Exploring an extended scope for rural allied health assistant (AHA) role in nutrition and dietetics: Can AHAs assist in malnutrition assessment?

Cristal Newman1, Petrea Cornwell2, Elizabeth Ward3, Annmarie McErlain1, Adrienne Young4

Community and Allied Health, Roma Hospital, 197-234 McDowall St, Roma, Qld 4455, cristal.newman@health.qld.gov.au
Allied Health Research Collaborative, The Prince Charles Hospital; and Menzies Health Institute Queensland, Griffith University, 627 Rode Rd, Chermside, Qld 4032, petrea.cornwell@health.qld.gov.au
Centre for Functioning and Health Research, Metro South HHS; and The University of Queensland, St Lucia, Qld 4072, PO Box 6053, Buranda Qld, 4102, liz.ward@uq.edu.au
Department of Nutrition & Dietetics, Royal Brisbane and Women’s Hospital, Butterfield St, Herston, Qld 4029, Adrienne.young@health.qld.gov.au


Malnutrition has a significant impact on hospital length of stay and patient outcomes. A solution for rural and remote dietitians to provide timely assessment and treatment of malnutrition could be to have extended scope allied health assistants (AHAs) complete initial assessment of malnutrition to guide dietetic services and interventions. The aim of this study was to assess the accuracy and confidence of trained AHAs to conduct the Subjective Global Assessment (SGA) in comparison to dietitians.


A non-inferiority cross-sectional design was used. A convenience sample of 45 adult inpatients admitted to a rural and remote health service was recruited to the study. Participants were assessed independently by both a trained AHA and dietitian within 24hours. Order of assessment was randomised, with the second assessor blind to outcome of the initial SGA. Minimal level of percent exact agreement (PEA) between AHA and dietitian was set at ≥80%.


Level of agreement for the overall SGA score was 84.4% (kappa = .839, p<.001), while for individual components of the SGA PEA ranged from 64.4 to 86.7%. Mean confidence in completing the SGA based an a 10-point scale was 7.5±1.7 for AHAs and 9.0±1.4 for dietitians. Where discrepancies were identified in overall SGA ratings AHAs tended to score more conservatively than dietitians.


AHAs can assist in completing malnutrition assessments to help identify patients who require further assessment and management by a dietitian. Further investigation is required to determine the benefits of incorporating this extended role into rural and remote healthcare services.


Cristal Newman is a Senior Dietitian at Roma Hospital in South West Queensland. Cristal has been working in the field of nutrition and Dietetics for over ten years, in both the public and private sectors. Cristal has a special interest in the nutritional management of chronic disease and malnutrition prevention and treatment.

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