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Periods of rapid growth are periods of special vulnerability to nutritional injury. Growth during pregnancy and in the first two years of life is more rapid than at any other stage in the life cycle and hence, optimum nutrition is vital at this time. Physicians are frequently the primary professionals concerned with the dissemination of nutrition advice to pregnant women and mothers of new infants. However, there are no studies in the literature that assess the quality of nutrition information provided by physicians in this important area of maternal and infant nutrition. A study was designed to investigate the nutrition attitudes and practices of general practitioners, pediatricians and obstetricians in the province of British Columbia. The influence of selected variates upon the criterion variables, nutrition attitudes and practices, was assessed. Variates studied included demographic and professional data on country of medical training, sex of respondent, location and type of practice, years of practice, number of patients seen weekly, sources of nutrition information consulted, attendance at continuing education programs, additional training for specialization, and inclusion of nutrition in medical school education. The nature of the relationship between nutrition attitudes and practices was also assessed. In March 1975, questionnaires were mailed to all 1981 practising general practitioners, pediatricians and obstetricians in the province of British Columbia. Questionnaires were returned by 724 ( 41.3% ) general practitioners, 69 ( 62.7% ) pediatricians and 51 ( 43.2% ) obstetricians. Responses from completed questionnaires were analyzed by computer; all tests were conducted at the 5% level of significance. Results were reported at the highest level of significance. Mean scores for nutrition attitudes for general practitioners, pediatricians and obstetricians were 72%, 81% and 64% respectively. Nutrition practices' scores were 60%, 66% and 65% for general practitioners, pediatricians and obstetricians respectively. Regression analysis indicated that nutrition attitude and practice scores of general practitioners were significantly higher for physicians who: (a) were female (b) consulted with a nutritionist-dietitian (c) had additional training (d) attended continuing education programs and (e) had nutrition in their medical school education. General practitioners who were in practice more than 10 years scored significantly lower on the attitude and practice tests. Nutrition practice scores were significantly higher for pediatricians trained in Canada while nutrition attitude scores were higher for pediatricians who were in practice more than five but fewer than 10 years. Obstetricians' attitude scores were significantly lower for physicians who were in practice more than 10 years. Obstetricians who consulted with non-human sources of nutrition information other than professional journals and human sources of information other than nutritionist-dietitians scored significantly higher on the nutrition practice test. Correlation analysis showed that nutrition attitudes were significantly correlated to nutrition practices for general practitioners ( r = 0.370 ), pediatricians ( r = 0.259 ) and obstetricians ( r = 0.424 ). Student t-test analysis indicated that pediatricians' and obstetricians' practice test scores were significantly higher than those of general practitioners. There were no significant differences among the nutrition attitude scores for the three groups. Implications for nutrition educators included the need for nutrition in the medical school curriculum, the incorporation of nutrition into continuing education programs and the need for nutritionists to act as consultants to physicians. / Education, Faculty of / Curriculum and Pedagogy (EDCP), Department of / Graduate

Background: During a woman's pregnant state, a diet that is adequate in nutrition is critical to the developing fetus, especially in the lower socioeconomic status population. The healthcare provider is charged with the acute fundamental awareness of this additional factor that can grossly impact pregnancy. Nutritional advice from the health care provider is one of many key points that contribute to the successful outcome of the pregnancy. Purpose: The purpose of this quality improvement project was to develop a standardized, evidence-based practice (EBP) protocol for the management of maternal nutrition, gestational weight gain, and physical activity for provider use at an LSE community clinic. Theoretical Framework: Theory of Planned Behavior Methods: After receiving institutional support for the implementation of the protocol presentation and instruction of the Maternal Nutrition Guideline, pre- and post-surveys were administered to eligible participants. A quantitative descriptive design was used for the project. Results: There were twenty-six respondents for both the pre-and post-survey. The data analysis revealed that two questions revealed the most significant increase between the pre-and post-survey occasions utilizing the Mann-Whitney test and related to physical activity during pregnancy and dietary intake. An independent sample t-test was performed to compare the two occasions. There was a tendency for an increase in the the total score between the pre-and post-surveys, but the difference did not reach statistical significance, which may be related to sample size (t24df = 1.782, p =0.087). Conclusion: A standardized, evidence-based nutritional guideline is a necessary tool to serve as a consistent resource and empower all health care providers to bring awareness and understanding to facilitate positive outcomes to the obstetric patient population for which they care.