Changes in clinical dietetics: impact of cost reduction in healthcare systems

There is a lack of research regarding cost reduction activities in healthcare systems and their impact on clinical dietitians\u27 (CDs\u27) jobs and their perceptions about their professions. Purposes of this research were to identify changes in clinical dietetics due to cost reduction activities and to assess perceptions of CDs on improving levels of practice and educational and preprofessional preparation;There were two studies included in this research project. In the qualitative study, 16 clinical dietetic experts provided their observations and experiences related to changes in clinical dietetics and shared insights of improving the level of clinical dietetic practice and preparing future CDs. The quantitative questionnaire was developed based on the qualitative study results;In the quantitative study, 1,200 members of the American Dietetic Association (ADA) employed in acute care hospitals in eight ADA Area 2 states were selected as subjects. Subjects were asked to indicate their experiences of downsizing and to rate the importance of various items regarding improvement of practice and preparation of CDs;Among 342 respondents, \u3e75% of respondents reported reduced clinical dietetic staff, limited time for inpatient instruction, increased caseloads and high-risk patient intervention and referrals. Although CDs reported having limited time and increased caseloads, a few (\u3c15%) CDs indicated their responsibilities were delegated to support staff frequently. Some respondents reported the separation of foodservice and clinical nutrition departments. Some CDs indicated they are accountable to nursing administrators or medical doctors;For improving clinical dietetic practice, collaboration with other healthcare professionals, proficiency in more than one area of specialty and in computer technology, and passage of medical nutrition therapy legislation were perceived to be important. For educational preparation, importance of computer and oral presentation skills, enteral/parenteral nutrition, and evaluation of cost-effectiveness received high ratings. For preprofessional preparation, more practicum experiences and flexibility in job situations were perceived to be important;Recommendations were made to minimize negative impact of cost reduction, and to improve the level of practice and educational and preprofessional preparation for future dietitians. Further research was recommended to be conducted in other geographic regions and with dietitians with different job settings

The Effectiveness of Web-based Food Allergy Training among Restaurant Managers

Many food allergic reactions occurred in restaurants indicating employee food allergy training is necessary. The hospitality industry adopts web-based training method as it is beneficial. The objective of the study is to identify the effectiveness of web-based food allergy training on knowledge, self-efficacy, and behavioral intention serving customers with food allergies. Participants will include 100 managers from independent restaurants in Kansas. A web-based training module will be developed and pilot tested. A quasi-experimental design (intervention and control groups) with a pre- and post-test will be used to assess knowledge scores. After six month, another questionnaire that assesses participants’ retention of food allergy knowledge, self-efficacy, and behavioral intention to serve customers with food allergies will be administered. Descriptive statistics, MANOVA, MANCOVA, Chi-square analyses, logistic regression, and regression will be employed for statistical analysis. Results of the proposed study will provide insights about using web-based training as future educational tool

The Exploration of Effects of Chinese Cultural Values on the Attitudes and Behaviors of Chinese Restaurateurs Toward Food Safety Training

Citation: Liu, P., & Kwon, J. (2013). The exploration of effects of Chinese cultural values on the attitudes and behaviors of Chinese restaurateurs toward food safety training. Journal of Environmental Health, 75(10), 38-46.Foodborne illness is a challenge in the production and service of ethnic foods. The purpose of the study described in this article was to explore variables influencing the behaviors of U.S. Chinese restaurant owners/operators regarding the provision of food safety training in their restaurants. Seventeen major Chinese cultural values were identified through individual interviews with 20 Chinese restaurant owners/operators. Most participants felt satisfied with their previous health inspections. Several expressed having difficulty, however, following the health inspectors’ instructions and in understanding the health inspection report. A few participants provided food safety training to their employees due to state law. Lack of money, time, labor/energy, and a perceived need for food safety training were recognized as major challenges to providing food safety training in Chinese restaurants. Videos, case studies, and food safety training handbooks were the most preferred food safety training methods of Chinese restaurant owners/operators, and Chinese was the preferred language in which to conduct the training

Effectiveness of Healthy Menu Changes in a Nontrainee Military Dining Facility

Citation: Belanger, B. A., & Kwon, J. (2016). Effectiveness of healthy menu changes in a non-trainee military dining facility. Military Medicine, 181(1), 82-89.The purpose of this study was to evaluate the impact of implementing the Initial Military Training (IMT) menu standards in nontrainee dining facilities (DFAC) on food selection, nutrient intake, and satisfaction of soldiers. Participants were recruited during lunch before and 3 weeks after the menu changes. Direct observations, digital photography, and plate waste methods were used to assess soldiers’ food selection and consumption, along with a survey assessing soldiers’ meal satisfaction under the two menu standards. Descriptive statistics and independent sample t-tests were used to summarize and compare the data. A total of 172 and 140 soldiers participated before and after menu changes, respectively. Soldiers consumed 886 kcals (38.6% from total fat and 11.2% from saturated fat) and 1,784 mg of sodium before the menu change. Three weeks after the change, all figures improved ( p < 0.01). The percentage of healthier food selections mirrored food items served at the DFAC and improved after the intervention ( p < 0.001). There were no differences observed in overall satisfaction and meal acceptability after the intervention. Our findings suggest implementing the Initial Military Training menu standards in nontrainee Army DFACs is feasible and has the potential to improve the overall healthfulness of soldiers’ food selection and consumption

Exploration of Attitudes and Behaviors of Consumer with Food Allergies about Dining Out: A Focus Group Study

Aim: To investigate attitudes and behaviors of consumers with food allergies about dining out. Method: All sessions were audio-taped, transcribed verbatim, and analyzed using NVivo Version 8.0. Results: Seventeen participants participated in four focus group sessions. Participants perceived cross-contact, hidden ingredients, and miscommunication as potential causes of food allergic reactions. Perceived barriers to provide allergen-free food were lack of training and awareness among employees. Participants perceived buffet, ethnic and specialty restaurants as risky dining places but preferred national brand, chain restaurants. Participants expected the servers to follow the given instructions and have the major allergens and ingredients listed on the menus. They felt the needs of regulations to protect people with food allergies. People with food allergies should ask for clarifications and bring an Epi-pen while dining out. Conclusion: Consumers with food allergies experienced many difficulties in restaurants due to restaurant employees’ lack of knowledge and training regarding food allergy

Effects of Workplace Fun on Employee Behaviors: Focused on Generation Y in the Hospitality Industry

The conceptual model of this study was tested based on responses from 234 hospitality students in the US who are Generation Yers and had worked in the hospitality industry for more than 3 months. This study revealed that Generation Y employees’ attitude toward workplace fun positively affects their experienced workplace fun. In turn, Generation Yers’ experienced workplace fun showed direct effects on their job satisfaction, task performance, and interpersonal citizenship behaviors. Affected by experienced workplace fun, job satisfaction significantly enhanced employees’ task performance and interpersonal job satisfaction. In essence, for Generation Y employees in hospitality businesses, workplace fun is a significant factor in their job satisfaction, task performance, and interpersonal citizenship behavior. These findings provide a significant insight to hospitality employers who typically have a hard time to attract best young talents and motivate them mainly due to low-paying, low-status nature of hospitality jobs

School Nutrition Directors’ Perceptions of Technology Use in School Nutrition Programs

Citation: Pratt, P., Bednar, C., & Kwon, J. (2012). School nutrition directors’ perceptions of technology use in school nutrition programs. Journal of Child Nutrition & Management, 36(2).Purpose/Objectives: This study investigated the types of technology/software currently used by Southwest Region school nutrition directors (SNDs) and assessed their perceptions of barriers to purchasing new technology/software. In addition, the importance of future technology/software acquisitions in meeting school nutrition program (SNP) goals was examined. Methods: A questionnaire was developed by the researchers, validated by an expert panel using the Delphi technique, converted to an online format, and pilot tested. A randomized group of School Nutrition Association SNDs and members of the Academy of Nutrition and Dietetics School Nutrition Services Dietetic Practice Group listserv participated. Participants (N = 111) identified technology/software currently used, their perceived computer skill level, and other demographics. Likert-type scales were used to rate agreement/disagreement with barriers to purchasing new technology/software and the importance of future technology/software acquisitions. Multivariate analyses were used to determine differences in SND ratings according to demographic variables. Results: SNDs who completed the survey used a variety of technology/software. The majority of respondents worked in suburban or metropolitan communities and perceived themselves as having advanced/expert computer skills. Older SNDs, SNDs with less education, and SNDs serving fewer meals per day found inadequate funds, outdated computers, and lack of information technology and administrative support to be barriers to acquiring new technology/software. However, SNDs with higher perceived computer skills (p = .003) and higher education levels (p = .073) were more likely to disagree with these barriers. SNDs with higher perceived computer skills utilized the most technology/software (p = .000) and were more likely to see future technology/software acquisitions (p = .551) as important to meeting SNP goals. Applications to Child Nutrition Professionals: Although technology is widely used by many SNDs, some SNDs have not implemented software applications that could help reduce costs and improve productivity. The school nutrition industry needs influential leaders who can develop local mentorship programs, initiate computer skill building classes, and encourage online training for this group of SNDs

Food Safety Training Needs at Evacuation Shelters Operated by Faith-Based Organizations

Citation: Kwon, J., Zottarelli, L., Kwon, S., Lee, Y. M., & Ryu, D. (2013). Food safety training needs at evacuation shelters operated by faith-based organizations. Journal of Environmental Health, 76(2), 14-21.The authors conducted a survey to identify food safety training needs at evacuation shelters operated by faith-based organizations (FBOs) in four hurricane-prone states. Five thousand randomly selected FBO leaders were asked questions about their food safety attitudes and food handling practices at evacuation shelters. Descriptive statistics and multivariate analysis of variance were calculated to summarize and prioritize the responses. Results from 138 leaders revealed that on average, 590 ± 4,787 evacuees were served for 36 ± 72 days at FBO-operated shelters. Only 19.6% felt they were well prepared for the shelter. Only 5.8% had professional food preparation staff and many accepted hot (47.8%) and cold (37%) prepared food donations. Some lacked adequate refrigerator (18.8%) or freezer (16.7%) spaces, but 40% kept hot food leftovers for later use. The majority did not provide food safety training before opening the shelters (73.2%), yet 76.9% said they will provide food to evacuation shelters again. The results show a need for food safety training and specific strategies for training at FBOs

A Focus Group Study of Child Nutrition Professionals' Attitudes about Food Allergies and Current Training Practices

Citation: Lee, Y. M., Kwon, J., & Sauer, K. (2014). A focus group study of child nutrition professionals’ attitudes about food allergies and current training practices. Journal of Child Nutrition and Management, 38(1).Purpose/Objectives: The purpose of this study was to explore child nutrition professionals' (CNPs) attitudes about food allergies, current practices of food allergy training, and operational issues related to food allergy training in school foodservice operations. Methods: Three focus groups were conducted with 21 CNPs with managerial responsibilities from a midwestern state. Responses to guided, open-ended questions were audio-recorded, transcribed verbatim, and analyzed to identify common themes. Results: Participants felt that the prevalence and types of food allergies affecting school nutrition programs have increased in recent years. They also felt that communicating with other stakeholders and verifying physicians' recommendations regarding food allergies can be difficult. Participants agreed that training could improve food allergy knowledge and awareness of their employees and improve safety of children with food allergies. However, only a few reported providing specific food allergy training for employees. Cost, scheduling difficulties, and time constraints were identified as barriers to providing food allergy training. Participants preferred having credentialed professionals to conduct employee food allergy training. Support from school administrators and witnessing a food allergic reaction in the cafeteria would trigger a decision to initiate food allergy training. Applications to Child Nutrition Professionals: Improved communication between school foodservice staff and other stakeholders is crucial to better serve students with food allergies. A well-planned, structured training program could better prepare school foodservice employees serving students with food allergies. CNPs might need continuous guidance and assistance regarding employee food allergy training. State agencies and professional organizations should work with CNPs to develop and communicate best practices for prevention and management of food allergic reactions

Connecting Supply Chain Through Sustainability: Initiating a Multi-Disciplinary, Multi-Industry Approach Using the Case of Beef Cattle

Disciplinary perspectives of supply chains are influenced by the “silo” nature of academia. For example, educators typically train students about appropriate supply chain management starting with the manufacturer of products used in their particular industry, as opposed to investigating the entire supply chain from raw material producer to finished consumer product through disposal or recycling. When educating sustainability, understanding the extent and interrelated nature of the entire supply chain is essential. Without foundational knowledge and systems thinking, students may not understand the impact of business decisions on sustainability, and motivation to make sustainable choices may be lacking. This project aims to develop a Collaborative Grant Type 2 to infuse sustainability education into a variety of baccalaureate programs (e.g., animal sciences, hospitality and textile programs) using the study of beef cattle. Beef cattle present complex issues that involve a global view of the challenge to feed, clothe and fuel 9.6 billion people by the year 2050 while conserving finite resources