Food Literacy Education During Nutrition Counseling for Patients With Diabetes: In-Depth Interviews With Registered Dietitians/Registered Dietitians Nutritionists

OBJECTIVES: To explore how food literacy is educated to patients with diabetes and related challenges encountered by the Registered Dietitians (RDs)/Registered Dietitian Nutritionists (RDNs) during nutrition counseling. METHODS: A qualitative research approach was used to explore the perceptions of 15 RDs/RDNs who have worked or are currently working with patients with diabetes. Participants were recruited through connection or snowball sampling. They completed a brief demographics survey and then an online in-depth interview. The interview questions were created based on the food literacy framework by Vidgen and Gallegos which addresses food-related knowledge, skills, and behaviors associated with four domains including planning and managing, selecting, preparing, and eating food to meet individual needs to help determine adequate intakes. Descriptive statistics was used to summarize the demographics of participants using SPSS. The audio-recordings from the in-depth interviews were transcribed verbatim and a content analysis of the transcripts was conducted to identify themes using NVivo. Data reached a point of saturation during the interviews. RESULTS: Even though all domains were educated on, planning and managing was the most taught domain of food literacy, focusing on meal planning and carbohydrate counting. Selecting, preparing, and eating domains of food literacy were less frequently discussed. Lack of educational materials considering different cultures and languages were identified as one of major challenges in educating food literacy. RDs/RDNs identified multiple challenges that their patients face when trying to control their diabetes including limited budget, previously developed eating behaviors and unwillingness to change. They also mentioned that the COVID-19 pandemic potentially led to patients with diabetes having poorer diabetes self-management and greater HbA1c levels. CONCLUSIONS: The findings suggested that RDs/RDNs provided education on food literacy during nutrition counseling for patients with diabetes; however, not all four domains of food literacy were evenly educated. In the future, creating culturally sensitive and relevant educational materials can promote education on food literacy and diabetes self-management during nutrition counseling. FUNDING SOURCES: None.