The traditional diets of Indigenous Peoples globally have undergone major transition due to settler colonization. This systematic review aims to provide a perspective of traditional food intake of Indigenous populations in high-income countries with a history of settler colonization. For inclusion, studies reported the primary outcome of interest: traditional food contribution to total energy intake (%E) and occurred in Canada, the United States (including Hawaii and Alaska), New Zealand, Australia and/or Scandinavian countries. Primary outcome data were reported and organized by date of data collection by country. Forty-nine articles published between 1987 and 2019 were identified. Wide variation in contribution of traditional food to energy was reported. A trend for decreasing traditional food energy intake over time was apparent; however, heterogeneity in study populations and dietary assessment methods limited conclusive evaluation of this. This review may inform cross-sectoral policy to protect the sustainable utilization of traditional food for Indigenous Peoples.
Purpose This study aimed to explore the patient-dietitian experience during an 18-week nutrition counselling intervention delivered using the telephone and a mobile app to people newly diagnosed with upper gastrointestinal (UGI) cancer to 1) elucidate the roles of the dietitian during intervention delivery and 2) explore unmet needs impacting nutritional intake. Methods Qualitative case study methodology was followed, whereby the case was the 18-week nutrition counselling intervention. Dietary counselling conversations and post-intervention interviews were inductively coded from six case participants which included: fifty-one telephone conversations (17 hours), 244 written messages and four interviews. Data were coded inductively, and themes constructed. The coding framework was subsequently applied to all post-study interviews (n=20) to explore unmet needs. Results Themes describing the roles of the dietitian were: regular collaborative problem solving to encourage empowerment, a reassuring care navigator including anticipatory guidance, and rapport building via psychosocial support. Psychosocial support included provision of empathy, reliable care provision and delivery of positive perspective. Despite intensive counselling from the dietitian, nutrition impact symptom management was a core unmet need as it required intervention beyond the scope of practice for the dietitian. ConclusionDelivery of nutrition care via the telephone or an asynchronous mobile app to people with newly diagnosed UGI cancer required the dietitian to adopt a range of roles to influence nutritional intake: they empower people, act as care navigators, and provide psychological support. Limitations in dietitians’ scope of practice identified unmet patient’s needs in nutrition impact symptom management, which requires medication management. Trial Registration 27th January 2017 Australian and New Zealand Clinical Trial Registry (ACTRN12617000152325).
Purpose This study aimed to explore the patient-dietitian experience during an 18-week nutrition counselling intervention delivered using the telephone and a mobile application to people newly diagnosed with upper gastrointestinal (UGI) cancer to (1) elucidate the roles of the dietitian during intervention delivery and (2) explore unmet needs impacting nutritional intake. Methods Qualitative case study methodology was followed, whereby the case was the 18-week nutrition counselling intervention. Dietary counselling conversations and post-intervention interviews were inductively coded from six case participants which included fifty-one telephone conversations (17 h), 244 written messages, and four interviews. Data were coded inductively, and themes constructed. The coding framework was subsequently applied to all post-study interviews (n = 20) to explore unmet needs. Results Themes describing the roles of the dietitian were as follows: regular collaborative problem-solving to encourage empowerment, a reassuring care navigator including anticipatory guidance, and rapport building via psychosocial support. Psychosocial support included provision of empathy, reliable care provision, and delivery of positive perspective. Despite intensive counselling from the dietitian, nutrition impact symptom management was a core unmet need as it required intervention beyond the scope of practice for the dietitian. Conclusion Delivery of nutrition care via the telephone or an asynchronous mobile application to people with newly diagnosed UGI cancer required the dietitian to adopt a range of roles to influence nutritional intake: they empower people, act as care navigators, and provide psychosocial support. Limitations in dietitians’ scope of practice identified unmet patient’s needs in nutrition impact symptom management, which requires medication management. Trial registration 27th January 2017 Australian and New Zealand Clinical Trial Registry (ACTRN12617000152325).
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