Perceptions, knowledge, and use of plant-based dietary interventions among healthcare providers in Nova Scotia (Veg-HP Study)

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Bockus, Laura
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Mount Saint Vincent University
Plant-based diets, including vegetarian diets, have been studied extensively for utility in chronic disease management. Recent public health initiatives, including the revision of the Canada’s Food Guide (CFG, 2019), reflect favourable health and wellness outcomes. Research investigating public perception of plant-based diets has identified several biases that may impact perceived and actual utility. Limited research exists on Healthcare Professionals’ (HCPs) perceptions, knowledge, or use of plant-based diets in practice, all well established outcomes that impact whether or not HCPs use an intervention. Aim: To capture and describe perceptions, knowledge, and practice behaviours of HCPs in Nova Scotia (NS), in relation to vegetarian diet usage in chronic disease management (prevention and treatment). Outcomes: Guided by our study aim, we collected data under four outcome categories, from registered and regulated physicians, dietitians, nurses, and pharmacists, practicing in NS 1) Demographics, 2) Perceptions 3) Knowledge 4) Use/Application. Methods: This cross-sectional survey study included development and implementation of a 60-item close-ended questionnaire which was distributed via LimeSurvey (October 2021-April 2022) to physicians, dietitians, nurses, and pharmacists in NS. Data was subjected to descriptive statistical analysis and described in text, tabular and figure format. Results: Of 53 respondents, 94% identified as female and 49% as registered dietitians (RDs). The sample was composed of people who consumed primarily omnivore (49%, n=23/47) or plant-based diets (49%, n=23/47). HCPs described vegetarian diets as a lifestyle choice (86%, n=43/50), legitimate medical practice (58%, n=29/50), and complimentary medicine (44%, n=22/50). Knowledge questions were correctly answered by most (85% or more), excluding one. Thirty-eight percent (n=31/50) of respondents did not know CFG no longer contains a meat and alternatives food group. Respondents identified cardiovascular disease (90%, n=45/50), diabetes (80%, n=40/50), cancers (74%, n=37/50), and mental health disorders (26%, n=13/50) could be beneficially impacted with plant-based diets, with no negative impacts (66%, n=33/50). Respondents (26%, n=13/50) expressed some concern for mental health impacts with vegetarian diets specifically, patients living with eating disorders (5%, n=2/43). Vegetarian diets were recommended by 68% (n=34/50) of HCPs, not recommended by 32% (n=16/50), and 58% (n=29/50) reported waiting for patient interest before discussing vegetarian diets. Conclusions: A large percentage of respondents recognized vegetarian diets could beneficially impact disease states and clinical outcomes, a similar percentage of respondents reported not introducing this dietary pattern without prompting from their patient. NS HCPs had better knowledge scores than previous peer-reviewed and published literature, although evaluations/ knowledge evaluation tools differ across studies. This is likely due to the increased representation of RDs in our sample.