Key enablers | Examples of quotes from primary care providers |
Chronic disease diagnosis | “Sadly, when people have a chronic illness, it is much easier to talk about nutrition. I find the blood pressure helps, if there is an increase; I talk about weight, diet, and exercise.” CHC, NP – participant 20 |
Patients showing interest | “I would say a lot of times patients actually bring up the topic if I am talking to them about their cholesterol, they will ask what they can do that is not medication. If I am talking about diabetes or cholesterol, I let them know about the non-medical management, which is obviously the preferred route because there are no side effects as opposed to medications that have side effects.” CHC, FP– participant 17 |
Dietitian on site | “If somebody is coming in and they are here for a prescription renewal, it’s hard to focus time but because I do have the option to refer them to the dietitian, it’s a huge help.” NPLC, NP – participant 1 |
Out of normal range blood test markers | “If cholesterol is elevated, glucose is elevated, fatty liver based on lab results, regardless of the age of the person. If none of these issues are there, it is possible that I would not bring it up.” NPLC, FP – participant 9 |
Having access to handouts | “I like handouts because sometimes I know they are not necessarily listening and taking in the information as I am giving them. Let’s say their blood pressure is out of whack and they don’t want to come back to see the dietitian, I will print out the handout.” NPLC, NP – participant 1 |
Trusting relationship with the patient | “A trusting relationship between the health professional and the patient is number one.” CHC, NP – participant 19 |
The whole family has obesity | “When more than one family member has obesity, it is easier to bring up the topic of nutrition.” FHT, NP – participant 12 |
Key barriers | Examples of quotes from primary care providers |
Lack of time | “Time consuming and we only have 15-min appointments so sometimes there is no time.” FHT, NP - participant 14 |
Patients not open to discussing it | “There are many clients who don’t want to hear about it. They’re unstably housed, they’re in abusive relationships, they have a lot of priorities and talking about nutrition and weight management is not among them.” CHC, NP – participant 18 |
Lack of rapport with the client | “Sometimes it’s the rapport. Some patients don’t care to interact.” NPLC, NP – participant 1 |
Competing demands | “They just have so many complex issues, mostly psychosocial issues that are predominant in their daily lives that nutrition is not something I can bring up.” CHC, NP – participant 19 |
Patient perceiving they already know what they need to change | “Some patients will say: yeah yeah, I’ve been told all this before, I know what to do, I just need to do it.” NPLC, NP – Participant 3 |
Low comfort level of provider to address nutrition | “Some providers may not be as comfortable because they think it is a sensitive topic but really if you just open a dialogue about it often times it will be OK to talk about it (nutrition).” NPLC, NP – Participant 2 |
Patients not understanding the implications of excess body weight | “I think that some patients may not understand some of the health consequences that could occur due to excess weight and unhealthy lifestyle behaviours” NPLC, NP – Participant 7 |