The Fifth International Heelsum Workshop 'more synergy between primary care and public health': mission statement

Present and future of nutrition guidance : lifestyle advice in primary care

“…The expression "creating supportive environments for nutrition guidance" in the title of the fifth Heelsum workshop " (2007) (65,(98)(99)(100)(101)(102)(103)(104)(105)(106)(107)(108)(109) shows that we were aware of the importance of the environment, both for GPs and for patients. The second part of the title shows that we were striving for a synergy between primary care and public health.…”

Nutrition care by primary-care physicians: advancing our understanding using the COM-B framework

“…Attempts to improve this situation have included: a physician nutrition specialist providing effective nutrition education within a residency programme (57) ; brief counselling, tailored messages and strategies (59) ; the use of the 5 A's model for stage-based counselling, cooking classes, demonstration kitchens, supermarket tours, computer-based automated telephone counselling and follow-up (59) ; nutrition modules for general practice vocational training (60) ; and a minimal intervention strategy to address overweight and obesity in adult primary-care patients (61) . The Heelsum workshops addressed topics such as nutritional attitudes and practices of PCP (54) , effective nutrition interactions between family doctors and patients (62,63) , nutritional guidance of family doctors (64,65) , empowering family doctors and patients in nutrition communication (66,67) , creating supportive environments for nutrition guidance (68,69) and weight management (69,70) . Further public health initiatives may still be required to overcome the 'problem' of low levels of nutrition care by PCP, such as international goals for the integration of nutrition into health services and for population receipt of nutrition care.…”

“…Zealanders visiting a GP annually and many GPs forming ongoing relationships with their patients (98). Previously, the Heelsum workshops discussed the problems, opportunities and future possibilities of nutrition guidance by family doctors in a changing world (66), and made recommendations: that both family doctors and patients need to be empowered in nutrition communication (68,69), for the development of supportive environments for nutrition guidance to create synergy between primary care and public health (68,70,99), for practice-based evidence for weight management, with an alliance between primary care and public health (71,100), all in acknowledgment of the ongoing relationship and trust patients have in their PCP (101,102). The embedding of family practice in a governments' health policy is also very important (71).…”

“…These factors include: PCP characteristics and those of their patients related to gender and medical conditions (44,49) ; personal interest in nutrition (37,39,40) ; years since completion of medical school (40,47) ; previous unsuccessful attempts in supporting patients to improve their eating habits (43,47) ; medical educators acting as role models for PCP as a student (36) ; and training in motivational interviewing (49) . Evidence exists that PCP nutrition guidance practices are not only determined by barriers (18,20,59,60,62,71,(75)(76)(77)(78)(79)(80)(81)(82)(83) but also by driving forces, self-efficacy factors and nutritional attitudes and beliefs (20,22,33,54,59,60,64,66,68,70,71,(78)(79)(80)(81)(82)(83)(84) . In the studies reviewed, having a personal interest in nutrition (37,…”

Obesity management in Australian primary care: where has the general practitioner gone?

“…All health conditions, including obesity, are influenced by the patient's social determinants of health that are in turn affected by factors specific to the community in which they live (van Weel et al 2008). This reality requires community awareness and action on the part of GPs.…”