Background: Health professionals, including dietitians, should adapt their clinical daily practice to evidence-based practice (EBP), but this does not happen often in daily practice. The aim of this study was to investigate the current status and barriers to evidence-based practice among dietitians. Methods: This was a mixed-method, cross-sectional, national study (questionnaire and focus group) performed on working and registered dietitians, both self-employed and employed by public hospitals. The main outcomes were EBP knowledge, frequency of use, and proficiency scores. Barriers to EBP implementation were also collected, as well as qualitative information from the focus group. Results: Forty-three dietitians were enrolled from August to November 2021 in Italy. Overall, EBP knowledge was moderate/good. Younger dietitians (< 50 years old) obtained better results than their older colleagues. A similar trend was observed in terms of seniority. There was a discrepancy between EBP knowledge and perception of EBP implementation: the worst scores were obtained by participants who claimed an already complete integration of EBP. The average frequency of EBP use was moderate, with higher scores in dietitians ≥ 50 years old and with seniority ≥ 20 years. EBP proficiency instead was poor. The focus group revealed a lack of time and resistance to change as the main barriers. Conclusion: The importance of EBP is well-acknowledged, but it is not correctly implemented yet, because of identified barriers that need to be fixed. These barriers include a lack of dedicated time, inadequate EBP training, and resistance to change, especially in hierarchical environments.
Academy of Nutrition and Dietetics (2017) Definition of terms list. Available at: https://www.eatright.org (accessed 8 February 2022).
2.
AmjadAFatimaABashirA (2020) Knowledge and use of evidence-based practice among physical therapists, dieticians and nurses. Rawal Medical Journal45(2): 493–496.
3.
BraunVClarkeV (2006) Using thematic analysis in psychology. Qualitative Research in Psychology3(2), Routledge: 77–101.
4.
Byham-GrayLDGilbrideJADixonLB, et al. (2005) Evidence-based practice: What are dietitians’ perceptions, attitudes, and knowledge?Journal of the American Dietetic Association105(10), United States: 1574–1581.
5.
ChiuYWWengYHWahlqvistML, et al. (2012) Do registered dietitians search for evidence-based information? A nationwide survey of regional hospitals in Taiwan. Asia Pacific Journal of Clinical Nutrition21(4): 630–637.
6.
DoughertyCMBurrowesJDHandRK (2015) Why registered dietitian nutritionists are not doing research-perceptions, barriers, and participation in research from the academy’s dietetics practice-based research network needs assessment survey. Journal of the Academy of Nutrition and Dietetics115(6), United States: 1001–1007.
7.
DunningD (2011) Chapter Five - The Dunning–Kruger Effect: On Being Ignorant of One’s Own Ignorance. In: Olson JM and Zanna MPBT-A in ESP (eds). New York: Academic Press, pp.247–296.
8.
GoodingBProbstYHoustonL, et al. (2020) Exploring perceptions, barriers and use of systematic reviews amongst nutrition professionals and nutrition students. Nutrition & Dietetics77(1), John Wiley & Sons, Ltd: 151–159.
9.
HeiweSKajermoKNRaijaT-L, et al. (2011) Evidence-based practice: Attitudes, knowledge and behaviour among allied health care professionals. International Journal for Quality in Health Care23(2): 198–209.
10.
HinrichsRJ (2018) Dietetic interns’ perceptions and use of evidence-based practice: An exploratory study. Journal of the Medical Library Association : JMLA106(1), 2018/01/02. Medical Library Association: 65–73.
11.
ICDA - International Confederation of Dietetic Associations (2014) International Standard for Education of Dietitians-Nutritionists. Available at: https://internationaldietetics.org/ (accessed 8 February 2022).
12.
KellyGA (1955) The Psychology of Personal Constructs. Vol. 1. A Theory of Personality. Vol. 2. Clinical Diagnosis and Psychotherapy. Oxford, England: W. W. Norton.
13.
LeckyP (1945) Self-Consistency; a Theory of Personality. Washington, DC, US: Island Press.
14.
MetcalfeCLewinRWisherS, et al. (2001) Barriers to implementing the evidence base in four NHS therapies: Dietitians, occupational therapists, physiotherapists, speech and language therapists. Physiotherapy87(8): 433–441.
15.
NealeEPTapsellLC (2019) Perspective: The evidence-based framework in nutrition and dietetics: Implementation, challenges, and future directions. Advances in Nutrition (Bethesda, Md.)10(1): 1–8.
16.
NielsenLDCastanoFMJørgensenRB, et al. (2024) Teaching evidence-based practice to undergraduate healthcare students Educators’ knowledge, skills, attitudes, current practice, perceived barriers, and facilitators: A Danish cross-sectional study. Nurse Education Today133: 106082.
17.
SoguelLVaucherCBengoughT, et al. (2019) Knowledge translation and evidence-based practice: A qualitative study on clinical dietitians’ perceptions and practices in Switzerland. Journal of the Academy of Nutrition and Dietetics119(11): 1882–1889.
18.
ThomasDEKukuruzovicRMartinoB, et al. (2003) Knowledge and use of evidence-based nutrition: A survey of paediatric dietitians. Journal of Human Nutrition and Dietetics16(5): 315–322.
19.
UptonDUptonP (2006) Knowledge and use of evidence-based practice by allied health and health science professionals in the United Kingdom. Journal of Allied Health35(3): 127–133.
