Evaluation of practice-based evidence in nutrition (PEN) service for dietetic practice

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Martin, Constance
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Mount Saint Vincent University
Objective: The analysis of the online evaluation survey of Practice-based Evidence in Nutrition (PEN) subscribers and non-subscribers quantitatively examined dietitians’ perceptions of the PEN service as a provider of evidence-based dietetic information. The purpose of the PEN evaluation was to measure the effectiveness of the PEN service as a knowledge translation and transfer tool for incorporating new knowledge into dietetic practice, and to identify barriers and facilitators that prevent users from using or enable users to use PEN to change the way they practice. Results of the evaluation were used to inform recommendations for improvements to the PEN service. Methods: A validated online survey was sent to all PEN subscribers (n=1,967) and a random sample of non-subscribers (n=1,542). The 333 respondents consisted of 265 PEN subscribers (13.5%) and 68 non-subscribers (4.4%). Respondents were dietitians or dietetic students. Survey responses were analyzed using descriptive statistics, proportions, the chi-square test and the z-test. Relationships between the survey responses and various demographic characteristics of the respondents were explored. Data compared to baseline data measured the difference between proportions. Results: When faced with a practice decision, 96% of PEN subscribers were likely to use PEN for practice guidance. Approximately 82% rated the PEN service as an excellent or very good practice guidance tool. Sixty-one percent indicated that when PEN was used to support decision making it led to positive health benefits for clients. This latter finding was reported by those who indicated that they also found the information in PEN to be up to date, to have sufficient detail to guide practice and to be of high quality. Problems with technology (e.g., printing difficulties and broken links); the perceived lack of resources, tools and content in some topic areas; and the amount of time available to use PEN at work were identified as barriers to using PEN for practice guidance. Being over 45 years of age was a demographic characteristic that was a barrier to frequent PEN use as well as a barrier to having sufficient time at work to use PEN. Facilitators that enabled dietitians to use PEN to change the way they practiced were accessibility to high-quality information, the perceived benefits to dietetic practice and the dietetic profession, and having sufficient time to use PEN. Being under 35 years of age was a demographic characteristic of subscribers who were more likely to use PEN frequently. Dietitians holding or working on a graduate degree were more likely to author or review PEN content. Compared to baseline data subscribers utilized PEN more frequently, had more time to use PEN at work, asked more practice questions and experienced more printing difficulties and broken links. Conclusions: Results indicate that the PEN service was effective as a KTT tool for incorporating new knowledge into dietetic practice. Barriers were related to user satisfaction with PEN features. Facilitators pertained to users’ perceptions of the value of PEN to their practice and quality of PEN content. This research supports Rogers’ Diffusion of Innovations Theory in that attributes of PEN influence its rate of adoption. Attributes of PEN as perceived by users can prevent dietitians from changing or enable them to change the way they practice. Recommendations that address the barriers, promote the facilitators and encourage further research were made to improve the effectiveness of the PEN service to transfer knowledge and change practice.
Practice-based Evidence in Nutrition (PEN) , Dieticians