TY - JOUR
AU - A. Barkmeijer
AU - J. Lamerichs
AU - L. V. Burgsteden
AU - H. T. Molder
AU - H. Jager-Wittenaar
A1 - 
AB - INTRODUCTION: Patient-centered counseling approaches tend to emphasize what practitioners are expected to do, providing limited guidance on how to respond to client contributions in real-time interactions. This study aimed to explore the value of a dietitian-client interaction (DCI) training program to enhance dietitians' awareness of client uptake, that is, how clients respond to dietitians' conversational contributions. METHODS: A mixed-methods pilot study was conducted in two phases. First, a DCI training program was developed for primary care dietitians treating clients with (risk of) malnutrition, based on analyses of video-recorded consultations. Next, the training was delivered and evaluated through: (a) determining changes in dietitians' awareness of client uptake using a pre-post 5-point Likert scale questionnaire and focus groups, and (b) dietitians' views on the training program's relevance, explored through focus groups. Changes in awareness scores were analyzed using descriptive analyses, while inductive thematic analysis examined themes regarding attention to client uptake. Quantitative and qualitative findings were integrated to assess convergence, divergence or complementarity. Deductive analysis with a priori codes (acceptability, appropriateness, and feasibility) explored dietitians' perspectives on the training's implementation potential. RESULTS: At T0, median item scores ranged between 4 (somewhat aware) for 8/10 items and 5 (aware) for 2/10 items. At T1, 2/10 items scored 4 and 8/10 items scored 5. Focus group analysis identified three key themes: (1) The role of precise wording: it is the exact phrasing, not only the content or intent, that shapes client responses; (2) Evidence-oriented listening: listening is considered successful when client responses indicate they feel heard; and (3) Moving beyond a biomedical perspective: addressing the social and emotional aspects of the client's dietary problem feels outside the dietitians' professional identity and requires flexibility. Integrated results indicate the training fostered deeper, instead of surface-level, awareness of uptake, demonstrating complementarity between quantitative and qualitative findings. Dietitians described the training as meaningful, highly appropriate, and easily accessible. CONCLUSIONS: The novel DCI training program deepens understanding of what an uptake-oriented approach and effective listening entails. Despite already high pre-training awareness, it shows promise in increasing dietitians' awareness of client uptake, potentially enhancing their responsiveness to client needs and improving the dietary treatment of (risk of) malnutrition.
AD - Faculty of Humanities: Language, Literature, and Communication, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.; Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, the Netherlands.; School of Health Care Studies, Nutrition and Dietetics Programme, Hanze University of Applied Sciences, Groningen, the Netherlands.; Research Group Mental Health Care and Society, Windesheim University of Applied Sciences, Zwolle, the Netherlands.; Department of Gastroenterology and Hepatology, Dietetics, Radboud university medical center, Nijmegen, the Netherlands.; Department of Physiotherapy and Human Anatomy, Research Unit Experimental Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium.
AN - 42200682
BT - J Hum Nutr Diet
C5 - Education & Workforce
CP - 3
DA - 06/2026
DO - 10.1111/jhn.70283
DP - NLM
IS - 3
JF - J Hum Nutr Diet
LA - eng
N2 - INTRODUCTION: Patient-centered counseling approaches tend to emphasize what practitioners are expected to do, providing limited guidance on how to respond to client contributions in real-time interactions. This study aimed to explore the value of a dietitian-client interaction (DCI) training program to enhance dietitians' awareness of client uptake, that is, how clients respond to dietitians' conversational contributions. METHODS: A mixed-methods pilot study was conducted in two phases. First, a DCI training program was developed for primary care dietitians treating clients with (risk of) malnutrition, based on analyses of video-recorded consultations. Next, the training was delivered and evaluated through: (a) determining changes in dietitians' awareness of client uptake using a pre-post 5-point Likert scale questionnaire and focus groups, and (b) dietitians' views on the training program's relevance, explored through focus groups. Changes in awareness scores were analyzed using descriptive analyses, while inductive thematic analysis examined themes regarding attention to client uptake. Quantitative and qualitative findings were integrated to assess convergence, divergence or complementarity. Deductive analysis with a priori codes (acceptability, appropriateness, and feasibility) explored dietitians' perspectives on the training's implementation potential. RESULTS: At T0, median item scores ranged between 4 (somewhat aware) for 8/10 items and 5 (aware) for 2/10 items. At T1, 2/10 items scored 4 and 8/10 items scored 5. Focus group analysis identified three key themes: (1) The role of precise wording: it is the exact phrasing, not only the content or intent, that shapes client responses; (2) Evidence-oriented listening: listening is considered successful when client responses indicate they feel heard; and (3) Moving beyond a biomedical perspective: addressing the social and emotional aspects of the client's dietary problem feels outside the dietitians' professional identity and requires flexibility. Integrated results indicate the training fostered deeper, instead of surface-level, awareness of uptake, demonstrating complementarity between quantitative and qualitative findings. Dietitians described the training as meaningful, highly appropriate, and easily accessible. CONCLUSIONS: The novel DCI training program deepens understanding of what an uptake-oriented approach and effective listening entails. Despite already high pre-training awareness, it shows promise in increasing dietitians' awareness of client uptake, potentially enhancing their responsiveness to client needs and improving the dietary treatment of (risk of) malnutrition.
PY - 2026
SN - 0952-3871
SP - e70283
ST - Supporting Responsive Practice: Training Dietitians to Meet Clients' Interactional Needs
T1 - Supporting Responsive Practice: Training Dietitians to Meet Clients' Interactional Needs
T2 - J Hum Nutr Diet
TI - Supporting Responsive Practice: Training Dietitians to Meet Clients' Interactional Needs
U1 - Education & Workforce
U3 - 10.1111/jhn.70283
VL - 39
VO - 0952-3871
Y1 - 2026
ER -