Nutrition Education Counseling Skills Training Module Developed by

Nutrition Education & Counseling Skills― Training Module Developed by Dairy Council of California 2012

Learner Objectives Upon completion of this module the learner should be able to: • Verbalize an understanding of embedding specific nutrition information in a total diet context. • Identify and demonstrate use of dietary patterns as nutrition education tools. • Verbalize an understanding of multiple factors influencing clients' and consumers’ dietary decisions.

Learner Objectives • Demonstrate client-centered counseling techniques, such as active listening. • Define and demonstrate a guided counseling approach. • Assess a counseling session using the Nutrition Care Process framework.

Total Diet Approach

Use the best counseling style for the situation § Directive § Guided § Motivational interviewing

Dietary Patterns

Assignment 1: Listen to this Online Narrated Power. Point Simplistic Nutrition Recommendations: Unintended Consequence www. dairycouncilofca. org/Health. Professionals/UCcourse/index. htm

Assignment 2: Case Study―Jessica Assessment: § Jessica is 16 yrs old white female § She is 5’ 5” and 125 pounds § She is a competitive swimmer and has come to see the dietitian to improve her times § She is muscular and there is a family history of type 2 diabetes

Case Study―Version 1 § Diet History reveals: o Skips breakfast o Power bar + soda for lunch o Very large dinner While listening, use the Case Study Evaluation of an Interview handout

Case Study―Version 2 § Client-centered counseling techniques? § Client problems? § RD recommendations? § Factors affecting food choices

Nutrition Diagnosis Jessica’s current dietary pattern: • skipping breakfast, inadequate lunch, large dinner • low fruit, vegetable, and milk intake • timing and content of meals does not adequately fuel her intense physical activity

Problem, Etiology, Signs & Symptoms § Sample PES statement: § Suboptimal oral intake related to food and nutrition-related knowledge deficit as evidenced by diet recall and patient report of fatigue.

Chart Note Activity § The final step in Assignment #2 is to complete the chart note for this client. § When charting, the Nutrition Care Process and Model (NCPM) is an accurate documentation procedure for clinical practice. § Chart note activity form

Assignment 3: Case study―Ms. Marco § Ms. Marco is a 67 year old Latina female § She has elevated LDL cholesterol, low HDL, hypertension, and pre-diabetes. § She is married and lives with her husband. § She is 5’ 1”, 167 pounds § Her doctor has referred her for “lowsalt, low-cholesterol, low-sugar diet instructions. ”

Case Study―Version 1 Diet History reveals: o Skips lunch o Snacks on candies and salted nuts o Pastry and several cups of sweetened coffee daily While listening, use the Case Study Evaluation of an Interview handout

Ms Marco―Scenario 2 § Now listen to a second version of this counseling session

Nutrition Diagnosis Ms. Marco’s current dietary pattern: • Skipping lunch, poorly balanced dinner • Snacks providing too many non-nutritious calories, sodium, fat and sugar • Low fruit, vegetable and milk intake

Possible PES Statement § Excessive energy, fat, and carbohydrate intake related to food and nutrition-related knowledge deficit as evidenced by elevated LDL and fasting blood glucose, and 20# weight gain in 5 years.

Chart Note Activity § The final step in Assignment #3 is to complete the chart note for this client. § When charting, the Nutrition Care Process and Model (NCPM) is an accurate documentation procedure for clinical practice. § Chart note activity form

Summary • Consider long-term health and wellness • Use a food grouping system • Encourage nutrientdense foods from all food groups

Summary § Client-centered counseling increases the likelihood that dietary counseling will be effective

Resources These tools can help you get the right balance between nutrition complexity and accuracy: The DASH Diet Eating Plan Eat Smart. Play Hard. Healthy Lifestyle USDA Daily Food Plan Personal Nutrition Planner

Resources 2011 Food and Health Survey: Consumer Attitudes toward Food, Nutrition & Health (IFIC). Miller WR. (2004). Motivational Interviewing: preparing people for change. 2 nd ed. 2002. Nutrition and You: Trends 2011 Eatright. org/nutritiontrends Satter EM. Part 1: How to Eat. Secrets of Feeding a Healthy Family: How to Eat, How to Raise Good Eaters and How to Cook. Madison, WI: Kelcy Press; 2008. Total Diet Approach to Communicating Food and Nutrition Information, J Am Diet Assoc. 2007; 107: 1224 -1232. Unintended Consequences of Simplistic Dietary Recommendations: Good Advice Gone Awry? Dairy Council of California, 2010