Dietetics practice standards state that registered dietitians (RDs) evaluate psychological factors related to food and weight concerns of weight management clients and make appropriate referrals; however, not all dietitians agree with these standards. RD beliefs and behavioral intentions were examined through correlational survey research with a simple random sample of 5,458 of the nation’s 74,723 RDs. The Dietitian Beliefs and Intentions Questionnaire (DBIQ), based on the Theory of Planned Behavior (Ajzen, 1988), was developed to investigate beliefs and intentions of RDs toward evaluating psychological factors and making referrals. The DBIQ was piloted for psychometric properties before use in collecting data in the final study phase. Test-retest reliability was confirmed using paired t-tests and the Spearman-Brown coefficient.

Multiple linear regression analysis techniques with cross-validation were used to develop prediction equations to test the null hypotheses (a) there is no difference between predicted and actual intention scores for evaluating psychological factors and (b) there is no difference between predicted and actual intention scores for referring weight management clients to psychological services. Regression models were used to determine the best predictor of intention to perform the practice behaviors. As expected, PCA with internal consistency reliability analyses resulted in four components for each intention variable: intention, attitude, perceived behavioral control, and subjective norm. Composite scores were created and used in analyses. The researcher failed to reject both null hypotheses. The best predictor for intention to evaluate and intention to refer was perceived behavioral control (p < .001). All TpB predictors were significant for both practice behaviors ( p < .001). Having taken a course of study in psychology or related field was a significant predictor for intention to evaluate (p = .027); working in a practice setting with psychology professionals was a significant predictor for intention to refer (p = .048).

It is reasonable to expect that dietitians can improve skills in the area of evaluating psychological factors and making referrals. When the possibility exists that psychological issues are adversely affecting nutritional status, dietitians must identify and refer clients to appropriate services and work collaboratively with other professionals to address client needs.