Hostname: page-component-586b7cd67f-2plfb Total loading time: 0 Render date: 2024-11-26T18:21:38.088Z Has data issue: false hasContentIssue false
  • English
  • Français

Competencies for effective public health nutrition practice: a developing consensus

Published online by Cambridge University Press:  02 January 2007

Roger Hughes
Roger Hughes*
Affiliation:
Nutrition Unit, School of Health Science, Griffith University, Gold Coast, Queensland 4217, Australia
*
*Corresponding author: Email [email protected]
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
Objectives:

To assess the level of consensus amongst an international panel of public health nutrition leaders regarding the essential competencies required for effective public health nutrition practice.

Design:

A modified Delphi study involving three rounds of questionnaires.

Subjects:

A panel of 20 public health nutrition experts from seven countries in the European Union, the USA and Australia.

Results:

Expert panellists completed three rounds of the study relating to competencies. A literature review conducted as a prelude to the expert panel survey identified common competency units from the fields of public health, health promotion, nutrition and dietetics, and health education. These were categorised into seven competency areas including analytical, socio-cultural and political, public health service, communication, management and leadership, nutrition science and professional competency categories. There was strong initial agreement (≥90% of panellists at Round 1) that developing internationally recognised competencies for public health nutrition specialists was a priority. Twenty-six of an initial listing of 52 competency units were rated as essential competencies by ≥80% of the panellists after Round 1. Iteration rounds resulted in the addition of five extra competency units suggested by panellists after Round 1 and an increase by 13 in the number of competencies rated as essential to consensus levels. From a total of 57 competency units rated after the final survey round, 41 competency units were rated as essential competencies by ≥80% of the panellists (consensus), with 21 of these unanimously rated as essential competencies.

Conclusions:

There is strong international agreement amongst public health nutrition leaders in Europe, the USA and Australia about a range of competencies required for effective public health nutrition practice. Essential competency units identified can be used to develop and review competency standards for public health nutrition.

Keywords

Public health nutritionCompetenciesConsensus development
Type
Research Article
Information
Public Health Nutrition , Volume 7 , Issue 5 , August 2004 , pp. 683 - 691
Copyright
Copyright © The Authors 2004

References

1McAllister, M. Competency standards: clarifying the issues. Contemporary Nurse 1998; 7: 131–7.CrossRefGoogle ScholarPubMed
2Dodds, J, Kaufman, M, eds. Personnel in Public Health Nutrition for the 1990's: A Comprehensive Guide. Washington, DC: The Public Health Foundation, 1991.Google Scholar
3Dodds, J, Polhamus, B. Self-perceived competence in advanced public health nutritionists in the United States. Journal of the American Dietetic Association 1999; 99: 808–12.CrossRefGoogle ScholarPubMed
4Landman, J, Buttriss, J, Margetts, B. Curriculum design for professional development in public health nutrition in Britain. Public Health Nutrition 1998; 1: 69–74.CrossRefGoogle ScholarPubMed
5Landman, J. Training in Public Health Nutrition: symposium at the 17th International Congress of Nutrition, Vienna. Public Health Nutrition 2001; 4: 1301–2.CrossRefGoogle ScholarPubMed
6Bowden, J, Masters, G. Implications for Higher Education of a Competency Based Approach to Education and Training. Canberra: Australian Government Publishing Service, 1993.Google Scholar
7Chapman, H. Some important limitations of competency-based education with respect to nurse education: an Australian perspective. Nurse Education Today 1999; 19: 129–35.CrossRefGoogle ScholarPubMed
8Hager, P. Is there a cogent philosophical argument against competency standards?. Australian Journal of Education 1994; 38: 3–18.CrossRefGoogle Scholar
9Gonzi, A. Competency based assessment in the professions in Australia. Assessment in Education 1994; 1: 27–44.Google Scholar
10Hager, P, Gonzi, A. Competency based standards: a boon for continuing professional education. Studies in Continuing Education 1991; 13: 24–40.CrossRefGoogle Scholar
11Rivers, K, Aggleton, P, Whitty, G. Professional preparation and development for health promotion: a review of the literature. Health Education Journal 1998; 57: 254–62.CrossRefGoogle Scholar
12Centers for Disease Control and Prevention/Agency for Toxic Substances and Disease Registry. Strategic Plan for Public Health Workforce Development. Toward a Life-long Learning System for Public Health Practitioners. Washington, DC: US Department of Health and Human Services, 2001.Google Scholar
13Kennedy, V, Moore, F. A systems approach to public health workforce development. Journal of Public Health Management and Practice 2001; 7: 17–22.CrossRefGoogle ScholarPubMed
14Riddout, L, Gadiel, D, Cook, K, Wise, M. Planning Framework for the Public Health Workforce: Discussion Paper. Melbourne: National Public Health Partnership, 2002.Google Scholar
15Gebbie, K, Rosenstock, L, Hernendez, L. Who will Keep the Public Healthy? Educating Public Health Professionals for the 21st Century. Washington, DC: Institute of Medicine/National Academic Press, 2002.Google Scholar
16Lichtveld, M, Cioffi, J, Baker, E, Bailey, S, Gebbie, K, Henderson, J, et al. Partnership for front-line success: a call for a national action agenda on workforce development. Journal of Public Health Management and Practice 2001; 7: 1–7.CrossRefGoogle Scholar
17Healthwork UK. National Standards for Specialist Practice in Public Health: An Overview (Approved Version). London: Healthwork UK, 2002.Google Scholar
18Council on Linkages between Academia and Public Health Practice. Core Competencies for Public Health Professionals. Washington, DC: US Department of Health and Human Services, 2002.Google Scholar
19Lane, D, Ross, V, Chen, D, O'Neill, C. Core competencies for Preventative Medicine residents: version 2. American Journal of Preventative Medicine 1999; 16: 367–72.CrossRefGoogle ScholarPubMed
20Precision Consultancy. Draft Health Promotion Competency Standards. Melbourne: Precision Consultancy, 2000.Google Scholar
21Howat, P, Maycock, B, Jackson, L, Lower, T, Cross, D, Collins, J, et al. Development of competency-based university health promotion courses. Promotion & Education 2000; 7: 33–8.CrossRefGoogle ScholarPubMed
22National Commission for Health Education Credentialing, Inc. (NCHEC). Responsibilities and Competencies for Health Educators. Allentown, PA: NCHEC, 2002.Google Scholar
23Nutrition Society. How to Specify Levels of Learning Outcome in Public Health Nutrition; Annex. London: Nutrition Society, 2000.Google Scholar
24Pelletier, D. Advanced training in food and nutrition: disciplinary, interdisciplinary, and problem orientated approaches. Food and Nutrition Bulletin 1997; 18: 134–45.CrossRefGoogle Scholar
25Rogers, B, Schlossman, N. ‘Public nutrition’: the need for cross-disciplinary breadth in the education of applied nutrition professionals. Food and Nutrition Bulletin 1997; 18: 120–33.CrossRefGoogle Scholar
26Hughes, R. Definitions for public health nutrition: a developing consensus. Public Health Nutrition 2003; 6: 615–20.CrossRefGoogle ScholarPubMed
27Murphy, M, Black, N, Lamping, D, McKee, C, Sanderson, C, Askham, J, et al. Consensus development methods, and their use in clinical guideline development. Health Technology Assessment 1998; 2: i–iv, 1–88.CrossRefGoogle ScholarPubMed
28Jones, J, Hunter, D. Qualitative research: consensus methods for medical and health services research. British Medical Journal 1995; 311: 376–80.CrossRefGoogle Scholar
29Rowe, G, Wright, G. The Delphi technique as a forecasting tool: issues and analysis. International Journal of Forecasting 1999; 15: 353–75.CrossRefGoogle Scholar
30Duffield, C. The Delphi technique: a comparison of results obtained using two expert panels. International Journal of Nursing Studies 1993; 30: 227–37.CrossRefGoogle ScholarPubMed
31Polit, D, Hungler, B. Nursing Research: Principles and Methods, 6th ed. Philadelphia, PA: Lippincott, 1999.Google Scholar
32Hughes, R. Public health nutrition workforce composition, core functions, competencies and capacity: perspectives of advanced-level practitioners in Australia. Public Health Nutrition 2003; 6: 607–13.CrossRefGoogle ScholarPubMed
33Health Care Alliance. Health Training Package: Population Health Scoping Report – Draft. Sydney: Community Services and Health Training Australia, Inc., 2003.Google Scholar
34Allegrante, J, Moon, R, Auld, E, Gebbie, K. Continuing-education needs of the currently employed public health education workforce. American Journal of Public Health 2001; 91: 1230–4.CrossRefGoogle ScholarPubMed
35American Dietetic Association (ADA). Standards for Professional Practice for Dietetics Professionals. Chicago, IL: ADA, 1997.Google Scholar
36Phillips, S, Ash, A, Tapsell, L. Dietitians' views on the current competency standards for entry-level dietitians. Australian Journal of Nutrition and Dietetics 2000; 57: 190–7.Google Scholar
37Phillips, S, Ash, A, Tapsell, L. Relevance of the competency standards to entry-level dietetic practice. Australian Journal of Nutrition and Dietetics 2000; 57: 198–207.Google Scholar
38Pew Health Professions Commission. Recreating Health Professional Practice for a New Century: Fourth Report of the Pew Health Professions Commission. San Francisco, CA: Pew Health Professions Commission, 1998.Google Scholar
39Olmstead-Schafer, M, Story, M, Haughton, B. Future training needs in public health nutrition: results of a national Delphi survey. Journal of the American Dietetic Association 1996; 96: 282–3.CrossRefGoogle ScholarPubMed
40Hughes, R. The experience of dietitians working on interventions in the takeaway food sector: lessons for workforce development. Australian Journal of Nutrition and Dietetics 2002; 60: 38–41.Google Scholar
41Association of Teachers of Maternal and Child Health (ATMCH). Maternal and Child Health Competencies. Washington, DC: ATMCH, 2001.Google Scholar
42Wright, K, Rowitz, L, Merkle, A, Reid, W, Robinson, G, Herzog, B, Weber, D, et al. Competency development in public health leadership. American Journal of Public Health 2000; 90: 1202–7.Google ScholarPubMed
43Hunt, A, Hilgenkamp, K, Farley, R. Skills and competencies of dietitians practising in wellness settings. Journal of the American Dietetic Association 2000; 100: 1537–9.CrossRefGoogle Scholar
44National Public Health Partnership (NPHP). Public Health Practice in Australia Today – Core Functions. Melbourne: NPHP, 2001.Google Scholar
45Hughes, R, Somerset, S. Definitions and conceptual frameworks for public health and community nutrition: a discussion paper. Australian Journal of Nutrition and Dietetics 1997; 54: 40–5.Google Scholar
46Food and Nutrition Special Interest Group. Strategic Plan of the Food and Nutrition SIG of the Public Health Association of Australia. 2001. Canberra: Public Health Association of Australia, 2001.Google Scholar
47Hughes, R. Work practices of the community and public health nutrition workforce in Australia. Nutrition & Dietetics 2003; in press.Google Scholar
48Haughton, B, Costello, C, Traylor, M, Reeves, K. Public health nutrition practices to prevent low birth weight in eight south-eastern states. Journal of the American Dietetic Association 1992; 92: 187–92.CrossRefGoogle Scholar