Identification of Multicultural Nutrition Counseling Competencies for Registered Dietitians

Objective: Research was conducted to develop a model and identify multicultural nutrition counseling competencies for Registered Dietitians

Design: A mail survey was administered followed by a post card reminder and a follow-up survey to non-respondents. The survey consisted of 46 competency items that subjects rated on a Likert scale of 1 to 7 (1=Unessential to 7 -Essential).

Subjects: A stratified random sample was taken from 1300 members of the American Dietetic Association's Public Health Nutrition Practice Group and directors of the Didactic Programs in Dietetics (DPD) and Dietetic Internship (DI) Programs. A total of 604 subjects were selected and mailed surveys. Surveys completed by Registered Dietitians who were members of the practice group or directors of a DPD or DI program were used for data analysis.

Statistical Analysis: Descriptive statistics were used to calculate frequency of response. Exploratory principal component analysis was used to analyze the dimensionality of the multicultural nutrition counseling competencies. MANOVA was used to determine if dimensions extracted differed among respondents who provided nutrition counseling or education to culturally different clients and those who did not.

Results: Of the 604 subjects surveyed, 60% responded (n=363) and of the respondents, 94.4% (n=343) met the selection criteria. Most respondents were Caucasian (86%), spoke English as their primary language (97%), and had Master's degrees (82%). Many (38.2%) worked in a community/public health facility or organization and 50% provided nutrition counseling or education to culturally different clients. Three dimensions were extracted with 28 competencies loading on them: Multicultural Nutrition Counseling Skills, Multicultural Awareness, and Multicultural Food and Nutrition Knowledge. Subjects responded similarly for the extracted dimensions regardless of whether or not they provided nutrition counseling to culturally different clients.

Application: It is imperative for Registered Dietitians who work with various cultural groups to be multi-culturally competent, given the changing and dynamic nature of our society. The resulting multicultural nutrition counseling model is a guideline, which can be applied to many aspects of the dietetic profession. The American Dietetic Association's Diversity Committee should review the model to determine how the competencies fit into the committee's objectives. Directors of Didactic Programs in Dietetics and Dietetic Internship Programs may want to focus on some of the competencies to enhance dietetic education and training. Public health nutritionists may use them as a basis for selecting continuing education opportunities to enhance their multicultural nutrition counseling competence. Additional research is recommended to further develop and define multicultural nutrition counseling competencies for Registered Dietitians.