Student profile - Melanie Voevodin

Tell us a bit about yourself and your thesis topic -

I am a dietitian, and worked for five years as a clinical dietitian after graduating. I then went on to project management and curriculum development for local dietetic training courses. I also worked for the Victorian Government and for a big food company. Over this time I did further study, public policy, and later health economics.

I wanted to do this research for years, but each time I set up a meeting with a potential supervisor…I found out I was pregnant.  This happened three times!  Six years and three babies later ... I went out again to select a supervisor, department, and university – yes, in that order. 

It happened that the political landscape was also more ready for the work: eHealth was a “trend” and within the profession, the concept of measuring and reporting what dietitians do had become better known.  Our US counterparts had developed an eHealth-language specific to dietitians.  This was used in my research in a preliminary modelling phase. 

The question I had posed years earlier remained unanswered: If dietitians are specifically trained to help with obesity and diabetes, where are we?  I wanted to know if dietitians can turn around this obesity epidemic and if they can, what was the complete infrastructure they needed to do this well, and, how can they generate the evidence for their contribution.  The central thesis (argument) is that dietitians can make a difference, it may not be large, it may not achieve the “two fruit five veg 60 minutes of exercise and a BMI of <25kg/m2”, but the small behaviour change a client makes because of the counselling a dietitian provides DOES make a measurable difference to health outcomes.

An output from my thesis is a minimum data set of what dietitians need to collect to be able to report what they do, and the health outcome that intervention achieved.  It is right in the pocket of eHealth – right treatment to the right person at the right time – and a system to record and report whatever that treatment was and whether it worked or not for this person at this time.  The data-collection system is built with the intention to be able to report to our National Health Performance Indicators.  So for the first time, dietitians will be able to generate evidence to show their national contribution to behavioural change.

You said that you worked as a dietitian for ten years, what made you decide to come back and write a thesis after practising for so long?

I always wanted to do my PhD and this idea, the concept for this thesis, came from an initial interest in data collection and reporting in the health system.  I had done a small thesis as part of the Master of Public Policy in data collection practices of dietitians in hospitals. Every day we (dietitians) had to enter data into a system to account for our 7.25 hours in the day. Yet the data was never used for anything!  Well, not very much compared with the medical professions.  So we collected data, but there was no requirement to report the data.  Economically, this made sense: why would a health service invest in developing a system to record and report what dietitians do when the whole department used up less than 0.5% of the total hospital budget!  I could see it would be down to us, the profession, to do it ourselves. 

I knew from my Masters research our professional capacity to develop a system, even with best intentions, was unlikely to take priority over all other priorities within the resources available.  Watching the health landscape, chronic disease was increasing, and public health policy was not recognising dietitians as a potential first line of defence to improve our health statistics!  Improving health outcomes through iterative behaviour change is exactly what dietitians are trained to do – but where were we?  It was time to develop a system, or at least make some headway to being able to record and report the contribution dietitians made to Australia’s health.  The question is: can dietitians turn around this obesity epidemic?

What have you learnt while writing your thesis?

I have found blogging helpful.  Blogging allows a “free-writing” style where you can play with ideas.  If an idea works, becomes more sophisticated I mean, I may keep it with the blog, but use the idea to move my idea in the thesis to the next level.  I see writing as a major contribution to my research method and design, and have made my best discoveries through writing (supported by the playing with ideas in blogging). 

The other benefit of blogging is the audience is my target audience – the people I most want to influence.  In contrast, you can do as many peer reviewed papers as you want but they have to be a particular format and a particular recipe (so to speak) and you often leave out the “story”, the real life bits translated in a way that is useful.
Communicating what I know through research is my “giving back” to those who have contributed to the research, and to raise awareness of the issues that face dietitians as a profession.  Keeping up with communication across the different mediums takes time: so it’s the blog with Twitter and Facebook plus the website for people who aren’t on social media.  But it is the thesis that talks the science. My job is to plant the idea seeds in the peer reviewed literature, and to go back and raise awareness through blogs.

What are your plans when you finish your thesis?

Sleep! And then I’d like to continue with the cluster randomised controlled trial written up to test the “preliminary” data-collection and reporting system.  Of course, I will only do this if I am successful at getting a grant.  If no grant, I will hand that next phase to a willing PhD student….and do some more writing!  Many stories to tell.

3MT thesis presentation 2012

Contact Melanie

Follow Melanie on Twitter, at @MDPStudy,  or her blog https://sites.google.com/site/monashmdp/