Nutrition guidance by primary care physicians: models and circumstances

Abstract

The perception of primary care physicians of the ability to in¯uence the lifestyle and eating habits of patients is an important factor in nutrition guidance practices. This perception is based on assumptions about the kind of in¯uencing process that is effective or not and on the capacity of primary care physicians to play an effective role in these processes. The ®rst elements is dealt with in this article.Three models are distinguished. The ®rst model is the prescription model, based on a medical optimum and on information transfer as a metaphor. The second model is the persuasion model, based on a medical optimum, but presupposing blockades that have to be cornered by persuasive communication. The third is the interaction model. It is not based upon a medical but on an ef®cacy optimum, and on sharing of information and continuous involvement of the client in the interaction.Behind these three models we can perceive different views on communication and knowledge. Moreover, these three models are more or less appropriate with regard to different circumstances. The current stress on the psychological, social and cultural meaning of food and the new information context in which clients live, asks for more attention to the interaction model.

Perceived relevance and information needs regarding food topics and preferred information sources among Dutch adults: results of a quantitative consumer study

“…In the meantime, ideas about effective nutrition communication have changed (Contento et al, 1995(Contento et al, , 2002Truswell, 1997Truswell, , 1999Goldberg, 2000). The supply of nutrition information in mass media has increased and new information sources have been developed with the emphasis on information on demand, such as telephone information services and web sites (van Woerkum, 1999(van Woerkum, , 2003Goldberg, 2000). Furthermore, concerns about food topics like food safety, genetically modified foods, vitamin supplements and functional foods have become apparent (Clayton, 2000;Miles & Frewer, 2001;Coulson, 2002).…”

“…However, consumers act more and more as initiators of the communication process by actively seeking for messages (Vaandrager & Koelen, 1997;van Woerkum, 1999). Underlying this process is an information need, as the result of a perceived problem and translated into a question when problem solution is in reach (te Molder, 1999).…”

Present and future of nutrition guidance : lifestyle advice in primary care

“…Professor Hautvast had a brilliant idea: to organize an International Workshop with all the important players in the field (8,(52)(53)(54), as an exploration of the existing practices and experiences worldwide with which to compare our results. In the first Heelsum workshop, Van Woerkum adressed three types of interaction between the GP and the patient: prescription, persuasion and the interaction model (55). In the last model, the GP and the patient are seen as partners.…”

Nutrition Communication in General Practice

“…It might imply that GPs who are acting in this way, had applied the interaction model. In this model, patient and GP learn from each other by means of interaction [45]. As mentioned below, it is not so strange, that family doctors perceive lack of time as an important barrier to providing nutrition information.…”

“…In the persuasion model, the GP provides messages adjusted to the patient. The interaction model is characterised by its two-sidedness [45]. In our study, we took an alternative approach, by concentrating on the nutrition communication styles of GPs.…”