Friday, October 30, 2009

Community Partnership Involving Dietetic Interns: A Public Health Nutrition Experience

Background

Partnership is one of the core functions in public health practice. The partnership described in this article arose from a joint commitment of bringing community nutrition and chronic disease prevention work into a community agency, the Patch Project1 (Hull Child and Family Services), whose nutrition programming was focused on emergency food access. This article describes what we did and provides perspectives of different partners including staff of the Patch Project, the University of Alberta Integrated Dietetic Internship Program (UA-IDIP), and Health Agency registered dietitian (RD) preceptors.

What We Did


We took an asset-based approach and conducted an inventory of current community based programming focused on nutrition. The Patch Project advised on the program areas of most relevance to the populations they served. Dietetic interns were key participants in this initial work. During their placements with health agencies they researched the unique needs of the population that the Patch Project served. The work was primarily health agency driven and the outputs included adaptations to the format and delivery of existing resources to address the needs of diverse populations.

The partners had shared values, goals and expectations around accessibility and appropriateness of existing programs and seeking opportunities to model healthy eating in non-health agency programming, rather than seeking initiative funding and/or creating new/temporary resources with limited sustainability. All partners concurred that the goals could be achieved by placing an intern directly with the Patch Project thus optimizing use of preceptors’ areas of expertise while providing dietetic interns with practical experiences in community nutrition work with at-risk populations. The health agency RDs mentored the intern in developing community and public health nutrition competencies including how to appropriately utilize nutrition standards, approaches and resources in working with at-risk populations.


The foundational work spent on building the partnership and the ongoing evaluation led to a decision to pilot a 12-week intern placement at the community agency. Additional components to the established internship placement process were developed including a community agency screening of the intern, intern orientation binder, and scheduled opportunities for partner communication (e.g., weekly meetings, template for weekly intern reflection reports).


Participants’ Reflections


Patch Project, Hull Child and Family Services:

We experienced more nutrition modelling, education, and skill building in our agency programming that clearly stimulated an interest in healthy eating. Nutrition was introduced in practical ways within achievable limits. A challenge is how to manage and sustain the ideas/ programming after the placement ended. Our goal is to integrate nutrition considerations into our practice.


Internship Coordinator (UA –IDIP):

This placement was in a non-traditional setting and was a way to offer hands-on experience for interns in community nutrition. Adding new (non-traditional) placements to the internship increases the number of meaningful placements available to interns and allows them to gain experience in nutrition education, needs assessment, program planning, implementation and evaluation.This particular placement also provided learning opportunities related to food insecurity.


Dietetic Intern (UA –IDIP):
Since I was directly immersed within a low-income, multicultural community during this placement, I was able to appreciate the work that goes into a community development project. I have always been interested in community nutrition and now I have had the opportunity to work on a community garden and to develop a community nutrition program.


Health Agency RDs – Alberta Health Services
(Nutrition Services, Population and Public Health);

Healthy Babies Network, Catholic Family Services:

Placing a dietetic intern in a community agency allowed for a person with nutrition expertise to participate in hands-on work. The shared responsibility of preceptorship and combined perspectives of Dietitians in public health and community nutrition broadened the scope of practice for the intern. This successful pilot placement is seen as a model that can support community level work. Because of the Patch Project’s commitment to health promotion we have been able to consult with them for a community perspective on other initiatives.

Conclusion


The internship placement described in this article is one example of the important role of partnerships in public health nutrition work. We believe that an open and transparent partnership, with common values and goals, where all partnership work is valued and where challenges are addressed from an asset-based approach has been central to the successful outcomes.


1 The Patch Project is a grassroots, community based program serving families that live in subsidized housing units located in high needs communities.



ACKNOWLEDGEMENTS
– Thank you to all partners in supporting this experience: Patch Project (David Wright, Christina Maes, Twyla Mudry, Teresa Rumdit, Stacey McRae, Claire Jackson); UA-IDIP (Carrie Mullin-Innes); UA-IDIP intern (Sandra Paquette); Alberta Health Services (Kathy Cunningham); Healthy Babies Network (Brinda Rao).

Contact

Nutrition Services, Population and Public Health

Alberta Health Services - Calgary, AB

Suzanne Galeslott, MSA, RD
T: (403) 943-6752
E: suzanne.galesloot@albertahealthservices.ca


Annette Li
T: (403) 355-3290
E: annette.li@cancerboard.ab.ca


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