Professional knowledge and expertise

Identifying the barriers and developing an integrated programme of complementary activities will require the input of people with a range of skills.

While most areas have access to a community dietitian, it is quite common for clinical duties to restrict the provision of their time in the community. In planning the resources needed to implement the strategy, it may be worth considering ring fencing a block of dietitian time to devote to community work. Public health nutritionists can provide the expertise to develop and implement a public health nutrition strategy and to work on other nutrition issues at a population level.

The Nutrition Society has in recent years introduced a registration system for Public Health Nutritionists (RPH Nutr). In addition, the Nutrition Society has also developed an associate registration scheme for newly qualified public health nutrition professionals who have not yet accumulated the three years’ experience required for full registration as a Public Health Nutritionist. Check the Register of Public Health Nutritionists or contact Jackie Landman at the Nutrition Society (020 7602 0228) for further information on the associate scheme.

A wide range of professionals from both the health sector and local government can contribute towards the development of a strategy to promote healthy eating and to delivering this through local strategic partnerships. These might include: health promotion specialists; public health specialists; representatives from primary care trusts; community development workers; local authority housing; regeneration and sustainable development officers; employment advisers; representatives from the voluntary sector and from business and commerce.

Local people are an important addition to the skill base. Research suggests that efficiency and effectiveness of community based interventions can be improved by using local people to complement the work of health professionals. McGlone et al. (1999) suggest that ‘if local food projects are to work, then they must genuinely involve local people’. Services provided by local people are often considered more appropriate and more accessible to the health needs of the community. Such services foster self-reliance, community participation and can help overcome barriers. They also allow access to typically hard to reach groups and can be particularly beneficial for black and minority ethnic groups.

These benefits are also two-way, as local people have the opportunity to develop their own skills. Exploratory work with this peer education approach (Hodgson et al., 1995; Kennedy et al., 1999) showed that it was possible to achieve both significant increases in nutrition knowledge and the potential for beneficial changes in the dietary practices of low income families. One successful approach appears to be one in which guided ‘hands on’ food preparation/cooking sessions allow the participants to acquire knowledge and skills. However, it was noted that this approach was resource intensive, particularly in professional staff time, and there is little evidence of effectiveness in terms of dietary change. This approach may result in potential health, social and economic benefits and therefore warrants further study.

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