Factors Influencing the Counseling Behavior of Clinical Dietitians

A survey of clinical dietitians in accredited clinical and generalist dietetic internships was conducted to construct a socio-demographic profile and to investigate influences on the counseling behavior of clinical dietitians. The Ajzen and Fishbein (1980) model was used to identify relationships between external variables, preparedness to use, attitude and subjective norm toward use, intention to use, and behavior toward use of counseling strategies. External variables included demographic characteristics, situational characteristics, and attitude toward targets. The five categories of counseling strategies were: assessment, educational, motivational, behavioral, and evaluation.

Respondents felt most capable using counseling skills requiring active interaction and least capable using skills of a facilitating nature. They felt most prepared using assessment and educational strategies and least prepared using behavioral strategies. Motivational strategies were rated most likely to promote patient compliance and most desirable to use. Evaluation strategies were rated least likely to promote patient compliance. Assessment strategies had the highest peer pressure to use, highest intention to use, and were used most in counseling patients. Behavioral strategies were the least desirable to use, had the lowest peer pressure to use, had lower intention to use, and were used least in counseling patients.

A socio-demographic profile was constructed using significant correlations (p < .05) between the external variables. Influences affecting counseling behavior were identified using regress ion analysis. The strongest determinant of counseling behavior was intention to use counseling strategies. Attitude toward use of counseling strategies influenced intention more than did subjective norm. Preparedness had a stronger influence on attitude than subjective norm, and has as much influence on intention as subjective norm. The external variables had a weak and mixed pattern (positive and negative) of influence on preparedness and an indirect influence on attitude, subjective norm, intention, and behavior, but did not influence the stability of the attitude-behavior relationship.

In conclusion, basic dietetic training programs should incorporate more behavioral and motivational theory and emphasize more patient interaction skills.