Factors influencing patient perceptions of nutritionists’ epistemic authority and tendency to comply with treatment recommendations

Maintaining a healthy nutrition lifestyle is a challenge associated with a high risk of quitting. However, it has been shown that healthcare providers who are perceived as having a high degree of epistemic authority (EA) can influence compliance. The aim of this study was to examine the individual level of compliance required to maintain the healthy lifestyle recommended by nutritionists with different levels of expertise. Specifically, the aim was to examine whether the degree of EA affects patients’ compliance and whether active or passive dietary recommendations can affect the patient’s perception of the nutritionist as someone who possesses credible knowledge in this particular area. The present study included 187 participants who completed scenario based questionnaires concerning the nutritionist’s approach to treatment (from passive to very active treatment) and level of expertise, followed by questions examining compliance and ranking the EA accorded to the nutritionist. Data were collected using a self-report questionnaire. The results indicated that the formal level of expertise had no influence on compliance. In contrast, the type of recommendation given had an effect on participants’ intentions to comply, and this effect was mediated by the level of the nutritionists’ EA. Surprisingly, more active recommendations, although more behaviorally challenging, resulted in a higher intention to comply. Patients may possess prior expectations regarding prescribed treatment and these may bias their perception of the nutritionist’s EA and consequently, their intention to comply. It is important that nutritionists understand patient expectations in order to tailor a strategy for treatment that will optimize the compliance with treatment recommendations. Academic programs in nutrition and dietetics should incorporate an appreciation of the importance of EA.