Domain I: Principles of Dietetics: Components of the Educational Plan Flashcards
To choose a setting and clientele for an educational plan, one must use multicultural _____
Awareness
Multicultural awareness requires one to evaluate their own ____ and ____ and become comfortable with differences
Beliefs and attitudes
Ineffective ____ can result in incorrect diagnoses and noncompliance with treatment
Communication
We should assume ____ until similarities are proven
Differences
Emphasize ____ rather than interpretation or evaluation; focus on getting a complete description of what is wanted rather than making judgments on how something was said and avoid stereotyping
Description
How do cultural communication styles differ?
-Rate, pitch, and volume of the voice
-Eye contact: direct gaze or avert the eyes as a sign of respect
-Expression restrained, emotional, or focused
-Speech: slow and soft, loud, fast
-Greetings: handshake firm, mild
Gestures, facial expressions, and postures are often a cause of _____; good posture is generally a sign of respect
Misinterpretation/confusion
____ relationships vary among cultures and individuals (how close you stand or sit to someone else)
Spatial
The ____ zone of spatial relationship is usually less than 18 inches and is used for very close friends or business handshakes
Intimate
The ____ zone of spatial relationship is between 18 inches and 4 feet and is used when giving instructions or working closely
Personal
The ____ zone of spatial relationship is 4 feet to 12 feet and is used in most business interactions
Social
The _____ zone of spatial relationship is over 12 feet and is used for very informal interactions
Public
When working with clients who speak limited English, use ____ terms and avoid slang, acronyms, and shorthand; use short, simple sentences and always speak directly to the client
Simple
_____ explains the art and science of teaching children where teachers are the authority figures
Pedagogy
_____ explains how adults are mutual partners in learning
Andragogy
Andragogy explains that adults are…
-More problem-centered than subject-centered
-Motivated by internal things rather than external things
-Self-directed learners
Middle and upper income adults are more ____-oriented and consider activities they can’t relate to as a waste of time
Goal
Lower-income adults have interests focused on costs and traditional food habits; they tend to be oriented towards the ____ and towards solving current problems
Present
Those who are very poor are ___-term planners
Short
Adolescents relate to their interests; it is important to consider the influence of ____ ____ and attitudes toward authority
Peer pressure
Elderly people have a ____ attention span and require audience participation to maintain interest; they may prefer shorter sessions and written material
Short
Develop goals and objectives based on an assessment of client ____
Knowledge
Educational goals must be set in accordance with the process of ____
Learning
Goals must be based on previous learning and the characteristics of the ____ being instructed
Group
Objectives in patient-centered counseling include…
-Increase awareness of diet-related risks
-Provide nutrition knowledge
-Enhance skills to promote long-term changes in intake
-Increase confidence for making dietary changes
Objectives should include what components?
-What it is (action)
-Who it is (target)
-When or time frame
-Measure of outcome
The measure of outcome should be _____ (acronym)
SMART (specific, measurable, attainable, relevant, time-bound)
_____ is a fit between the program and the expected outcomes based on the objectives
Consonance
The _____ of the education can be made up of community resources, learning activities/methodology, references, handouts, instructional materials
Content
Steps of creating the content for an education session:
-Evaluate the information available and match it objectives
-Organize into a logical sequence
-Develop lesson plan
-Evaluate what you have developed
A lesson plan is a written summary of information about a unit of instruction and describes all aspects including plans for _____, as well as objectives, content, sequence, activities, and time available
Reassessment
Instructional media selected depends on the ____ goals, the size and learning style of the audience, the physical facility, the equiptment, and time allotted
Teaching
_____ and programmed instructional materials can substitute for instructors in certain aspects of the learning process
Computers
Computers can be used to learn purely _____ material, which leaves the instructor with more time to develop affective and psychomotor learning
Cognitive
_____ strategies should reflect the objectives of the educational program
Evaluation
____ ____ compares outcomes of students with the norm of a group
Norm referencing
____ ____ measures the performance of students against a standard or defined objective
Criterion referencing
____ is closely linked to planning; must account for all expenses
Budgeting
Budgeting should consider the…
-Funding
-Expenditures to date
-Current estimated costs to complete the budget
-Anticipated profit or loss
Periodic budget reviews help control _____ and help adhere to the planning schedule
Resources
Program ____ informs and educates consumers about the existance of a product or service
Promotion
Tools for program promotion:
-Advertising
-Sales promotion
-Personal promotion
-Public relations
Advertising can be in the form of purchased or electronic media; ____ message to carefully defined audience
Targeted
Sales promotion includes ___-___ incentives to encourage purchases (coupons)
Short-term
Personal promotion includes formal/informal ____, health fairs, cooking demos, media interviews (direct contact, provides positive feedback)
Presentations
Public relations includes organized effort to promote a ____ image through news coverage or goodwill
Favorable
What are the three domains of learning?
-Cognitive
-Affective
-Psychomotor
The _____ domain of learning is the acquisition of knowledge or subject matter (factual information)
Cognitive
The _____ domain of learning is the acquisition of attitudes and values, growth in feelings or emotions
Affective
The _____ domain of learning is the acquisition of muscular skills (exercises, food preparation)
Psychomotor
____ ____ explains how objectives at a lower level must be mastered before more complex learning can take place
Blooms Taxonomy
How to teach depends on the ____ and ____ of the learner
Needs and readiness
_____ level of the learner affects the attention span
Motivation
The ____ level of the learner is not always related to the amount of formal education
Education
For ____ learners, like young children and some adults who lack nutrition training, you need to do a thorough introduction and background
Inexperienced
For _____ experienced learners, like teachers health educators, and patients already instructed, emphasize review of material, reorganize it for better use, and move on to more complicated topics
Moderately
For ____ experienced learners, limit audience participation at first, establish yourself as the expert, cite credentials, and use a lecture formal with audiovisuals
Very
____ strategy techniques are based on a cause-and-effect explanation of behavior
Change
The ABC framework of change states that therapy can focus on the cues, or ____, the ____, or the ____ of the behavior (ABC)
Antecedents, behavior, consequence
An antecedent is an event or environment that ____ a specific behavior or response
Triggers
What are three behavior modification methods?
-Positive reinforcement
-Avoidance learning
-Extinction
Positive reinforcement encourages ____ of a given behavior; should be specific and immediate (can get meaningful attention from superiors)
Repetition
Avoidance learning explains how people learn to escape from unpleasant _____ (people try to avoid future criticism by improving future performance)
Consequences
Extinction works to ____ undesired behavior; no reinforcement for undesired behavior (ignore) which leads to the behavior eventually disappearing
Reduce
The _____ ____ ___ ____ model states that behavior involves a series of stages
Transtheoretical stages of change
You must determine the stage that someone is in to assess ____ to change
Readiness
What are the five stages of change?
-Pre-contemplation
-Contemplation
-Preparation
-Action
-Maintenance
The pre-contemplation stage of change is when someone is ____ or _____ in making a change
Unaware, uninterested
Someone is in the contemplation stage of change if they are thinking about making a change in the near ____ (“I know what to do, BUT…”)
Future
Someone is in the preparation stage of change if they decide to make the change and ____ the change
Plans
Someone is in the action stage of change if they ____ to make the change
Try
Someone is in the maintenance phase if they maintain the change for ___ months or longer
6
The ____ ____ model was developed to explain why people, especially those at high risk, fail to participate in programs designed to detect or prevent disease
Health Belief
The Health Belief model explains how a person must perceive the ____ and the susceptibility to the threat for the threat to be a behavior-motivating factor
Severity
The Health Belief model states that people will engage in healthy behaviors if they value the _____
Outcome
What are the five components of the Health Belief model?
-Perceived susceptibility
-Perceived impact
-Perceived advantage of change
-Appraisal of barriers
-Self efficacy
_____ of innovation is how an innovation, an idea, or a behavior spreads
Diffusion
_____ are people who adopt an idea readily, usually without input from others
Innovators
____ ____ are opinion leaders in a community and are usually well-respected
Early adopters
The ____ ____ is a group of people who are typically cautious of adopting a new idea
Early majority
The ____ _____ is a group of people who are skeptical and only adopt an idea through peer pressure
Late majority
_____ are the last to adopt a new idea
Laggards
What are the four components of diffusion of innovation:
-Knowledge
-Persuasion
-Decision
-Confirmation
_____ eases the transition to new behaviors; the key is success and support
Motivation
When implementing a new idea, emphasize human factors like feelings, anxieties, and concerns and involve the learner in an ____ way to permit greatest retention
Active
It is also important to establish _____ which allows the client to express fears and concerns about impending changes
Rapport
Four steps for instruction:
-Prepare
-Present
-Try
-Follow-up
When teaching, discuss problems _____ rather than evaluatively; don’t be judgmental, which puts clients on the defensive
Descriptively
Offer alternatives _____, rather than dogmatically (commanding); offer options to keep the door open for client to add information which is less threatening
Provisionally
Teaching should be ____-oriented rather than manipulative; be straight forward and authentic
Problem
A teacher should be ____ rather than neutral which allows you to respond without giving advice and allows for their need to talk and express feelings and concerns
Empathetic
A message should be clear, complete, concise, concrete, and ____
Correct
A teacher must also have ____ responses such as clarification (pose a question after an ambiguous client message), or active and reflective listening
Listening
Active and reflective listening, such as ____ or ___ ____ focus on the thoughts and feelings of others rather than on their own personal reaction and allow a teacher to absorb what is being said what respond to concerns
Paraphrase, repeat back
A ____ statement acknowledges that there was a reason for a behavior, indicating that the response from the client was appropriate (ex: “You have a right to feel upset, anyone would”)
Legitimation
____ is information a client gives back to you as you are discussing and questioning; it lets you know what they know and what they understand about what you are saying
Feedback
A positive _____ environment should be open, encourage questions, be informal and supportive
Psychological
A positive _____ environment should be a comfortable temperature, good lighting, comfortable chairs, good eye contact, and be free from outside noise
Physical
The method of instruction is based on the ____ of the group, as well as educational and motivational aspects of the group’s members
Size
The _____ method of teaching helps master higher-level cognitive objectives
Discussion
In a small group discussion (3-5 people), there is some ____ plus some _____; it is beneficial in clinical settings (teacher remains in control and people learn from each other)
Lecture, interaction
In a large group discussion, there is just ____, or a one-way flow of information; this allows for the presentation of a large amount of material in a short period of time
Lecture
Group ____ is a skill to develop as a group leader
Dynamics
What are some skills for leading a group?
-Relieve any social concerns of the group
-Tolerate silence
-Guide and encourage interactions without becoming the focus
-Know how to when to resume control
-Reinforce multi-sided conversations
-Halt side conversations
-Help group stay on topic without showing preferences
-Negotiate (plan strategy in advance, don’t start with hard issues)
_____ explains how the groups product or decision is superior to what the most resourceful individual within a group would have produced working alone
Synergy
____ requires strong listening and verbal communication skills
Interviewing
The first step in interviewing is _____, where you would collect background information like age, weight, height, and diet history
Preparation
During the preparation stage of interviewing, you should also establish ____ for collecting information during the interview and clearly define the purpose and goals
Objectives
The first thing you should do during an interview is to establish ____ with the client
Rapport
When collecting data, begin with ___-___, non-judgmental questions
Open-ended
Open-ended questions are ____ and give freedom in responding; they also give the interviewer a chance to listen and observe (this takes more time but is less threatening)
Broad
A ___-___ question is more restrictive, limits answers, gives you more control, and takes less time
Close-ended
A ____ question introduces new topics, while a ____ question is a follow-up to obtain more information
Primary; secondary
____ questions are preferred, as they do not reveal any bias, where a leading question does reveal bia
Neutral
It is not beneficial to begin a question with the word “____” because the client may feel threatened and unwilling to reveal the answer
Why
The closing of an interaction should include a ____ for the client to check accuracy and telling the client what will be done with the information and when they will be contacted again
Summary
Non-verbal communication involves…
-Kinesics (physical communication)
-Paralinguistics (how the message is delivered)
-Proxemics (personal space)
Examples of kinesics (physical communication):
-Direct eye contact (attentiveness)
-Lowering eyes, looking away (preoccupation)
-Arms folded across chest (dislike, avoidance)
-Clenched fists (anxiety, anger)
-Crossing and uncrossing legs (anxiety)
Examples of paralinguistics:
-Hesitations, stuttering (sensitivity, anxiety)
-Whispering (difficulty in disclosing)
Examples of proxemics:
-Moves away (discomfort)
-Moves closer (seeking more interaction)
-Sits behind or next to an object (seeks protection)
What are some strategies when delivering culturally diverse nutrition counseling?
-Listen first to assess prior knowledge
-Reinforce correct knowledge, clarify misinformation
-Use simple language and visual media
-Talk in slow, clear words and repeat as needed
-Encourage questions and strive for interaction
-Use teach-back
A ____ response to a client is when a counselor makes judgment about a person’s feelings, or implies how they should feed; leads to offering advice instead of problem-solving and is rarely helpful (Ex: “If you eat too much ice cream, I suggest you stop buying ice cream”)
Evaluative
A _____ response to a client involves uncontrolled anger or frustration; it may antagonize or humiliate the client (Ex: “Maybe you are not losing weight because you are not trying hard enough”)
Hostile
A _____ response to a client may make it hard to solve the client’s problem or discuss it further; it suggests that the problem doesn’t exist and prevents the client from working through their feelings; little attempt is made at understanding the client’s needs (Ex: “Don’t worry about making changes, it just takes time”)
Reassuring
A _____ response is an attempt to clarify or gain more information as they recall details, which may encourage conversation (Ex: “Can you tell me more about that?”)
Probing
An _____ response is one of the best ways to respond; try to recreate the person’s message in your own frame of reference which may lead to more client cooperation and helps the client feel accepted and safe in expressing their feelings (Ex: “You seem to be saying that you are feeling…”
Understanding
___ ____ therapy focuses on identifying behaviors and thoughts that have a negative impact on desired behaviors and goals and applying strategies to change those thoughts
Cognitive Behavioral
_____ are thoughts or perceptions at a particular moment in time that can influence our behaviors and feelings; a cognitive change may affect a desired behavior change
Cognitions
Negative self-talk or ____ talk can inhibit behavioral change (Ex: “I have no willpower”)
Sustain
Client ____ talk is when clients verbalize their reasons that favor the targeted behavior change (Ex: “I want to lose weight to feel better”)
Change
Cognitive behavioral therapy is based on the assumption that behavior is ___ and can be ____ as the client learns new and adaptive responses
Learned and unlearned
The aim of CBT is to introduce changes in the cognitive or thought process that help to _____ a behavior that needs to be changed
Maintain
____ ____ helps clients recognize and begin to resolve their concerns and problems with a main goal of increasing motivation so clients are able to express the rationale for the changes that need to be made (assumes that people make changes only when they are ready to change)
Motivational interviewing
Motivational interviewing is a client-centered method for enhancing ____ motivation
Intrinsic
Motivational interviewing ____ rather than directs and does not give advice to the client
Guides
What are some important parts of the motivational interviewing technique?
-Express empathy (suggests acceptance), evoke feelings
-Develop discrepancy between where they are and where they want to be
-Avoid arguments and confrontation
-Roll with resistance (acknowledge reluctance to change and ambivalence; offer new info or alternatives to consider)
-Support self-efficacy (reinforce hope and optimism)
-Leave decisions up to the client (support autonomy)
____ communication is more formal and authoritative (email, text, handouts)
Written
Written information is interpreted more ____ and is used when record is required
Accurately
Keep reading level of written material around an ____ grade level for the general public and around a ____ grade level for those with lower literacy
8th, 6th
Use the ____ test to determine readability, which gives a grade level of written text by determining the average number of polysyllabic words
SMOG
_____ information is more personal and encourages two-way communication
Verbal
The most critical barrier to verbal communication is poor ____ skills
Listening
_____ activities such as radio and TV extend the reach to audiences that are maybe out of reach due to financial situations
Media
We should evaluate each step in the educational process, which include…
-Assessment
-Planning
-Implementation
-Evaluation
A _____ evaluation is made early or during the course of education; it can change direction
Formative
A formative evaluation helps pinpoint parts that were or were not ____
Mastered
Formative evaluations allow for ____ of plans and methods to improve the process
Revision
A formative evaluation answers what question?
How should we do it?
A client must be involved in the formative evaluation process, for example in a focus group, pilot test, or ___-test
Pre
Frequent feedback of results of a formative evaluation guides the rest of the ____ process
Educational
The data collected from a formative evaluation is often _____ data collected from observation or interviews
Qualitative
A _____ evaluation is designed at the planning stage, but conducted at the end
Summative
A summative evaluation is considered _____; purpose may be for grading or evaluation of progress
Final
A summative evaluation answers what questions?
-Did we achieve what we planned?
-What was the impact and outcome?
An example of a summative evaluation is a ___-test where the client performs a task using new information
Post
The purpose of a summative evaluation is to improve the program’s delivery and _____
Effectiveness
Summative evaluations use _____ approaches to appraise results, outcomes, or quality
Quantitative
Evaluation strategies are developed once ____ are established
Objectives
What are two examples of formal evaluation methods?
-Objective test (mult. choice)
-Performance test (client asked to perform tasks based on learning objectives)
Objective tests are not well suited for ____ or ____ settings
Clinic; community
An example of an ____ evaluation strategy would be unstructured observation of food selection and behaviors
Informal
What questions can be asked to evaluate the effectiveness of educational plans?
-Did it alter patient knowledge, behavior, or attitude?
-Was it timely, appropriate, and accurate?
-Was it within budget?
-Did it meet specific targeted needs?
_____ of employee education and training is essential for safety issues and the correct use of all equipment
Documentation
To document training, use orientation ____ and note the date and content of the training
Checklist
The ___ ___ requires documentation of nutrition services to evaluate the medical nutrition therapy and for any legal issues that may arise
Joint Commission
All medical and financial information from a client is ____
Confidential
Nutritional ____ is the intersection between nutrition, information, and technology; includes the use of technology in spreading information
Informatics
_____ drives change in the practice of nutrition
Technology
____ ____ ____ allow providers to enter, store, retrieve, and manage information related to healthcare
Electronic medical records
With a _____ health record, the consumers maintain health information
Personal
_____ maintains the privacy of protected health information
HIPAA
HIPAA requires that patients must be notified if their medical information is to be ____ outside of the care process or if protected information (address, email, income) is to be shared
Shared
_____ services include the use of electronic information and technologies to support long-distance clinical health care, patient and professional education, public health administration, or remote patient face-to-face services, via live video conferencing, as well as store and forward telecommunication services, which can then be retrieved by another site for clinical evaluation
Telehealth
_____ for telehealth services varies among payers; each payer determines the Current Procedural Terminology (CPT) codes they will recognize
Reimbursement
____ ____ uses behavior change models and motivational interviewing, often in the form of telehealth services
Health Coaching
With ____, the RD uses electronic information and technologies to implement the nutrition care process with clients at a remote location within provisions of their state license as applicable
Telenutrition
Medicare Part ____ allows some services provided by RDNs to be offered via telehealth including MNT and diabetes self-management training
B
The Academy of Nutrition and Dietetics ____ ____ _____ tracks nutrition care outcomes and advances evidence-based nutrition practice research
Health Informatics Infrastructure
The ____ ____ ____ aggregates anonymous data available for outcome research
Dietetics Outcome Registry
_____ is the presentation of the amount of activity from things like Twitter, Facebook, science blogs, mainstream news, and other sources over time
Altmetrics
The ____ ____ _____ reports on data that helps manufacturers understand consumer preferences of specific brands; this enables retailers to stock the right item assortment for their local markets
National Consumer Panel
Public policy ____ and legislation is an interaction between the legislative, executive, and judiciary branches of the government
Advocacy
The ____ branch (congress, senators, and representatives) may introduce and enact a law and can override a veto by the executive branch
Legislative
The ____ branch (president) may veto legislation or sign it into law
Executive
The ____ branch may discard a law if it considers it in violation of a person’s basic rights and freedoms
Judiciary
What are the stages of legislation being signed into law?
-Legislation enters as a bill or resolution
-The bill is sent to committees that schedule public hearings where testimony is taken from the bill’s sponsors (RD can present views here or in earlier planning stages)
-The committee revises the bill during a markup sessions nd put into final form; if approved, it is sent to Rules Committee for debate
-It needs approval from both the House and the Senate and the President
-Differences between the two Houses are worked out in a Joint House-Senate Conference committee, ultimately passing a reconciliation bill
-Appropriations bill must be passed to provide funding
-Formulate regulations that interpret and operate the law
What are some examples of operating and enforcement agencies that may carry out a law related to nutrition?
-FTC
-FDA
-FCC
Roles of the Federal Trade Commission (FTC):
-Regulates content of food ads
-Enforces truth-in-labeling
-Challenges product claims when product crosses state lines
Role of the Food and Drug Administration (FDA):
Ensures the safety of some domestic and imported food products and food supplies
Role of the Federal Communications Commission:
Licenses radio and TV
The ____ ____ publishes information weekly on notices of public hearings, proposed and final rules, and agency decisions; they also list changes in USDA food programs
Federal Register
The ____ ____ has information from the floor; does not have a hearings, lists bills with sponsors and action, and is issued daily when Congress is in session
Congressional record
The ____ ____ has weekly updates and identifies bills with sponsors and committees
Congressional Index
____ is an aggressive form of action where someone pleads a cause of a group
Advocacy
Advocates must know the ____ and arguments for and against the issue and be realistic and willing to compromise
Facts
____ is activity aimed at influencing public officials and legislators
Lobbying
What are some examples of public policy advocacy and legislation that affect nutrition education programs?
-Child Nutrition Reauthorization (covers NSLP, SBC, CACFP, CFSP, SMP, WIC)
-The Farm Bill
-The Older Americans Act
The Child Nutrition Reauthorization Act covers…
-National School Lunch Program
-School Breakfast Program
-Child and Adult Care Food Program
-Summer Food Service Program
-Special Milk Program
-WIC
The Farm bill covers…
-National and international nutrition education
-Research
-Funding
The Older Americans Act funds nutrition programs in the ____
Community
