VALIDATING A MODEL FOR RESEARCH AND

EVIDENCE-BASED PRACTICE SKILLS IN DIETETICS

RAEANNE JORDAN
PRECEPTOR: ROSA HAND, PHD, RDN, LD, FAND
FUNDING
RESEARCH & EVIDENCE-BASED PRACTICE (EBP)

 Research: foundation and “backbone” of nutrition and dietetics

 EBP: consideration of relevant research, patient values and preferences, and contextual circumstances in order to
attain positive outcomes for a particular patient or population.

Manore M, et al. J Am Diet Assoc. 2003.

Hand RK, et al. Nutr Diet. 2020.

Definition of Terms Task Force, Quality Management Committee, Board of Directors. Published online at eatrightpro.org. October 2020.
CURRENT RESEARCH MODEL

Byham-Gray L, et al. J Am Diet Assoc. 2006.

Graphic: Whelan K, et al. J Acad Nutr Diet. 2013.

VALIDATED SURVEYS

Dietitian
Research
Research
Involvement
Involvement
Questionnaire
 Used to explore perceptions, barriers, and attitudes Survey
(RIQ)
towards research (DRIS)

 Based on Wylie-Rosett Research Continuum

Practice-
Based
Perception,
Dietitian
Attitude,
Research
Knowledge
Involvement
(PAK)
Survey
(PBDRIS)
RESEARCH

1. Cross-sectional study (n=~4100)

 99.5% agreed or strongly agreed that research is important (n=4100)
 More value was seen in research application (84%) than in participation (18%)

2. Cross-sectional study (n=~580)

 Activities associated with EBP were most highly utilized (DRIS score of 8.3 ± 2.2 out of 15)

3. Inhibitors to higher-level involvement: Lack of time (82%) & other work being more important (79%)
4. Primary area of practice and proportion of job role designated to research are significantly associated with
research involvement (P<0.005)(n=258)
Boyd M, et al. Top Clin Nutr. 2016.

Dougherty C, et al. J Acad Nutr Diet. 2015.

Byham-Gray L, et al. J Am Diet Assoc. 2006.

Howard A, et al. J Hum Nutr Diet. 2013.

Hand RK, et al. Top Clin Nutr. 2020.

EBP

 Utilization (n=~200):
 Majority consulted EBP resources less than once a month (52.6%)
 5.8% of respondents consulted EBP resources a few days per week
 Significant relationship between PAK score and frequency of consulting EBP resources and reading professional journals (p
< 0.0001)
 Common barriers to applying research to practice (n=~200):
 Lack of resources (29, 18%)
 Unsupportive team members (21, 14%)
 Poor organizational culture (22, 15%)

Byham-Gray L, et al. J Am Diet Assoc. 2005.

Vogt E, et al. Top Clin Nutr. 2013.
Hinrichs R. J Med Libr Assoc. 2018.
WHAT’S THE DIFFERENCE?

Who is
Goals
involved

Purpose of
level one
activities
PROPOSED MODEL
STUDY AIM

To determine the ability of the new model to correctly classify RDNs in the United States during the
summer of 2021 as research expert or non-expert and EBP expert or non-expert compared to
previously validated tools.
DATA COLLECTION

Inclusion Criteria
Cross-sectional study Credentialed RDN

Maximum of two email contacts w/ potential participants Active email address listed with CDR

Opted for CDR email communications

Second survey w/ opportunity to enter a raffle
Work in the United States
IRB approval from Case Western Reserve University English-speaking

Goal: 250 participants

SURVEY

PART 1

 Custom, two-part questionnaire

 Part 1 = RIQ and PBDRIS; based off of current research
continuum
 Part 2 = newly created; based off of new model
PART 2
 Additional questions measuring demographics
 Anticipated 30 minutes to complete

Whelan K, et al. J Acad Nutr Diet. 2013.

Kaiafas Plant M, et al. Top Clin Nutr. 2017.

DATA MANIPULATION & ANALYSIS

 Expert (Parts One and Two) = scores at or above the median score of the sample
 Continuous variables with be reported with mean ± SD or median + range
 Nominal variables with be reported as frequencies
 Chi-square tests will be used to compare expertise levels in Part Two to expertise levels in Part One
 Statistically significant at the α ≤ 0.05
LIMITATIONS

Unequal distribution of participants in

expertise groups
• Solution: Additional round of recruitment utilizing the
Dietetic Practice Groups

Low response rate

• Solution: incentive
BUDGET

Item Cost

Research assistant ($10/hr for ~3 hr/wk over 16 $480

weeks)
Participant compensation (10 x $50 gift cards) $500

Email addresses (free to students) $0

Total requested $980

OVERVIEW
QUESTIONS?
REFERENCES

1. Manore M, Myers E. Research and the dietetics profession: making a bigger impact. J Am Diet Assoc. 2003;103(1):108-112. doi:10.1053/jada.2003.50021

2. Hand RK, Davis A, Thompson K, Knol L, Thomas A, Proano G. Updates to the definition of evidence-based (dietetics) practice: providing clarity for practice. J
Acad Nutr Diet. 2020.
3. Definition of Terms Task Force, Quality Management Committee, Board of Directors. Academy of Nutrition and Dietetics definition of terms list. Published
online October 2020. https://www.eatrightpro.org/-/media/eatrightpro-files/practice/scope-standards-of-practice/academy-definition-oftermslist.pdf?
la=en&hash=397C681EFB1CD79FE03FB60C8D2BC008FC5BC530
4. Byham-Gray L, Gilbride J, Dixon L, King Stage F. Predictors for research involvement among registered dietitians. J Am Diet Assoc. 2006;106:2008-2015.
doi:0.1016/j.jada.2006.09.017
5. Boyd M, Byham-Gray L, Touger-Decker R, Marcus A, King C. Research interest and research involvement among US registered dietitian nutritionists. Top Clin
Nutr. 2016;31(3):267-277. doi:10.1097/TIN.0000000000000080
6. Dougherty C, Burrowes J, Hand, RK. Why registered dietitian nutritionists are not doing research - perceptions, barriers, and participation in research from the
Academy’s Dietetics Practice-Based Research Netword needs assessment survey. J Acad Nutr Diet. 2015;115(6):1001-1007. doi:10.1016/j.jand.2015.01.012
7. Howard A, Ferguson M, Wilkinson P, Campbell K. Involvement in research activities and factors influencing research capacity among dietitians. J Hum Nutr
Diet. 2013;26(Suppl. 1):180-187. doi:10.1111/jhn.12053
REFERENCES

8. Hand R, Sears E, Harris S. Research involvement of alumni from a combined dietetic internship/master’s degree program with a research concentration. Top Clin Nutr.
2020;35(4):329-340. doi:10.1097/TIN.0000000000000226
9. Byham-Gray L, Gilbride J, Dixon L, King Stage F. Evidence-based practice: what are dietitian’s perceptions, attitudes, and knowledge. J Am Diet Assoc. 2005;105:1574-
1581. doi:10.1016/j.jada.2005.07.007
10. Vogt E, Byham-Gray L, Touger-Decker R. Perceptions, attitudes, knowledge, and clinical use of evidence-based practice among US registered dietitians: a prospective
descriptive pilot study. Top Clin Nutr. 2013;28(3):283-294. doi:10.1097/TIN.06013e31829dee5e
11. Hinrichs R. Dietetic interns’ perceptions and use of evidence-based practice: an exploratory study. J Med Libr Assoc. 2018;106(1):65-73. doi:10.5195/jmla.2018.308
12. Carter E, Mastro K, Vose C, Rivera R, Larson E. Clarifying the conundrum: evidence-based practice, quality improvement, or research? The clinical scholarship continuum. J
Nurs Admin. 2017;47(5):266-270. doi:10.1097/NNA.0000000000000477
13. Fitzpatrick J. Distinction between research, evidence based practice, and quality improvement. Appl Nurs Res. 2016;29:261. doi:10.1016/j.apnr.2015.12.002
14. Hand RK, Abram JK. Sense of competence impedes uptake of new Academy evidence-based practice guidelines: results of a survey. J Acad Nutr Diet. April 2016;116(4):695-
705. doi: 10.1016/j.jand.2015.12.020.
15. Whelan K, Copeland E, Oladitan L, Murrells T, Gandy J. Development and validation of a questionnaire to measure research involvement among registered dietitians. J Acad
Nutr Diet. 2013;113(4):563-568. doi:10.1016/j.jand.2012.08.027
16. Kaiafas Plant M, Fleisch Marcus A, Zeigler J, Byham-Gray L. Testing of a tool to measure practice-based research involvement for registered dietitian nutritionists in clinical
practice. Top Clin Nutr. 2017;32(1):47-59. doi:10.1097/TIN. 000000000000009