Oncology nutrition care in Indonesia: a cross-sectional survey to characterise practices, barriers and enablers among nutritionists and dietitians

PurposeNutrition care is essential for improving oncology treatment outcomes, however evidence on current practices and adherence to the Nutrition Care Process framework in Indonesia is scarce. This study explored oncology nutrition care practices, identified barriers, enablers and behavioral determinants influencing evidence-based practice experienced by Indonesian nutritionists and dietitians.MethodsBased on the Theoretical Domain Framework (TDF) and Capability Opportunity Motivation – Behavior (COM-B) system, a 32-item survey was developed to characterise nutrition care practice, identify barriers and enablers, and the behavioral determinants influencing evidence-based oncology nutrition care in Indonesia. The cross-sectional survey was distributed online to members of the Indonesian Dietitian Association.Results268 participants (91% female; 67.5% nutritionists, median age 34 (interquartile range 28–41) years) met eligibility criteria and completed the survey. Participants reported high confidence, being motivated by a strong professional identity and personal satisfaction. Awareness of international evidence-based oncology nutrition guidelines was low (ranging from 11.2 to 44.8%), most of which are only available in English. Individual components of nutrition assessment were completed by most participants (anthropometry 91.8%, biochemical data 88.4%, physical examination 71.3%, and dietary intake 95.1%); however, only 55.6% used a validated malnutrition assessment tool. Key enablers to providing nutrition care included access to general nutrition training (64.2%) and peer support (79.9%), while major barriers were lack of oncology-specific nutrition training (75.7%) and limited access to guidelines in the Indonesian language (42.9%).ConclusionDespite strong motivation, gaps in capability and opportunity hinder evidence-based oncology nutrition care in Indonesia. Implementation strategies to address these gaps include development of culturally adapted Indonesian oncology nutrition care guidelines, integration of validated malnutrition assessment tools into practice, and implementation of accessible cost-effective oncology-specific nutrition training. These strategies are essential to strengthen evidence-based practice and improve patient outcomes in Indonesia.