Call for Standardized Language and Training for Evidence-Based Practice (EBP).

LETTERS TO THE EDITOR ARE WELCOMELetters to the Editor may be submitted at https://ees.elsevier.com/andjrnl for consideration regarding manuscripts published within the past 6 months. Letters should be no more than 500 words, can contain up to 20 references, and should include a funding disclosure, conflict of interest disclosure, and copyright/authorship form. All letters will be subjected to editorial review and decision before acceptance. Letters to the Editor may be submitted at https://ees.elsevier.com/andjrnl for consideration regarding manuscripts published within the past 6 months. Letters should be no more than 500 words, can contain up to 20 references, and should include a funding disclosure, conflict of interest disclosure, and copyright/authorship form. All letters will be subjected to editorial review and decision before acceptance. Although we appreciate the need for strategies to appraise and apply evidence-based practice (EBP) in nutrition settings, we identified gaps in Watowicz and Hand’s article1Watowicz R.P. Hand R.K. Call for standardized language and training to bridge the appraise/apply gap in evidence-based dietetics practice.J Acad Nutr Diet. 2023; 123: 1126Abstract Full Text Full Text PDF Scopus (0) Google Scholar that warrant consideration. First, using “client” to encompass “individuals, groups, populations, supportive individuals, and communities” is problematic. Communication strategies and channels used when working with individuals do not always reflect community and population needs. To implement EBP in public health settings, prioritizing the communication strategies that resonate with larger audiences and the dissemination strategies that will be most meaningful beyond underscoring the strength and magnitude of the evidence are essential. Rather than encouraging uniform terminology, using language that genuinely connects with clients and communities by considering health literacy, cultural appropriateness, and behavior change theory may be more effective in facilitating education and behavior change.2Longnecker N. Good science communication considers the audience.in: Rowland S. Kuchel L. Teaching Science Students to Communicate: A Practical Guide. Springer International Publishing, 2023: 21-30Crossref Scopus (1) Google Scholar, 3Schiro J.L. Shan L.C. Tatlow-Golden M. Li C. Wall P. #Healthy: Smart digital food safety and nutrition communication strategies—A critical commentary.Npj Sci Food. 2020; 4: 14Crossref Scopus (8) Google Scholar, 4Rigby R.R. Mitchell L.J. Hamilton K. Williams L.T. The use of behavior change theories in dietetics practice in primary health care: A systematic review of randomized controlled trials.J Acad Nutr Diet. 2020; 120: 1172-1197Abstract Full Text Full Text PDF PubMed Scopus (31) Google Scholar We also would like to highlight that solutions to challenges raised by the authors already exist. For example, patient- and family-centered nutrition care training encourages collaborative decision-making and presents a model that aligns well with EBP principles.5What is PFCC?.https://www.ipfcc.org/about/pfcc.htmlDate accessed: September 5, 2023Google Scholar In addition, dissemination and implementation science terminology,6Bauer M.S. Damschroder L. Hagedorn H. Smith J. Kilbourne A.M. An introduction to implementation science for the non-specialist.BMC Psychol. 2015; 3: 32Crossref PubMed Google Scholar frameworks,7Dissemination implementation: An interactive webtool to help you use D&I models.https://dissemination-implementation.org/Date accessed: September 5, 2023Google Scholar and compilations8Powell B.J. Waltz T.J. Chinman M.J. et al.A refined compilation of implementation strategies: Results from the Expert Recommendations for Implementing Change (ERIC) project.Implement Sci. 2015; 10: 21Crossref PubMed Scopus (1898) Google Scholar, 9Balis L.E. Houghtaling B. Harden S.M. Using implementation strategies in community settings: an introduction to the Expert Recommendations for Implementing Change (ERIC) compilation and future directions.Transl Behav Med. 2022; 12: 965-978Crossref Scopus (8) Google Scholar, 10Implementing Evidence from Guidelines to Daily Practice.https://www.eatrightpro.org/practice/research/tools-and-initiatives/implementing-evidence-from-guidelines-to-daily-practiceDate accessed: September 5, 2023Google Scholar offer tools for practitioners. These tools can be used to identify needed support regarding the use of a new EBP and to inform the design of implementation strategies to improve EBP dissemination and implementation among diverse audiences. There have been prior calls to action in this regard for nutrition practitioners.11Murofushi K. Badaracco C. County C. et al.Implementation science in evidence-based nutrition practice: Considerations for the registered dietitian nutritionist.J Acad Nutr Diet. 2021; 121: 1392-1400Abstract Full Text Full Text PDF PubMed Scopus (10) Google Scholar,12Warren A.M. Frongillo E.A. Rawat R. Building implementation science in nutrition.Adv Nutr. 2020; 11: 1392-1398Abstract Full Text Full Text PDF PubMed Scopus (12) Google Scholar Furthermore, nutrition practitioners’ limited time for patient interactions in clinical settings can be potential roadblocks to the effective application of EBP. Addressing these challenges might involve finding innovative ways to streamline the process of appraising and applying evidence while acknowledging the need for support and resources. Instruments such as the Pathway to Practice Resource Center13CDC. Pathway to Practice (P2P) Resource Center. Centers for Disease Control and Prevention, 2018https://nccd.cdc.gov/PRCResearchProjects/Search/Search.aspxDate accessed: September 5, 2023Google Scholar and the Evidence Analysis Library14Academy of Nutrition and Dietetics’ Evidence Analysis Library.https://www.andeal.org/default.cfmDate accessed: September 5, 2023Google Scholar encourage the wider adoption and application of EBP within various settings; these instruments provide practitioners with resources to identify and implement essential components of successful public health programs and nutrition recommendations. Understanding the implementation strategies to assist in EBP application within limited resource contexts is another path forward.8Powell B.J. Waltz T.J. Chinman M.J. et al.A refined compilation of implementation strategies: Results from the Expert Recommendations for Implementing Change (ERIC) project.Implement Sci. 2015; 10: 21Crossref PubMed Scopus (1898) Google Scholar,9Balis L.E. Houghtaling B. Harden S.M. Using implementation strategies in community settings: an introduction to the Expert Recommendations for Implementing Change (ERIC) compilation and future directions.Transl Behav Med. 2022; 12: 965-978Crossref Scopus (8) Google Scholar We also must critically consider the role of education in refining practitioners’ evidence-appraising skills. Dietetics graduate programs have historically played a pivotal role in nurturing research and critical thinking skills, but there is a growing trend toward capstone projects rather than traditional theses. This trend is attributable in part to the numerous Accreditation Council for Education in Nutrition and Dietetics–required competencies that must be taught and assessed in accredited graduate programs, most of which are not related to research.152022 Standards and Templates.https://www.eatrightpro.org/acend/accreditation-standards-fees-and-policies/2022-standards-and-templatesDate accessed: September 5, 2023Google Scholar,16Future education model accreditation standards for graduate degree programs (GP).https://www.eatrightpro.org/acend/accreditation-standards-fees-and-policies/future-education-model-standards-and-templatesDate accessed: September 5, 2023Google Scholar In fact, only one required domain or unit is related to research or critical thinking for Accreditation Council for Education in Nutrition and Dietetics–accredited programs.152022 Standards and Templates.https://www.eatrightpro.org/acend/accreditation-standards-fees-and-policies/2022-standards-and-templatesDate accessed: September 5, 2023Google Scholar,16Future education model accreditation standards for graduate degree programs (GP).https://www.eatrightpro.org/acend/accreditation-standards-fees-and-policies/future-education-model-standards-and-templatesDate accessed: September 5, 2023Google Scholar The potential gaps in research experience during these programs could impact graduates’ ability to appraise evidence critically. Given this, building proficiency to develop and maintain research-to-practice partnerships may be more practical than recommending more complex research methods, such as rapid reviewing.1Watowicz R.P. Hand R.K. Call for standardized language and training to bridge the appraise/apply gap in evidence-based dietetics practice.J Acad Nutr Diet. 2023; 123: 1126Abstract Full Text Full Text PDF Scopus (0) Google Scholar Although rapid reviews are less time-intensive compared with systematic reviews, they arguably require even more skill and topic-specific knowledge.17Tricco A.C. Langlois E.V. Straus S.E. Research A. for HP and S, Organization WHRapid Reviews to Strengthen Health Policy and Systems: A Practical Guide. World Health Organization, 2017https://apps.who.int/iris/handle/10665/258698Date accessed: September 5, 2023Google Scholar