Search

Aim: This study aimed to identify how dietitians and other healthcare providers work to build trust in food systems in the course of providing dietary education. Methods: Qualitative semi‐structured interviews were conducted with 15 purposefully sampled dietitians (n = 5), general practitioners (n = 5), and complementary and alternative medicine practitioners (n = 5) within metropolitan South Australia. Interview data were then interpreted using an inductive thematic analysis approach, involving the construction of themes representing trust‐enhancing roles around which beliefs about professional roles, the 'patient', and food and health were clustered. Results: Healthcare providers communicate beliefs regarding (dis)trust in food systems through: (i) responding to patient queries and concerns following a food incident or scare; (ii) helping patients to identify (un)trustworthy elements of food supply systems; and (iii) encouraging consumption of locally produced and minimally processed food. Importantly, the expression of these roles differed according to participant beliefs about food and health (medico‐scientific versus alternative medicine) and their adoption of professional projects that sought to promote medico‐scientific ways of thinking about health and diet or manage the failures of Western medicine. Conclusion: The development and consolidation of trust‐enhancing roles amongst healthcare providers likely requires disciplinary reflection on professional values and the processes by which practitioners apply these values to understanding food systems. [ABSTRACT FROM AUTHOR]

Introduction: This study sought to identify how diabetes organisations conceptualize the problem of diabetes‐related stigma and how this shapes the selection of stigma‐reduction interventions. Methods: A qualitative deliberative democratic methodology was used to access an informed dialogue about what should be done by diabetes organisations to address diabetes‐related stigma, drawing from the perspectives of board members, healthcare services staff, and communications and marketing staff from a single state‐wide diabetes organisation in Australia (n = 25). Results: Participants navigated the stigma concept along two axes: one that drew attention to either disease attributes or personal moral attributes as the object of stigmatisation, and one that positioned stigma as an individual or structural problem. This shaped the selection of stigma‐reduction interventions, which included interventions to: (i) reduce the prevalence of stigmatized attributes, (ii) correct misunderstandings about diabetes, (iii) modify representations of persons with diabetes, (iii) enhance coping amongst persons with diabetes and (iv) make healthcare more person‐centred and democratic. Conclusion: This study identified several grievances with 'diabetes‐related stigma', which are grievances that can be conceptualized and addressed at both individual and structural levels, and involve correcting misinformation about diabetes or challenging and communicating alternative representations of persons living with diabetes. Patient or Public Contribution: The organisation's management and board were consulted throughout all stages of research development, analysis and reporting. The information and vignettes presented to participants drew from illness narratives obtained from earlier research involving adults with type 2 diabetes. Research participants included adults with various diabetes types. [ABSTRACT FROM AUTHOR]

Although recent research has highlighted the importance of understanding the structural social processes through which stigma is produced and maintained, educational approaches to stigma-reduction have not yet engaged with this concept. Recognising that critical pedagogies have been used in other contexts to help learners better understand and challenge structural social processes of marginalisation, we conducted a review of educational interventions that were informed by critical pedagogies and delivered within settings of health and social care. A systematic search was performed on academic and grey literature databases between January 1970 and 17 May 2017 to identify all literature reporting on the learning outcomes of educational interventions informed by frameworks of critical consciousness development. Articles were selected following a two-stage screening process and an assessment of methodological quality. Of the 9,674 articles identified from the systematic search, 33 were found to satisfy the inclusion criteria and were of sufficient quality to be considered within this review. Two major findings emerged from the analysis of interventional studies. Firstly, it was found that learners consistently articulated a sociostructural understanding of oppressive social relations and their position within it, based upon an understanding of their own group identity. Secondly, and despite the sociostructural content of reflection, individual actions tended to focus on the modification of interpersonal interactions. Although educational interventions informed by a critical pedagogy appear to support a structural analysis of social marginalisation or disadvantage, there is limited evidence to suggest how these structural processes might be challenged following this analysis. [ABSTRACT FROM AUTHOR]