Aims: To assess the feasibility of implementing data standards in Australian primary care dietetics practices.Methods: A mixed‐methods pragmatic study of dietitians working in primary care. Using a four‐point Likert scale, participants were surveyed on their baseline use of the 45 business and 33 clinical evidenced‐based data standards. The content validity index and kappa statistic for each standard were calculated with a kappa statistic of 0.60–0.74 considered ‘Good’ and > 0.74 ‘Excellent’. After 4 weeks of assessment, dietitians were surveyed on the feasibility of implementing each standard and standards in total. Qualitative feedback on enablers and barriers to implementing standards was gathered and triangulated with interviews with select participants.Results: Forty‐five dietitians from every Australian state and territory completed both surveys (response rate: 100%). At baseline, 24% of business and 79% of clinical standards were rated ‘Good’ or ‘Excellent’ for current usage. The feasibility of implementing standards was rated ‘Good’ or ‘Excellent for 86% of the business and 97% of the clinical standards. Software, training and time limitations are enablers and barriers to implementing standards.Conclusion: Embedding data standards within dietetics practices are feasible and have broad applicability for assessing outcomes of care.

Aim: To identify minimum reporting standards for assessing the processes and outcomes of Australian primary care dietetics practice.Methods: A sequential, mixed‐method, exploratory process with peer‐nominated Australian ‘thought leaders’. A literature review was undertaken to identify possible standards, followed by semi‐structured qualitative interviews with thought leaders. Content analysis was used to identify a comprehensive group of items that could inform evidence‐based reporting standards. Two rounds of a modified Delphi survey were conducted with the same thought leaders to seek consensus on the most relevant items. Individual items were analysed for content validity, and those with a rating of excellent item‐content validity (index >0.78) were included as evidenced‐based standards for primary care practice.Results: Twenty‐six thought leaders (response rate: 87%) from all mainland Australian states completed a qualitative interview and two rounds of modified‐Delphi consensus surveys. Items were identified and categorised into three domains: business, clinical, and implementation. Content analysis identified 216 items published or used in practice by the thought leaders. After two rounds of consensus review, 97 items (45 business, 33 clinical, and 19 implementation) achieved excellent consensus ratings. Combining these items into a standardised tool, the scale‐content validity index average was >0.90, which is considered excellent content validity.Conclusions: This study has identified minimum reporting standards for evidence‐based process and outcome assessments in primary care dietetics practice in Australia. Incorporating such standards into a standardised tool could enable benchmarking across the dietetics workforce and contribute to a broader understanding of the dietetic impact on public health.

Aims: This study aimed to describe private dietetics practices in Australia in terms of ownership, size, and operation, team composition, and products and services. Methods: Australian dietitians operating private practices were invited to participate in a cross‐sectional survey between May and June 2024. The survey captured data regarding the business, including ownership, revenue, business and clinical operation, team composition and remuneration, products and services, and consultation and program characteristics. Data were analyzed descriptively. Results: One hundred and fifty‐four participants completed the survey (22% response rate). Businesses were primarily sole traders ( n = 105; 68%) that neither employed nor contracted health professionals ( n = 94; 61%) and generated less than AU$149999 in revenue ( n = 114; 77%). Most businesses specialised ( n = 107; 69%), with common areas of specialisation being eating disorders ( n = 49; 32%), disability support ( n = 35; 23%), and weight inclusive care ( n = 35; 23%). Client consultations ( n = 146; 95%) were the most frequently offered service. Initial consultations were most frequently 60 min ( n = 83; 59%), attracting a mean fee of AU$173 (±$9 95% CI), while review consultations were most frequently 30 min ( n = 80, 57%) and AU$113 (±$7 95% CI). Business and dietitian performance evaluation were typically not performed periodically, yet both were positively correlated with revenue ( τ _b = 0.231, p < 0.001 and τ _b = 0.338, p < 0.001, respectively). Conclusions: Sole practitioners represent a significant proportion of private dietetics practice. With a significant proportion of the workforce working in this area, support is needed to ensure private practices are sustainable and the workforce can continue to provide much‐needed services for Australians.

Aims: This study aimed to establish the processes for a national dataset describing Australian private practice dietetics and to report baseline workforce data. Methods: A cross‐sectional survey captured workforce and business data for dietitians working in private practice dietetics in Australia. Business owners from a national register were invited to complete the survey and to share the survey with employed or contracted dietitians between May and June 2024. Data were analysed descriptively. Results: Seven hundred and three business owners were invited to participate, and 176 participants completed the workforce items (25% response rate). Participants were primarily female ( n = 158; 90%) business owners ( n = 161; 91%), mean ± SD age of 42 ± 9 years and mean time since graduation of 15 ± 9 years. Mean time spent per week working in private practice was 26 ± 15 hours. Most participants were satisfied with their work in private practice ( n = 160, 91%) and anticipated working in private practice in 5 years' time ( n = 155, 88%), though some ( n = 62, 35%) felt some degree of unwellness due to stress. Business owners were generally dissatisfied with the applications received for advertised dietetics roles. One hundred twenty‐one participants consented to follow‐up in 2 years as part of the ongoing survey. Conclusions: A national dataset describing the dietetics workforce, supported by ongoing data capture, is essential to support workforce planning and ensure that private practice is a legitimate and sustainable career path, thereby future‐proofing this segment of the workforce and ensuring access to high‐quality preventative and primary dietetics care.

The underlying tenet of evidence-based decision-making in health services is assessing all the relevant evidence. Using the traditional qualitative and quantitative approaches to identifying evidence may not capture the full spectrum of factors that need to be addressed. A selective mixed-method approach may provide a comprehensive assessment of the relevant knowledge. This paper adds to the methodological literature by outlining a novel sequential, mixed-method, exploratory process for identifying evidence-based data standards that may be used for health service decision-making. The three-phase process, entitled Delphi Plus, engages peer-nominated topic-specific experts to assess all publicly available and practice-based items and, through a series of reviews, reach an evidence-based consensus on standards for decision-making. Each process phase is outlined in-depth and supplemented by practical learnings gained through its implementation. The Delphi Plus methodology provides the first comprehensive process for combining the published and practised data to develop evidence-based data standards. The routine use of Delphi Plus would provide a framework for benchmarking in health services, enabling greater monitoring and evaluation of client outcomes and improving quality care. This manuscript describes the process of implementing Delphi Plus and provides an example of data standards generated from its use, which directly inform the Australian Government’s Primary Health Care 10 Year Plan.