Dietitians and Community Mental Health: Setting the Research Agenda
Although nutrition and mental health is becoming an area of increasing investigative interest, no specific research agendas to help guide research, policy, and practice currently exist. Based on evidence that mixed approaches that engage diverse stakeholders with an experiential understanding of the nutrition and mental health system generate meaningful action plans, an integrated, citizen-engaged research agenda-setting project, Dietitians and Community Mental Health: Setting the Research Agenda, was conducted from 2013 to 2014. This national initiative was a collaborative effort of Dietitians of Canada (DC), Canadian Mental Health Association Ontario, and the University of British Columbia, with funding from the Canadian Institutes of Health Research (CIHR). The consultation process engaged researchers, policymakers, service providers, persons with lived experience of mental illness and/or family members of persons living with mental health conditions. The end result was the formulation of a Canadian nutrition and mental health research agenda ultimately aimed at the optimization of nutrition and mental health services in community settings.
Methods in Developing the Research Agenda
The national nutrition and mental health research agenda-setting project was a mixed methods, participatory initiative that involved five steps:
- a scoping review to contextualize current nutrition and mental health knowledge
- a national online stakeholder survey to prioritize research topics (n=811)
- key informant consultations to define prioritizing criteria (n=79)
- a national workshop involving representatives from research, policy, and practice to further define priorities
- synthesis of findings – triangulation of textual, descriptive and inferential data to formulate the final research
Summary of Research Priorities
Based on the integrated analysis of this national multi-step initiative, four nutrition and mental health research priorities were identified:
1. Nutrition and Mental Health Programs and Services
- Research Priority: Identify nutrition program/service needs, gaps and barriers for people living with mental health conditions with respect to healthy diet, food access and skills development.
- Research Use: Identify and implement effective models of care to address nutrition and mental health needs in community settings.
2. Service Provider Roles in the Provision of Nutrition Care
- Research Priority: Explore and define roles and responsibilities of mental health service providers, including dietitians, in the effective provision of nutrition care to individuals living with mental health conditions in the community.
- Research Use: Enhance collaboration and cross-training among service providers, and improve access to nutrition care at the most effective points of intervention.
3. Informing Policy through Determinants of Health
- Research Priority: Investigate the impact of social determinants (housing, income, education, employment, etc.) on diet, food security and mental health.
- Research Use: Advocate for and establish effective systems-level policies to benefit people living with mental health conditions.
4. Knowledge Translation and Exchange
- Research Priority: Explore and evaluate methods of knowledge translation and exchange to effectively mobilize evidence from nutrition and community mental health research.
- Research Use: Improve dissemination and uptake of new and existing knowledge to strengthen the impact of community services, inform policy and program decision-makers, and increase food literacy in the target population.
Moving the Research Agenda Forward
Given the evidence that optimal nutrition supports the mental health of Canadians and the national research priorities identified from the Dietitians and Community Mental Health: Setting the Research Agenda project, a foundation has been established that will help direct multiple stakeholders in formulating studies, policies, and knowledge translation initiatives aimed at the optimization of population nutrition and mental health.
Since the completion of the CIHR-funded consultation, project team members have done preliminary work in presenting the findings at various conferences and in scientific publications. However, more targeted work is required to fully disseminate the results and effectively engage investigators and knowledge users to act on the findings in research, practice, and policy-making. Specifically, a targeted knowledge mobilization plan is needed to develop and disseminate tailored knowledge products and tools that are related to the four research priorities and that reach diverse audiences including researchers, policymakers, practitioners, funding agencies, administrators, non-profit organizations, private industry, and people with lived experience of mental illness.
Identifying and prioritizing research topics in consultation with a broad spectrum of stakeholders has been a critical element in defining nutrition and mental health investigative targets, particularly in the context of increased competition for funds. Since the best predictor of research uptake is early and continued involvement of relevant stakeholders, a sustained and deliberate effort must now be made to engage stakeholders in meaningful dialogue about the research priorities and initiate investigations that represent a true collaboration between researchers and knowledge users. Actively engaging stakeholders from research, policy, practice, and those with experiential understanding will require focused and proactive facilitation. The investment in a process that mediates and directs diverse stakeholders to engage in identified national research priorities will ultimately lead to the optimization of nutrition and mental health-related outcomes
Presentation to Canadian Collaborative Mental Health Care Conference (Toronto, June 2014)
Dietitians of Canada
Promoting Mental Health through Healthy Eating and Nutritional Care (2012)