H. Zhang¹, J. Chang¹, O. Fournier¹, M. Wyatt², L. Dietrich³, P. Brauer¹, J. Randall Simpson¹
¹Department of Family Relations and Applied Nutrition, College of Social and Applied Human Sciences, University of Guelph, Guelph ON, ²London, ON, ³Haliburton, ON

Systemic changes to public health dietitians refer to the significant shifts in the structure of the profession (e.g., responsibilities, compensation, resources). There is a need to document these structural changes due to the tremendous growth public health practice has undergone since the last published historical account in 1993.

To document reflections from dietitians of significant structural changes influencing public health practice, and to capture these impacts in a timeline.

A draft timeline was initially created through a literature review grounded on grey literature. Through convenience and snowball sampling, key informants were identified and interviewed virtually and by telephone through one-hour semi-structured interviews, with the draft timeline as a source for discussion for additional perspectives. Interviews were recorded, transcribed, and thematically content analyzed with a team of four researchers to create an ultimate timeline and summary of key changes.

Two major meta-themes were identified from the interviews: (1) imposed changes and (2) evolutionary changes. Five themes were established under imposed changes: (1) reorganizing provincial health entities; (2) implementing regulations; (3) increasing nutrition emphasis on provincial policies/strategies; (4) evolving provincial funding for nutrition programs; and (5) fluctuating compensation for nutrition professionals. Three themes under evolutionary changes were identified as: (1) broadening responsibilities; (2) changes in peer support; and (3) evolving use of technology and resources. Key challenges included a lack of recognition from external bodies, internal disagreements with messaging and with other dietetic specialties, and issues with education standards.

Structural changes have occurred including reorganization within health departments, the increased prominence of technology, and defunding of certain nutrition programs. Public health dietitians continue their extensive work surrounding nutrition through policy and guideline development, advocacy, and student education.

The results will help inform dietitians on past systematic changes that occurred in the public health field.

In kind support from University of Guelph.