Oncology Registered Dietitian Nutritionists' Knowledge, Attitudes, and Practices Related to Food Insecurity among Cancer Survivors: A Qualitative Study

Amirah A Burton-Obanla; Stephanie Sloane; Brenda Koester; Craig Gundersen; Barbara H Fiese; Anna E Arthur

doi:10.1016/j.jand.2021.12.004

Oncology Registered Dietitian Nutritionists' Knowledge, Attitudes, and Practices Related to Food Insecurity among Cancer Survivors: A Qualitative Study

J Acad Nutr Diet. 2022 Dec;122(12):2267-2287. doi: 10.1016/j.jand.2021.12.004. Epub 2021 Dec 9.

Authors

Amirah A Burton-Obanla¹, Stephanie Sloane², Brenda Koester², Craig Gundersen³, Barbara H Fiese⁴, Anna E Arthur⁵

Affiliations

¹ Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Urbana, Illinois.
² Family Resiliency Center, University of Illinois at Urbana-Champaign, Urbana, Illinois.
³ Department of Agricultural and Consumer Economics, University of Illinois at Urbana-Champaign, Urbana, Illinois.
⁴ Family Resiliency Center, University of Illinois at Urbana-Champaign, Urbana, Illinois; Department of Human Development and Family Studies, University of Illinois at Urbana-Champaign, Urbana, Illinois.
⁵ Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Urbana, Illinois; Department of Food Science and Human Nutrition, University of Illinois at Urbana-Champaign, Urbana, Illinois; Department of Dietetics and Nutrition, University of Kansas Medical Center, Kansas City, Kansas. Electronic address: aarthur4@kumc.edu.

PMID: 34896629
DOI: 10.1016/j.jand.2021.12.004

Abstract

Background: Understanding the knowledge, attitudes, and practices pertaining to food insecurity among oncology registered dietitian nutritionists (RDNs) is critical to ensuring that cancer survivors have adequate nutrition-a fundamental component of successful treatment and recovery.

Objective: To qualitatively assess oncology RDNs' knowledge, attitudes, and practices regarding the food access needs of their patients using a qualitative semantic approach to thematic analysis.

Design: The qualitative cross-sectional study was conducted from September 2018 to January 2019.

Participants and setting: Forty-one oncology RDNs working with cancer survivors in various clinical settings across the United States participated.

Main outcome measures: Participants completed a semistructured, in-depth interview via telephone, lasting an average of 49 minutes.

Statistical analyses performed: Two coders (primary and secondary) trained in qualitative thematic data analysis methods used a semantic approach to thematic analysis to analyze transcripts. A qualitative and mixed methods online coding program Dedoose was used to organize and analyze the data.

Results: Participants defined food insecurity (FI) as a lack of access to nutritious foods and a lack of resources to purchase nutritious foods. RDNs stated they believe FI is a serious problem in the United Staes, has a greater influence on cancer survivors than healthy individuals and they have specific concerns about FI among their own patients. Despite their concerns, most expressed that they do not use a validated tool to identify FI, nor were they aware that any exists. Only a small proportion of the RDNs stated that they regularly ask patients about their food access needs.

Conclusions: Although Oncology RDNs have heard of FI, they do not routinely assess patients' food security status with a validated tool, nor do they consistently ask patients directly about their food access needs. These findings suggest there is a need for developing education and training opportunities for oncology RDNs to enhance their ability to screen for and address FI with their patients.

Keywords: Cancer; Food security; Qualitative research; Registered dietitian nutritionist; SNAP.

Publication types

Research Support, U.S. Gov't, Non-P.H.S.
Research Support, Non-U.S. Gov't

MeSH terms

Cancer Survivors*
Cross-Sectional Studies
Dietetics*
Food Insecurity
Health Knowledge, Attitudes, Practice
Humans
Neoplasms* / therapy
Nutritionists*
United States