Staff-perceived barriers to nutrition intervention in substance use disorder treatment
By David A. Wiss, Lisa Russell, & Michael Prelip
Given emerging evidence in the domain of nutritional psychiatry, improving nutrition in early recovery has the potential to improve mental health and overall chances of recovery, although to date there is limited support. Vulnerable populations including those who are food insecure need more attention amidst the addiction crisis. Future research should examine client barriers as well as satisfaction with nutrition-related changes, in both public and private treatment settings. Nutrition interventions can also be an important part of harm reduction approaches aimed at decreasing food insecurity and increasing quality of life in those who are not abstinent.
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Abstract
Objective:
While organisational change in substance use disorder (SUD) treatment has been extensively studied, there is no research describing facility-wide changes related to nutrition interventions. This study evaluates staff-perceived barriers to change before and after a wellness initiative.
Design:
A pre-intervention questionnaire was administered to participating staff prior to facility-wide changes (n 40). The questions were designed to assess barriers across five domains: (1) provision of nutrition-related treatment; (2) implementation of nutrition education; (3) screening, detecting and monitoring (nutrition behaviours); (4) facility-wide collaboration and (5) menu changes and client satisfaction. A five-point Likert scale was used to indicate the extent to which staff anticipate difficulty or ease in implementing facility-wide nutrition changes, perceived as organisational barriers. Follow-up questionnaires were identical to the pre-test except that it examined barriers experienced, rather than anticipated (n 50).
Setting:
A multisite SUD treatment centre in Northern California which began implementing nutrition programming changes in order to improve care.
Participants:
Staff members who consented to participate.
Results:
From pre to post, we observed significant decreases in perceived barriers related to the provision of nutrition-related treatment (P = 0·019), facility-wide collaboration (P = 0·036), menu changes and client satisfaction (P = 0·024). Implementation of nutrition education and the domain of screening, detecting and monitoring did not reach statistical significance.
Conclusions:
Our results show that staff training, food service changes, the use of targeted curriculum for nutrition groups and the encouragement of discussing self-care in individual counseling sessions can lead to positive shifts about nutrition-related organizational change among staff.