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Table 4 Key enablers and barriers for providing a dietetic referral

From: Nutrition care practices of primary care providers for weight management in multidisciplinary primary care settings in Ontario, Canada - a qualitative study

Key enablers Examples of quotes from primary care providers
Increasing access to a dietitian “It’s very easy here to make a referral since we have a dietitian on site and she is pretty quick to see patients.” FHT, NP – Participant 12 “Access. How quickly they can be seen – not just location access, but also even how quickly they can get on the bandwagon. I find that sometimes if there are long delays – it wears off by the time they get in. Whereas if we have one (dietitian) on site and access is quick, I find it’s received well because of that.” NPLC, NP – participant 5
Increasing patient comfort “Well it’s on site and it’s not a new environment where they have to meet strangers.” NPLC, NP – participant 6
Cost-free dietitian service at point of care “They (dietitians) are in the building and it is free for the patient.” FHT, FP – Participant 15
Flexible schedule “Being on site, free of charge, offered in the evenings so more availability for people working” FHT, FP – participant 14
Having a relationship with the dietitian “Having a relationship with the dietitian. The more you know their abilities. I know the dietitian here is brilliant and I know that she is located in the clinic so that helps me sell it to the patient rather than saying ‘you might get an appointment in 3 months across the city’.” FHT, NP – participant 11
Key barriers Examples of quotes from primary care providers
None “None here but in general it would be cost and transportation, but they are already in to see us, we are ground floor, parking is free, easy access, senior access, wheelchair access. We worked hard to bring down the barriers.” FHT, FP – participant 15
Wait times “The wait time is 2 weeks so that is sometimes not soon enough because it gives patients time to change their mind but I think it is still good.” CHC, NP – participant 19
Not thinking about making a dietetic referral “Not thinking of it or making assumptions that the patient would not be interested. But it would still be good to offer it.” NPLC, FP – participant 9
Patient not buying in “Barriers include patient factors such as patients not buying in.” CHC, FP – participant 21
Patients’ negative perception of the session with the dietitian “The lecture that people think they’re going to get and the shame element about being overweight.” NPLC, NP – participant 6
Requires the patient to come in again “It would require another appointment.” NPLC, NP – participant 4
Patients not showing interest “Some people just aren’t interested; they have hang-ups around weight and dieting and don’t want to talk about it.” CHC, NP – Participant 18
Patients’ lack of time “Those are typically the working group, that their time is fairly limited with family and work so they want a quick in and out, give me the information and I will do the work.” CHC, NP – Participant 19