1. Nutrition Services in Family Health Networks / Primary Care
Model Sites: A Demonstration Project
The Ontario Ministry of Health and Long term Care’s Primary Health Care Transition
Fund Program has provided funding for a Demonstration Project that will develop and
test an integrated model for nutrition services. The Interdisciplinary Nutrition Services
in Family Health Networks/Primary Care Model Sites project led by Dietitians of Canada
and Principal Investigator Paula Brauer of the University of Guelph will place registered
dietitians in three Family Health Networks in Ontario. An evaluation with patients and
health professional team members will be used to make recommendations for
integrating nutrition services within primary health care settings.
Since nutrition is a major lifestyle factor in health promotion and in the prevention and
management of some common chronic conditions such as diabetes, heart disease and
obesity, it is logical that nutrition services be positioned in the primary health care
setting. Primary Health Care (PHC) is the “first level of contact” to comprehensive
health care. Traditionally the physician has been the first contact and quite possibly the
only contact to health care. Dietitians of Canada (DC) will demonstrate that by
introducing nutrition services in three primary health settings in the province of Ontario
that physicians need not be the only or the first level of contact for health care. Two
year funding (until March 2006) from the Primary Health Care Transition Fund (PHCTF)
has provided DC with this important opportunity to advance interdisciplinary primary
health care reform.
The three primary health care sites chosen for the demonstration project are Family
Health Networks in Kingston, Parry Sound and Stratford, Ontario. Family Health
Networks (FHNs) are a group of physicians who work together to provide primary care
services to their patients 24 hours a day, seven days a week by providing after-hours
telephone advisory service along with regular office hours. The networks emphasize
illness prevention as well as comprehensive care.
Comprehensive nutrition services are logically placed in the primary health care (PHC)
setting where initial identification, accessible intervention and long-term relationships
can be established between the client and provider. Such comprehensive services
would include a range of health promotion and treatment services. Health promotion
activities might include simple interventions such as promoting a healthy lifestyle to
specialized services aimed at preventing diabetes, low birth weight or failure to thrive
among children or the elderly. Treatment services might range from advice to avoid
high doses of a particular vitamin supplement to complex interventions for management
Dietitians of Canada 13/10/2004
2. of chronic conditions, especially various combinations of dyslipidemia, glucose
intolerance, and hypertension.
In this project, DC along with Principal Investigator Paula Brauer of the University of
Guelph and the team of dietitians working at each site, will develop and test an
integrated model for nutrition services. Selected aspects of PHC and nutrition service
quality and effectiveness will be evaluated.
Key deliverables of the project:
Completion of a systematic literature search on interdisciplinary nutrition service
Baseline telephone survey of advice from providers in current PHC settings
Production of comprehensive guidance materials including a template for
interdisciplinary practice for use by:
• Provincial decision makers on the administrative costs of the model
• Local decision makers planning for nutrition services in their own PHC site
• Dietitians and others offering nutrition services in PHC sites
Before and after reported client satisfaction with PHC services
Evaluation of dietitian counselling services
Costing of nutrition services
Wide dissemination of the reviews and evaluation results through multiple
strategies - web sites, workshops, peer reviewed publications
For questions about the project please contact Bridget Davidson RD (Project
Coordinator) at bdavidson@golden.net or any of the Dietitians working in the FHNs:
Theresa Schneider for the Kingston FHN (plan@nutritionassessment.com), Eva West for
the Parry Sound FHN (Muskoka.Nutrition@sympatico.ca) or Deb Northmore for the
Stratford FHN (northmore@golden.net).
Dietitians of Canada 13/10/2004