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Topical Area: Protocols

Protocols (Poster Session)

(P22-024-23) Exploring Strategies To Better Equip Primary Care Physicians To Provide Nutrition Care: A Mixed-Methods Study Protocol

Sunday, July 23, 2023
12:45 PM – 1:45 PM ET
Location: Poster Board 390

    Presenting Author(s)

  • CH

    Caitlin A. Hildebrand, MD, MPH (she/her/hers)

    Postdoctoral fellow and nutrition doctoral candidate
    Cecil G. Sheps Center for Health Services Research at the University of North Carolina - Chapel Hill, Department of Nutrition - Gillings School of Global Public Health at the University of North Carolina at Chapel Hill, Center for Health Promotion and Disease Prevention
    Chapel Hill, North Carolina, United States

    • Co-Author(s)

  • AA

    Alice S. Ammerman, DrPH

    Gillings School of Global Public Health at the University of North Carolina - Chapel Hill, Center for Health Promotion and Disease Prevention
    chapel Hill, North Carolina, United States

Disclosure(s):
Caitlin A. Hildebrand, MD, MPH: No relevant financial relationship(s) with ineligible companies to disclose.


Objectives: Primary care physicians (PCPs) face multiple barriers to addressing diet with patients, and deficits in nutrition training in medicine are well-documented. Using a design thinking approach, this study will explore the complex problem of integration of nutrition care in primary care to identify potential solutions desired by the end user, physicians.

Methods: To better understand the problem and identify potential solutions, we will conduct a mixed-methods study. Semi-structured interviews with up to 25 Family Medicine (FM), Internal Medicine (IM), Pediatrics (Peds), or combined Internal Medicine/Pediatrics (Med-Peds) PCPs will inform the next step, a survey of 165 physicians that will explore: 1) priority nutrition learning outcomes for their practice, 2) desired nutrition learning experiences in medical school and residency, 3) preferred methods to enhance nutrition care in their current practice, and 4) perceived importance of nutrition in their practice and training. Survey participants will be practicing PCPs and residents in their final year of residency training in FM, IM, Peds, or Med-Peds. The final step is a pilot test of a potential solution, a brief dietary screening and counseling tool, in an adult primary care setting using an iterative process. We will recruit 40 PCPs from FM, IM, and Med-Peds who will be divided into groups of 10 PCPs for 4 consecutive iterations of the 4-week intervention. Participants will receive the tool and a 30-minute video and written guide on how to implement the tool. Using a pre/post-test survey and brief interview at the end of the intervention, we will evaluate feasibility, desirability, and potential areas for improvement of the tool and the impact of the tool on provider confidence and attitudes and on registered dietitian referrals. We will integrate feedback after each iteration for the next group.

Results: Pending

Conclusions: Results will identify priority learning outcomes and desired learning strategies to inform nutrition training of physicians and strategies to improve integration of nutrition in primary care to test in future interventions.

Funding Sources: International Association of Medical Science Educators 
National Research Service Award Post-Doctoral Traineeship from the Agency for Healthcare Research and Quality sponsored by The Cecil G. Sheps Center for Health Services Research