Table 2 Summary of factors impacting delivery of corrections-based medical nutrition therapy in Canada (Theme 2)
From: Medical nutrition therapy in Canadian federal correctional facilities
1. Access | |
System gate keeping | • Medical model system used for access to MNT (e.g., requirement for referrals) • Service delays due to clinic cancellations • Attempts to fill MNT voids by other health professionals |
2. Visibility | |
Lack of awareness about services | • Limited awareness of MNT by staff and incarcerated individuals |
Misconceptions about services | • Tendency to view MNT as being about menu development |
3. Adequacy | |
Limited work time | • Low dietitian to incarcerated individuals ratio (e.g., one full-time equivalent dietitian to 2150 incarcerated individuals) • Services dispersed over many facilities with varying geographical proximities and diverse populations • Resource constraints (e.g., clinic space availability) creating delays in service |
Skills development and utilization | • Post-secondary and entry-level nutrition training does not include correctional facilities • Limited therapeutic standards specific to incarcerated individuals (e.g., nutrition risk screening, assessment) • Underutilization of clinical nutrition skills |
4. Environmental Barriers | |
Food availability | • Options available to incarcerated individual vary by facility |