Medicine, Nursing and Health Sciences

Melanie Voevodin, PhD Candidate Paul Komesaroff, DirectorDepartment of Medicine Centre for Ethics in Medicine & SocietyCentral Clinical School Central Clinical School

e melanie.voevodin@monash.eduw www.sites.google.com/site/monashmdpt @MDPStudyf Measuring Dietetic Practice 16 November 2012

Measuring Dietetic Practice for Obesity (MDP-O):Socio-politics of Dietetic Practice

Declaration of interest

2

1998

16th November 2012Socio-politics of Dietetic Practice

2003 2005 2012

Dietetics Policy & Gov Health Eco PhDStudy

Austin RMH AlfredReal Jobs RMIT Deakin Nestle

WCMICSARBIAS / YPINH Food LawOther Jobs

Melanie Voevodin & Paul KomesaroffPhD Student 2010-2013 Supervisor

paul.komesaroff@monash.edumelanie.voevodin@monash.edu

MMeasuring DDietetic PPractice for OObesity (MDP-O Study)

Can DietitiansDietitiansturn

thearound ObesityObesityepidemic??

GP Dietitian Patient

4

The Problem

16th November 2012Socio-politics of Dietetic Practice

Tertiary-trained profession + EBM

Weight management service in the community

Experts in changing food behaviour for good health

5

The Problem

16th November 2012Socio-politics of Dietetic Practice

Tertiary-trained profession + EBM

Weight management service in the community

Experts in changing food behaviour for good health

Australians are NOT healthy Dietitians not forefront of policy

GP Red Book outlines ‘nutrition intervention’

Limited efficiencies in practice

Limited capacity for innovation

6

Finding Solutions

16th November 2012Socio-politics of Dietetic Practice

How to measure and report what dietitians do Generate evidence from practice to inform policy

Achieving cost-effectiveness

Maintaining client-centeredness

Career satisfaction (recruitment and retention)

7

Finding Solutions

16th November 2012Socio-politics of Dietetic Practice

How to measure and report what dietitians do Generate evidence from practice to inform policy

Achieving cost-effectiveness

Maintaining client-centeredness

Career satisfaction (recruitment and retention)

Data capture, analysis & reporting

MDP-O

816th November 2012Socio-politics of Dietetic Practice

Why?

1.

2.

916th November 2012Socio-politics of Dietetic Practice

Why?2.

10

Efficiency & EffectivenessDietitians providing a weight loss service in the community

A. Weight loss(to BMI 25kg/m2)

B. Inputs-Wages-Overheads-Materials

C. Outputs-Time-Products-Service

D. Outcomes-Weight (kg)-HbA1c

Efficiency = B + CCost to have the dietetic service available and time spent with client and materials provided to client

Effectiveness = B + C + D against ACost of providing the service to get 1kg weight lossHealth benefit in $ for every kg lost

16th November 2012Socio-politics of Dietetic Practice

11

How? MDP-O

16th November 2012Socio-politics of Dietetic Practice

Study 1 Study 2

Data Mining10 Years of a Dietetic Practice

n=1 DietitianProviding ~1000 new episodes of care

plus review appointments

Cross-sectional CohortNational Survey of Dietitians

n=141 DietitiansAnywhere across Australia

Any number of weight-loss clients

12

Achieving the Health Benchmarks (ADG)

What we want people to do What we actually do

16th November 2012Socio-politics of Dietetic Practice

13

Scientific Evidence(prescribed behaviour)

Real Life(actual behaviour)

Good Health Poor Health

Achieving the Health Benchmarks (ADG)

16th November 2012Socio-politics of Dietetic Practice

14

How? MDP-O

16th November 2012Socio-politics of Dietetic Practice

Study 1 Study 2

Data Mining10 Years of a Dietetic Practice

n=1 DietitianProviding ~1000 new episodes of care

plus review appointments

Behaviour ChangeCapitalising on the small gains

Information(recording & reporting)

Accurate, timely, relevant

Cross-sectional CohortNational Survey of Dietitians

n=141 DietitiansAnywhere across Australia

Any number of weight-loss clients

Yes can record & reportHow? And Efficient?

Some capacity

15

How? MDP-O

16th November 2012Socio-politics of Dietetic Practice

Study 1 Study 2

Data Mining10 Years of a Dietetic Practice

n=1 DietitianProviding ~1000 new episodes of care

plus review appointments

Behaviour ChangeCapitalising on the small gains

Information(recording & reporting)

Accurate, timely, relevant

Cross-sectional CohortNational Survey of Dietitians

n=141 DietitiansAnywhere across Australia

Any number of weight-loss clients

Yes can record & reportHow? And Efficient?

Some capacity

Need another n=150

Melanie Voevodin & Paul KomesaroffPhD Student 2010-2013 Supervisor

paul.komesaroff@monash.edumelanie.voevodin@monash.edu

MMeasuring DDietetic PPractice for OObesity (MDP-O Study)

Can DietitiansDietitiansturn

thearound ObesityObesityepidemic??

GP Dietitian Patient

Melanie Voevodin & Paul KomesaroffPhD Student 2010-2013 Supervisor

paul.komesaroff@monash.edumelanie.voevodin@monash.edu

MMeasuring DDietetic PPractice for OObesity (MDP-O Study)

Can DietitiansDietitiansturn

thearound ObesityObesityepidemic??

GP Dietitian Patient

Reporting

18

Blatant Plug

16th November 2012Socio-politics of Dietetic Practice

MDP-O Q1 National Survey of Dietitians

Improving Australian Dietetic Weight Management Services

Online, 20 minutes, anonymous

All 5 Sections need completing for data to be included

STARTS NOVEMBER 19

https://sites.google.com/site/monashmdp/OR

https://www.research.net/s/Q1MDPRound2

Plug 1: MDP-ORDG National Survey of Dietitians

Want to be a goodcritical analyst?

Online, 2 minutes

Supporting skill development in practice

OPEN NOW

https://sites.google.com/site/monashmdp/OR

https://www.research.net/s/RDGCritAnalysis

Plug 2: RDG