New Publication by David Wiss in the High Impact Public Health Nutrition Journal


Objective: While organizational change in substance use disorder treatment has been extensively studied, there is no research describing facility-wide changes related to nutrition interventions. This study evaluates staff-perceived barriers to change before and after a wellness initiative.

Design: A pre-intervention questionnaire was administered to participating staff prior to facility-wide changes (n=40). The questions were designed to assess barriers across five domains: 1) provision of nutrition-related treatment; 2) implementation of nutrition education; 3) screening, detecting, monitoring (nutrition behaviors); 4) facility-wide collaboration; and 5) menu changes and client satisfaction. A 5-point Likert-scale was used to indicate the extent to which staff anticipate difficulty or ease in implementing facility-wide nutrition changes, perceived as organizational barriers. Follow-up questionnaires were identical to the pretest except that it examined barriers experienced, rather than anticipated (n=50).

Setting: A multisite substance use disorder treatment center in Northern California which began implementing nutrition programming changes in order to improve care.

Participants: Staff members who consented to participate.

Results: From pre to post, we observed significant decreases in perceived barriers related to the provision of nutrition-related treatment (p=0.019), facility-wide collaboration (p=0.036), menu changes and client satisfaction (p=0.024). Implementation of nutrition education and the domain of screening, detecting, monitoring did not reach statistical significance.

Conclusion: Our results show that staff training, food service changes, the use of targeted curriculum for nutrition groups, and the encouragement of discussing self-care in individual counseling sessions, can lead to positive shifts about nutrition-related organizational change among staff.

Dr. David Wiss became a Registered Dietitian Nutritionist (RDN) in 2013 and founded Nutrition in Recovery, a group practice of RDNs specializing in treating eating and substance use disorders. In 2017, David received the “Excellence in Practice” award at the National Food and Nutrition Conference and Expo. The California Academy of Nutrition and Dietetics awarded him the “Emerging Dietetic Leader Award” in 2020. He earned his Ph.D. from UCLA’s Fielding School of Public Health in the Community Health Sciences department (with a minor in Health Psychology) by investigating the links between adverse childhood experiences and various mental health outcomes among socially disadvantaged men. His treatment philosophy is based on a biopsychosocial model which incorporates an understanding of biological mechanisms, psychological underpinnings, and contextual factors that integrate the social determinants of health. Wise Mind Nutrition is an app-based interactive treatment program available for download now -

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