Personal trainers are confident in their ability to provide nutrition care: a cross-sectional investigation

Highlights

• Personal trainers are confident in their ability to provide nutrition care.

• Personal trainers report providing nutrition care is a good use of their professional time.

• Confidence was lowest in nutrition knowledge, and highest in communication and counselling.

• As a workforce, personal trainers may be useful to facilitate changes in dietary behaviours.

• Education on how to provide nutrition care within limitations of professional scope is needed.

Abstract

Objective

To measure the self-perceived competence of Australian personal trainers in providing nutrition care.

Study design

Cross-sectional online survey.

Methods

A validated survey was used to measure confidence in the ability to provide nutrition care among a snowball sample of 142 Australian-based personal trainers. The survey used 5-point Likert scale statements across four nutrition related constructs: knowledge; skills; communication and counselling; and attitudes. Scores for each construct were averaged and summed to provide a self-reported nutrition competence score as a percentage. Pearson Chi-squared analyses were used to identify associations between demographic variables and competence scores, and associations between construct scores.

Results

Personal trainers felt confident to provide nutrition care for all clients (mean score 76%; ‘very confident’). Greater confidence in nutrition knowledge was seen in personal trainers with greater experience (χ² = 6.946, P = 0.008) and education higher than a certificate IV (χ² = 5.079, P = 0.024). Greater confidence in nutrition knowledge was also associated with greater confidence in nutrition skills (χ² = 49.67, P ≤ 0.001) and more favourable attitudes towards providing nutrition care (χ² = 4.73, P = 0.03).

Conclusions

Personal trainers feel confident in their ability and show favourable attitudes towards providing nutrition care to clients. This workforce has the potential to support lifestyle modification for chronic disease prevention.

Introduction

Chronic disease imposes a large burden on health worldwide.1, 2 Poor dietary behaviours and physical inactivity influence the development of many chronic diseases and are estimated to contribute to 10% of the global burden of disease.² The prevalence of poor dietary behaviours and physical inactivity is considerable in many countries. For example, the majority of adults in the USA, UK and Australia consume less fruit and vegetables than recommended.3, 4, 5 Furthermore, less than half of adults in the USA, UK and Australia meet the recommended levels of physical activity.4, 6, 7 Clearly, strategies that simultaneously facilitate adults to improve dietary behaviours and increase physical activity levels are important to prevent and manage chronic disease.⁸

Personal trainers are a large workforce of exercise professionals who provide guidance, instruction and motivation for individuals initiating or engaging in physical activity.9, 10, 11 As such, personal trainers have been identified as ideally placed to provide basic nutrition care to their clients in line with national dietary guidelines.9, 12, 11 In addition, individuals who are attempting to improve their physical activity behaviours are likely to seek advice on other health topics, including dietary behaviours.14, 15 In this context, nutrition care refers to any practice conducted by a professional in an attempt to facilitate an individual to improve their dietary behaviours.¹⁶

A scope of practice which limits the provision of nutrition care by personal trainers has been recommended by the International Confederation of Registered Exercise Professionals.¹⁷ For example, in Australia the regulating body (Fitness Australia) has created a national scope of practice document for exercise professionals that states personal trainers may provide basic nutrition information in line with the national dietary guidelines.⁹ However, Australian and international research has shown that more than three quarters of personal trainers provide nutrition care beyond this recommended scope of practice.12, 18, 19 The provision of nutrition care beyond the recommended scope of practice has been identified as a major industry risk due to the potential for inappropriate or misleading nutrition advice to result in negative health outcomes for individuals.²⁰ A primary concern raised within, and externally to, the fitness industry is a perceived lack of competence in providing nutrition care, mostly due to inadequate education in nutrition.20, 21, 22 However, the competence of personal trainers to provide nutrition care has not been widely investigated.

Competence refers to the ability to perform a task and comprises specific knowledge, skills and attitudes that facilitate appropriate task performance.²³ Competency standards are predominantly used in health care to define the minimum quality standard for professional practice and to guide education and training.23, 24 The direct measurement of competence is challenging. Significant time and resources would be required to observe or monitor the provision of nutrition care, and such study designs are likely to introduce bias. Alternative measurements of nutrition care outcomes could be investigated; though, in contexts such as personal training the outcomes of care are multifaceted.9, 23, 25, 26 For example, nutrition care provided by personal trainers should facilitate clients to improve their dietary behaviours in a safe, evidence-based manner. However, the factors influencing dietary behaviour change over time and any improvements in diet quality may not be directly associated with nutrition care provided by a personal trainer. In these contexts, self-perceived competence refers to a subjective rating of personal ability that has been demonstrated to predict actual competence when the constructs under investigation are clearly defined.²⁵

Investigating the self-perceived competence of personal trainers may help to clarify the concerns previously raised of low competence in providing nutrition care. This understanding will also help to identify areas in which personal trainers require further education or support for competent care. Therefore, the aim of this study was to explore the self-perceived competence of Australian personal trainers in providing nutrition care to clients.