians varying in age, experience, and location of employment participated in the study. The views expressed during the discussions were diverse, however general themes developed. The participants did not describe many team roles for a general staff dietitian. Most roles and responsibilities were specific to specialized teams such as nutrition support or rehabilitation. Overall, the participants agreed their roles are changing or will change, but were uncertain of the outcomes. Dietitians felt their current roles are multi-faceted and commonly function as educators, leaders, and subject-matter experts. The participants concluded to remain an integral part of the team, dietitians need to become more proactive, increase the marketing of their skills, acquire new skills, expand responsibilities, and take more risks. Ultimately, dietitians may use this information to better position themselves in health care teams.

Poor Adherence to Preventive Health Care and Cancer Screening Guidelines Among Food Pantry Clients

ABSTRACT The objective of this study was to identify barriers related to poor adherence to preventative health behaviors in a disparate population. In-depth interviews were conducted with food pantry clients to gain an understanding of food pantry client demographics, health status, concordance to health care and screening guidelines, barriers to food and health care, and food security status. Disparities in health and adherence to preventive health recommendations exist for food pantry clients. Significant barriers contribute to poor adherence to cancer screenings and preventive health guidelines. These data highlight the need to design and implement targeted and multifaceted interventions to improve the health practices of food pantry clients.

Assessing Teamwork Skills of Foodservice Directors and Subordinates

Abstract The development of teamwork skills is a concern for foodservice organizations. Teamwork provides the opportunity to achieve better outcomes with fewer resources. The promise of increased effectiveness (quality/appropriateness of service) coupled with greater efficiency (cost containment/employee satisfaction) explains part of the substantial lure of teamwork in healthcare and other organizations. If teamwork is to be implemented in the dietetics/foodservice arena, assessment of the personnels knowledge, skill, and ability to perform teamwork must be the first step in planning the development process. The members of the Management in Health Care Systems Practice Group were surveyed to request willingness for their subordinates and themselves to participate in a study regarding their teamwork skills, knowledge, and ability. The Teamwork Knowledge Skill Ability test was administered to 73 foodservice directors and 528 subordinates. The majority of subordinates worked in hospitals (78%), were female (79%), participated in decision-making groups at work (69%), and were diet-aides (29%) or supervisors (19%). The foodservice directors described themselves as situational leaders (77%) and persons who include the staff in decision-making groups (77%). The test is a 35-item, multiple choice questionnaire which is designed to measure the essential knowledge, skills, and abilities that individuals must have to work in teams. Five major subcategories, which include conflict management, collaborative problem solving, communication, goal setting and performance management and planning and tasks coordination, are represented. The participants overall mean Teamwork score was 19.5 out of 35 questions. Results suggest a need for the development of teamwork skills especially in the area of collaborative problem solving and communication.