Implementation of evidence-based nutritional management in primary health care settings: a systematic scoping review
Nara Letícia Zandonadi de Oliveira
A D , Marina Peduzzi A , Heloise Lima Fernandes Agreli B and Karen dos Santos Matsumoto C
+ Author Affiliations
- Author Affiliations
A University of Sao Paulo, School of Nursing, Department of Professional Orientation, Avenida Dr Enéas de Carvalho Aguiar, 419, São Paulo, SP, Brazil.
B Center for Work, Technology and Organisation, Emlyon Business School, 15 Boulevard Diderot, F-75012 Paris, France.
C State University of Rio de Janeiro, Social Medicine Institute, Rua São Francisco Xavier, 524, Rio de Janeiro, RJ, Brazil.
D Corresponding author. Email: narale.zandonadi@gmail.com
Australian Journal of Primary Health 28(1) 1-17 https://doi.org/10.1071/PY20280
Submitted: 27 November 2020 Accepted: 22 August 2021 Published: 15 December 2021
Journal Compilation © La Trobe University 2022 Open Access CC BY-NC-ND
Abstract
Scientific evidence is used to inform clinical nutritional guidelines in order to prevent diseases and promote health. However, little is known about the process of implementing evidence-based clinical nutritional guidelines in health services. This scoping review aims to map the steps in the implementation of evidence-based nutritional management within primary health care, as well as the facilitators and barriers to implementation. Electronic databases and the grey literature were searched for original studies on the implementation of evidence-based dietary recommendations and/or nutritional counselling in primary health care settings conducted by health practitioners. Studies were selected by independent reviewers. Extracted data were analysed and grouped into thematic categories and are presented in a narrative synthesis. In all, 26 studies were included. A review of the studies demonstrated four steps in the process of implementing evidence-based nutritional management in primary care: (1) acknowledging health needs in the catchment area and determining the characteristics of services and health professionals; (2) developing continuing education aimed at practitioners; (3) integrating nutritional management into interprofessional practice; and (4) adapting the interventions using a patient-centred care approach. The predominant facilitators were providers’ pre-intervention training and the provision of support materials. Barriers included time constraints, a lack of resources and an incompatibility of the interventions with living conditions and patients’ health needs.
Keywords: evidence-based practice, implementation science.
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