Eleven process evaluation strategies for education of individual clients in dietetic practice

Aim: To examine process evaluation methods used by Australian dietitians in nutrition education of individual clients. Methods: A qualitative-quantitative design was used. A purposive sample of 46 clinical dietitians working in Victorian hospitals, community or private practice attended audio-recorded focus groups or an in-depth interview. Themes identified were used to develop a questionnaire to survey Australian dietitians asking about client education strategies and evaluation methods. Two hundred and fifty-eight dietitians (16%) responded to a Web-based questionnaire. Criterion for extraction of results was ≥70% agreement. Descriptive statistics, chi-squared and Spearman's rank order correlation analyses were used (if P ≤ 0.05). Results: Eleven process evaluation strategies were used by ≥84% of dietitians. Results clustered into a typology of four evaluation strategies: evaluating planning of the intervention; evaluating assimilation of new information; evaluating intention to change behaviour; and determining a patient's satisfaction with a consultation. Only two methods were used 'often' by more than half the respondents, indicating a wide range in choice of strategies. Seven of 11 strategies in use evaluated information assimilation. There was no significant difference by work category, state of employment or seniority. Evaluative questions to be answered are: Did they agree to it? Did they learn it? Will they use it? What has changed? Conclusion: Process evaluation is best achieved by simultaneous teaching and evaluation. Dietitians may benefit from further skills training to more fully utilise patient-centred planning. Further investigation is warranted to define best practice.