NUFD 107 Exam 2

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42 Terms

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Advantages of documenting nutrition counseling sessions

1. Evidence of care
2. Basis for evaluation
3. Legal protection
4. Communication tool for health care team - continuity of care
5. Justification for third party reimbursement
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ADIME steps of the Nutrition Care Process

1. Nutrition assessment/re-assessment - anthropometric, biochemical, clinical, dietary, environment
2. Diagnosis - naming the problem
3. Intervention - should resolve or improve identified nutrition “problem”
4. Monitoring and Evaluation - monitor progress and determine if goals are met, measure and compare to client’s previous status, nutrition goals, or reference standards
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5 categories of nutrition assessment

1. Anthropometric: height, weight, BMI
2. Biochemical: hematocrit/hemoglobin, cholesterol/TGs, glucose/Hbg A1c
3. Clinical - diseases, physical conditions: hypertension, cleft palate
4. Dietary: food and liquid intake, food preferences, food allergies, food sensitivities, swallow restrictions
5. Environment: family dynamics, homeless, lead paint
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Determinants of food choice

1. Food - taste, preference
2. Personal - culture, beliefs, knowledge, motivations
3. Environment - availability, advertising, economic
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What is the biggest influence on diet?
Taste
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What are the six constructs of the Health Belief Model?

1. Perceived susceptibility
2. Perceived severity
3. Perceived benefits
4. Perceived barriers
5. Cues to action
6. Self-efficacy
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Perceived Susceptibility
One’s opinion of chances of getting a condition

Application: define population at risk, risk levels; personalize risk based on a person’s behavior
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Perceived Severity
One’s opinion of how serious a condition

Application: specify consequences of the risk and the condition
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Perceived Benefits
One’s opinion of the efficacy of the recommendation to reduce risk or seriousness of impact

Application: define action to take; how, where, when; clarify the positive effects to be expected
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Perceived Barriers
Opinion of the tangible and psychological costs of the advised action

Application: identify and reduce barriers through reassurance, incentives, assistance, practice, taste-testing
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Cues to Action
Strategies to activate “readiness”

Application: provide how-to information, promote awareness, reminders
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Self-Efficacy
Confidence in one’s ability to take action

Application: provide skills training, guidance in performing action, goal setting, contracting
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Ways to enhance self-efficacy regarding food-related behaviors
Provide step-by-step instructions and demonstration of behavior by credible role models. Engage in direct experience such as food preparation. Provide positive reinforcement on achievements and successful performance.
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Theory of Planned Behavior
Individual’s health behavior is directly influenced by intention to engage in the behavior
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Theory of Planned Behavior constructs

1. Behavioral intention
2. Attitudes
3. Social norms
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Behavioral intention
Self-efficacy (how-to knowledge + skills)

Barriers
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Attitudes
Anticipated outcomes

Value of the outcomes
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Social norms
Peer pressure

Motivation to comply
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Social Cognitive Theory
People learn by observing social interactions and media. Personal factors, behavior, and environment interact continuously and influence each other
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Social Cognitive Theory constructs

1. Behavioral capability
2. Reinforcements
3. Observational learning
4. Social support
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Behavioral Capability
Knowledge and skill to perform behavior
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Reinforcements
Rewards

Affirm accomplishments
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Observational Learning
Demonstrations, role models
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Social Support
Relationships and social network
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Practice using the Social Cognitive Theory to develop a nutrition education intervention
Use PowerPoint presentations, visuals, and cooking demonstrations to teach food and nutrition-related knowledge and skills to enact behavior. Provide step-be-step demonstration of food preparation and cooking skills
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Goals
(know, value, learn, believe)

Broadly stated learning outcomes

Overall intent of the intervention

i.e. Participants will increase physical activity
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Objectives
(compare, list, identify, differentiate)

Specific learning outcomes

What the participant will have done after the intervention

i.e. by the end of the lesson, parents will compare high fiber and low fiber breakfast items
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Who, What, How of learning objectives
Who - are the learners?

What - knowledge, skills (behaviors), attitudes?

How - what materials do they need to do this? (list of resources, sample materials)
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KAB Model
(Knowledge, Attitude, Behavior)

K: information dissemination - knowledge accounts for 4-8% of variance in eating behavior

A: attitude change - more effective
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Example of a learning objective
Given several vegetables, pickling brine, spices, and jars (how)…the attendees of the Robinson Center nutrition class (who)…will practice making at least 6 different vegetables and choose the one or two they are most likely to try at home (what)
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ABC’s of Learning Objectives (example)
By the end of the program, college students will have identified 3 quick breakfast options they can prepare at home
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ABCs of Learning Objectives
Audience - who?

Behavior - will do what?

Condition - by when, where, and with what?
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Nutritional Genomics
Interaction between human genes, nutrition, and health
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Nutrigenetics
The study of effect of genetic variation on dietary response
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Nutrigenomics
The study of the effects of food on gene expression
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Epigenetics
The study of mechanisms that will switch genes on and off, ie. epigenetic determines the specialization of cells a fetus develops through gene expression or silencing, and environmental stimuli
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Possible ways to positively influence your microbiome

1. Breastfeed infants at least 6 months
2. Eat a variety of foods - whole grains fruit/veg, high fiber sources
3. Fermented foods - kimchi, miso tempeh
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Goal vs. Objective
Goal - big picture, distant

Objective - smaller
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Guidelines for developing and evaluating education materials

1. Content
2. Readability
3. Layout/graphics/visuals
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Content
Nutrition content accurate and current, clear messages, focused on action - what to do, free of sponsor/product bias, culturally sensitive
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Readability
Simple, plain language, familiar vocabulary, common short words, minimal jargon, short sentences (8-10 words) and short paragraphs or bullets, information clustered using headings, type size 12-14 point, use capital and lower case letters, avoid all caps and italics, avoid abbreviations, contractions, acronyms, quotation marks, hyphens, reading level about 5th-6th grade or below as appropriate for audience, conversational, personal, positive tone
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Layout/graphics/visuals
Attractive and appropriate, near relevant text, lots of white space to balance the text and illustrations, simple and realistic to help explain the messages, positive, related to the audience, age, culture, avoid stereotyping, include space for personalizing