Table 3

Context, mechanism and outcome configurations

ContextIntervention characteristicsMechanisms triggeredOutcomes
  • Participants lacking nutrition counselling skills

  • Participants having inadequate knowledge

  • Participants being future and practising healthcare professionals

Emphasizing skills building instead of knowledge outcomes (‘let me be skilful’)
  • Being more confident

  • Feeling adequately prepared

  • Use of dietary counselling steps

  • Self-reported confidence to counsel patients and change in counselling behaviour

  • Lack of faculty to provide nutrition training at preclinical and clinical settings

  • Participants being future and practising healthcare professionals

Superiors role modelling the delivery of nutrition care (‘I look up to you’)
  • Being more confident

  • Sense of acceptance

  • Sense of credibility

  • Anticipation of being valued

  • Better delivery of nutrition care in clinical settings

  • Greater confidence in nutrition counselling

Participants being future and practising healthcare professionalsMeeting the needs of potential participants of an intervention (‘Ask me what I want’)
  • Interest

  • Sense of knowing the needs of participants

  • Greater satisfaction with educational intervention

  • Significant gains in knowledge outcomes

  • Participants lacking time to provide nutrition care

  • Lack of payment for providing preventive care

  • Participants having limited access to referral sources and materials for nutrition care

  • Poor investment into nutrition care

  • Lack of supportive office systems to deliver nutrition care

  • Separation of prevention and curative services in the healthcare system

Addressing structural and systemic factors to make an enabling environment (‘Is my consulting room enabling?’)
  • Feeling comfortable to deliver nutrition care

  • Sense of acceptance

  • Perceiving fewer barriers to the delivery of nutrition care

  • Sense of recognition

  • Structured office environment conducive to providing nutrition-related services

  • Strategies to address lack of support systems

  • Encountering fewer barriers to lifestyle medicine

  • Inadequate instruction and syllabi for nutrition training in curricula

  • Busy healthcare professionals lacking time to attend continuing education programmes in nutrition

Incorporating technology-based education (‘My computer is a learning tool’)
  • Convenience and self-paced study

  • Interactivity

  • Instant feedback

  • Accessibility

  • Significant gains of knowledge

  • More positive attitudes towards nutrition care

  • Changed real-time practice behaviour

  • Greater confidence in skills of nutrition counselling

  • Better counselling skills

  • Practising healthcare professionals

  • Participants lacking appropriate tools to deliver nutrition care

  • Participants’ personal dietary and lifestyle habits

  • Participants having inadequate training in nutrition

  • Participants not routinely addressing patients’ nutrition problems

  • Existence of structural barriers to providing nutrition care to patients

Providing participants with local, practical relevant tools and messages (‘Give me tools’)
  • Removal of perceived barriers

  • Feeling comfortable

  • Facilitating the uptake of nutrition messages

  • Changed nutrition practice behaviour

  • Engaging in specific rather than general discussion with patients

  • Giving relevant advice and recommendations to patients

  • Simplifying complex messages

  • Poor interest in nutrition education

Use of non-traditional teaching strategies (‘Using the right strategy for the right job’)
  • Capture interest of participants

  • Meet the learning needs of participants

  • Active participation and uptake of knowledge and skills

  • Relevance of learning

  • Engaging the management of malnutrition

  • Engaging in exercise and dietary counselling

  • Ability to counsel overweight/obese patients

  • Significant changes in knowledge gains

  • Positive personal health habits of participants

  • Lack of confidence to deliver nutrition care

  • Among future and practising healthcare professionals

Improving self-efficacy (‘I feel that I can do it, so I will do it’)
  • Feeling motivated

  • Feeling confident

  • Self-reported changes in practice behaviours

  • Intentions to change behaviour

  • Participants having inadequate knowledge

  • Among future and practising healthcare professionals

  • Participants lacking training in diet counselling

  • Lack of patient motivation to change dietary pattern

  • Lack of time

Improving the personal health habits of healthcare professionals (‘Do as I do’)
  • Being more confident

  • Sense of being a role model

  • Sense of relatedness to patients

  • Greater counselling confidence

  • Intentions to change behaviour

  • Positive healthy lifestyles

  • Engaging in dietary assessment

  • More favourable attitudes towards nutrition counselling

  • Low priority given to nutrition

  • Inadequate time dedicated to nutrition

  • Healthcare students

  • Reported inadequate knowledge in nutrition

Integrating nutrition content (‘Add nutrition to my learning’)
  • Accepting nutrition education

  • Reduction in perception of time limitations

  • Greater recognition of the relevance of nutrition education

  • Increased in the number hours dedicated to nutrition

  • Greater gains in cognitive outcomes

  • Multidisciplinary nature of healthcare delivery

  • Cross-disciplinary nature of nutrition

Adopting a multidisciplinary approach in intervention design and implementation (‘Working with others’)
  • Sense of belonging

  • Acceptance

  • Recognising the multidisciplinary nature of nutrition healthcare delivery

  • Multidisciplinary designed programme

  • Meets the needs of all participants

  • Greater satisfaction