Education, Communication and Technology

Components of the educational plan

1. Targeted setting and clientele - multicultural awareness

2. Needs assessment

3. Develop goals and objectives - based on assessment of client knowledge

4. Content: community resources, learning activities/methodology, references, handouts, instructional materials

5. Evaluation criteria

6. Budget development

7. Program promotion

Pedagogy

art and science of teaching children; teachers are authority figures

Andragogy

adults are mutual partners in learning, more problem-centered than subject-centered, motivation is more internal than external, self-directed learner

Spatial relationships vary among cultures and among individuals

• Intimate zone: less than 18" very close friends, business handshakes

• Personal zone: 18" -4' when giving instructions or working closely

• Social zone: 4-12' most business interaction

• Public zone: greater than 12' very formal interaction

Sales promotion

short term incentives to encourage purchases (coupons)

Personal promotion

formal/informal presentations, health fairs, cooking demonstrations, media interviews

cognitive

acquisition of knowledge or subject matter (factual information)

affective

acquisition of attitudes and values, growth in feelings or emotions

psychomotor

acquisition of muscular skills (exercises, food preparation)

Bloom's taxonomy

Objectives at lower level must be mastered before more complex learning can take place.

Is the level of learning appropriate based on the group's prior learning and present ability?

ABC framework

therapy can focus on the cues (antecedent), the behavior itself, or the consequences of the behavior

• an antecedent is an event or environment that triggers a specific behavior or

  response

Behavior modification methods

• positive reinforcement

• avoidance learning

• extinction

positive reinforcement

encourages repetition of a given behavior

• should be specific and immediate; meaningful attention from superiors

avoidance learning 

learn to escape from unpleasant consequences

• avoid future criticism by improving future performance

extinction

reduce undesired behavior

• absence of reinforcement following undesired behavior (ignore)

• if extinction is repeated, behavior will eventually disappear

Transtheoretical Stages of Change model:

behavior involves series of stages

pre-contemplation

unaware or not interested in making a change

"I did not know salt had any effect on my blood pressure."

contemplation

thinking about making a change in the near future

"I was looking at the salt content in the foods I have at home."

"I know what to do, but. ..... "

preparation

decides to change and plans the change

"I bought a cookbook on low salt cooking."

action

tries to make the change

"I removed the salt shaker from the kitchen table."

maintenance

sustains the change for six months or longer

“I found a website that helps me plan family low sodium meals."

Health Belief Model

• developed to explain why people, especially those at high risk, fail to participate in programs designed to detect or prevent disease

• a person must perceive the severity and their susceptibility to the threat for the threat to be a behavior-motivating factor

• people will engage in healthy behaviors if they value the outcome

perceived susceptibility

“obesity puts me at risk for heart disease?”

perceived impact

“heart disease will impede my ability to work”

perceived advantage of change

“greater mobility”

appraisal of barriers

“I don’t like to exercise”

self-efficacy

(conviction that you can successfully execute the behavior

required to produce the outcomes) - “I can join the gym close to work”

Diffusion of innovation

how an innovation, an idea, or behavior spreads

• people fall into categories:

  • innovators: adopt an idea readily usually without input from others

  • early adopters: opinion leaders in the community, well-respected

  • early majority: cautious in adopting a new idea

  • late majority: skeptical, adopt an idea only through peer pressure

  • laggards: last to adopt the idea

Cognitive-Behavioral Therapy

• focus on identifying behaviors and thoughts that have a negative impact on desired behaviors and goals and apply strategies to change those thoughts

• Cognitions are thoughts or perceptions at a particular moment in time

  • They can influence our behaviors and feelings.

  • Cognitive change may affect a desired behavior change

• Based on an assumption that behavior is learned and can be unlearned as the client learns new and adaptive responses

• The aim is to introduce changes in the cognitive or though process that maintain a behavior that needs to be changed

Motivational Interviewing (MI)

Goal: to increase motivation so that the clients are able to express the rationale for the changes that need to be made

• client-centered method for enhancing intrinsic motivation, guides rather than directs

• client autonomy means that decisions are left to the CLIENT

5 principles of MI

1. Express empathy (suggests acceptance) - evocation (summons feelings)

2. Develop discrepancy - between where he is and where he wants to be

3. Avoid arguments and confrontation

4. Roll with resistance - acknowledge reluctance to change and ambivalence; offer new information or alternatives to consider

5. Support self-efficacy - reinforce hope and optimism

Formative evaluation

made early or during course of education, can change direction

• helps pinpoint parts mastered and parts not mastered

• allows for revision of plans and methods to improve the process

• answers "How should we do it?"

• client must be involved; focus group, pre-test, pilot test

• frequent feedback of results guides the rest of the educational process

• often qualitative with data collection by observation, interviews

Summative evaluation

designed at planning stage but conducted at end

• considered final; purpose may be grading, or evaluation of progress

• Did we achieve what we planned? What was the impact, the outcome?

• example: post-test

• have client perform a task using new information

• purpose is to improve a program's delivery and effectiveness. Did it result in desired changes?

• uses quantitative approaches to appraise results, outcomes, or quality

Nutrition informatics

the intersection between nutrition, information, and technology

• Technology drives change in the practice of Dietetics

• ex. EHR/EMR, personal health record

HIPAA

• maintains privacy of PHI - Protected Health Information

Telehealth services

use of electronic information and technologies to support long-distance clinical health care, patient and professional education, public health administration, remote patient face-to-face services, via live video conferencing, store and forward telecommunication services

Telenutrition

RDN uses electronic information and technologies to implement the NCP with clients at a remote location within provisions of their state license as applicable

• Medicare Part B allows some services provided by RDNs to be offered via telehealth including MNT, diabetes self-management training

ANDHII - Academy of Nutrition and Dietetics Health Informatics Infrastructure

• tracks nutrition care outcomes and advances evidence-based nutrition practice research. On-line data collection uses familiar terminology

• DOR - Dietetics Outcomes Registry aggregates anonymous data available for outcomes research

Altmetrics

presentation of amount of activity from Twitter, Facebook, science blogs, mainstream news and other sources over time

National Consumer Panel (NCP)

data helps manufacturers understand consumer preferences on specific brands; enables retailers to stock the right item assortment for their local markets

Federal Trade Commission (FTC)

Federal Trade Commission - regulates content of food ads; enforces truth-in-labeling; challenges product claims when product crosses state lines

FDA

ensures safety of some domestic and imported food products

Federal Communications Commission (FCC)

licenses radio and TV

Lobbying

activities aimed at influencing public officials and legislators

Child Nutrition Reauthorization

covers NSLP, SBP, CACFP, SFSP, SMP, WIC

The Farm Bill

covers national and international nutrition education, research, funding

The Older Americans Act

funds nutrition programs in the community