final exam goal 1 Flashcards
clinical dietitian vs administrative dietitian vs. Community/public health dietitian
clinical: is a specialist in therapeutic and normal nutrition. Is responsible for the assessment
of the nutritional status of patients with a condition, illness, or injury that puts them at nutritional risk.
Plans, implements and evaluates the results of client’s nutrition care plans, in conjunction with the client.
administrative dietitian: An administrative dietitian specializes in human, financial, and capital resource management of food
services systems, ultimately providing high quality food.
A community/public health dietitian/nutritionist is a specialist in applied human nutrition with a focus
on health promotion and disease prevention and is responsible for nutrition in a variety of community
settings. Assesses, plans, coordinates, implements and evaluates nutrition intervention programs.
Community vs Public Health Nutrition
Community nutrition is a broad term that encompasses any nutrition program whose target is the
community.
Public health services refers to those community-based programs conducted by a government agency
whose official mandate is the delivery of health services to individuals in a particular area – their scope
of practice usually covers the entire population or community; public health nutrition services are one
of many services offered.
community nutrition
a few definitions
The branch of nutrition that addresses the entire range of food and nutrition issues related to individuals,
families, and special needs groups living in a defined geographical area.
A discipline that strives to prevent disease and enhance health by improving the public’s eating habits
(text).
The art and science of influencing interpersonal and collective behavior for the purpose of optimizing the
nutritional health of groups.
Is the whole of the nutritional sciences applied to the consumer as groups or as individuals.
A discipline focusing
definition for public health nutrition)
The branch of nutrition that addresses the entire range of food and nutrition issues related to individuals,
families, and special needs groups living in a defined geographical area.
A discipline that strives to prevent disease and enhance health by improving the public’s eating habits
(text).
The art and science of influencing interpersonal and collective behavior for the purpose of optimizing the
nutritional health of groups.
Is the whole of the nutritional sciences applied to the consumer as groups or as individuals.
A discipline focusing
The Forces Affecting Community/Public Health Nutrition Practice
Several forces influence community/public health nutrition professionals as they work to promote optimal nutrition
status and to maintain health in the populations they serve. These forces include:
a. Major Nutrition Related Problems
-heart disease
< stroke
< hypertension
< diabetes
< overweight and obesity
< cancer
< low birth weight infants
< HIV infection/AIDS
< cancer
< osteoporosis
b. Health Care Realities
Changes in Canada’s and Saskatchewan’s Health Care System affect community/public health nutrition
professionals: Costs of health care
< Limited resources
< Equity and access issues
< Restructuring of services
< Shift in focus to health promotion and disease prevention
c. Health Agendas
-Federal, provincial, and local governments and health organizations and agencies all have their own “agendas” or
mandates. Community/public health nutrition professionals need to be familiar, at the very least, with the nutrition
and health agendas for their federal, provincial and local governments. Such “agendas” will influence community
nutrition practice.
d. Societal and Health Trends -A trend is a general direction or tendency, especially of events or opinions. A trend is likely in effect 5 years or
more. Trends are found in broad, more macro areas such as the economy, technology or social behavior. In
contrast, a fad is a craze and plays itself out in a much shorter time. Fads appear in a much smaller arena - food,
entertainment, fashion, sports merchandise.
Economic Trends
< income inequities
< poverty
< hunger and food insecurity
< homelessness
< disasters, terrorism
< decline in standardized work
< increased female influence
< more educated workers
< expansion of trade globally
< strong global linkages
Environmental and Health Trends
< alternative health practices
< shift to health promotion and disease prevention
< advances in medical science
< self-health care
< continued environmental abuses
< environmentalism
Trends in Food Intake and Diets
< fast foods
< slow foods
< comfort foods
< trans fat
< local foods
< others
Technological Trends
< infiltration of microprocessors in all facets of life - i.e., in communication with others, as a main source of
information, as our primary work tool, as an entertainment vehicle, to educate us, to run our major
appliances and automobiles, to improve our health care, etc.
< digital networks - microprocessors linked electronically
< converging of technologies
< wireless technological advances
e. The Changing Food Supply
-Issues
< Foods to promote or maintain health (i.e., organic foods, fruits and vegetables)
< Functional foods, phytochemicals, chemopreventive agents, designer foods, nutraceuticals, pharmafoods,
and energy enhancing foods
< Food additives, ingredients, and technologies to improve/modify foods
< Food substitutes and replacements (i.e., reduced fat/fat-free products)
< Nutritive and nonnutritive sweeteners
< Food irradiation
< Biotechnology
< Food safety
-Workplaces of Community/Public Health Nutritionists
The practice setting for community nutrition is the community where the client or group resides. The
focus may be on the individual. However, the individual is seen in relation to the group, community or
population
Government (federal, provincial, region) Day care centres
International (WHO, CUSO, UNICEF) Public/private schools
Industry (pharmaceutical, food) Residential facilities
Voluntary and non-profit organizations (Heart and Stroke Fitness centres
Foundation, Cancer Society) Sports clinics
Universities, colleges, medical/dental schools Hospital outpatient clinics
Home health care agencies Restaurants
Private practice Workplaces
1.5 Position Titles for Community/Public Health Nutritionists
Public health nutritionist School nutritionist or dietitian
Public health dietitian Private practice dietitian
Community nutritionist Sports dietitian or nutritionist
Community dietitian
Others
Home care dietitian, dietitian educator, regional dietitian or nutritionist
nutrition educator, nutrition education specialist, nutrition specialist
Etc.
Community nutrition focuses on:
promoting and enhancing health and Public health nutritionists:
promoting and enhancing health and preventing diseases by:
advocating for healthy public policy in all sectors of society
promoting a healthy lifestyle
population - population-oriented - groups, communities, population
issues that affect lives of the largest number of the community’s people
unserved or underserved populations
collaboration and partnerships
1.6 Roles and Responsibilities of Community/Public Health Nutritionists
Public health nutritionists work to:
Community dietitians/nutritionists work to:
In general, public health nutritionists and community dietitians:
- assess, plan, coordinate, market, implement, manage and evaluate nutrition intervention
programs for individuals, groups, communities and/or populations (depending on mandate).
Public health nutritionists:
Work to promote, protect, and support nutritional health and prevent nutrition-related disease in groups,
communities and populations.
Typical responsibilities include:
Population health assessment Research and evaluation
Policy, standards and guidelines development Capacity building
Technical consultation and advice Advocacy
Project development and management Partnerships
Professional education Leadership
Media work
Community dietitians/nutritionists:
Works to prevent disease in groups and individuals by reducing risk factors that are related to injury and
illness.
Typical responsibilities include:
Working with individuals and groups Providing public and professional
Helping high risk groups education
Assessing needs Working on committees
Planning services and programs Advocating for change
Developing resources Other
Providing individual and group counseling
See handout: Public Health/Community Nutrition Examples
See handout: Public Health Nutritionists in Saskatchewan
See text reading: Professional Focus (Community-Based Dietetic Professionals) p. 32
1.7 Educational Preparation of Community/Public Health Nutritionists
Minimum – Bachelor’s degree in nutrition from a DC accredited university program
Usual -
Bachelor’s degree in nutrition
Postgraduate dietetic internship or Master’s degree (registered dietitian status)
Some experience in community nutrition
Preferred For Public Health Nutritionists (required in some provinces) -
Bachelor’s and master’s degree (and registered dietitian status)
Some experience in community nutrition
1.8 Knowledge and Skills Needed
Nutrition competence Communication competence
Public health competence Education competence
Management competence Professional competence
Competence Areas for Community/Public Health Nutritionists
NUTRITION COMPETENCE is the integration and application of the science and art of
nutrition to promote optimum health for individuals, groups, and populations.
PUBLIC HEALTH COMPETENCE is the integration of the science and art of preventing
disease, prolonging life, and promoting health through organized community effort. Public
health focuses primarily on the health of populations, communities, and organizations and is
committed to social responsibility.
EDUCATION COMPETENCE is the integration of communication skills and knowledge of
professional subjects, behavioral sciences and education principles to influence the practices of
clients, personnel, other professionals, and the general public. This includes the formal aspects
of developing, conducting, and evaluating education programs.
COMMUNICATION COMPETENCE is the application of theories of communication to
written and verbal communications for individuals, groups, and societies.
MANAGEMENT COMPETENCE is the integration and application of human, conceptual and
technical skills to manage human, material, physical and operational resources and to develop,
administer, and evaluate community programs.
PROFESSIONAL COMPETENCE is the application of specialized knowledge of community
nutrition, professional ethics and the principles of personal development to all professional
activities.download
Knowledge: # Normal nutrition during pregnancy, lactation, infancy, childhood, adolescence, adulthood and older adulthood # Meal planning, food selection and preparation for individuals, groups and organizations # Canada's Food Guide to Healthy Eating # Nutrition assessment techniques (anthropometric, biochemical, clinical, dietary, socioeconomic) # Diseases commonly seen in the community, e.g. heart disease, obesity, eating disorders, diabetes, cancer # Therapeutic/clinical nutrition - general principles and practices # Alternative health therapies, e.g. iridology, herbology # Human behavior related to health and diet including theories and techniques for affecting behavior change within individuals, groups/organizations and communities # Cultures and lifestyle of ethnic and socioeconomic groups represented in the community (e.g. aboriginal, lower socioeconomic status) # Population health # Community assessment # Epidemiological approach to measurement and description of health # Determinants of health (i.e., social environment, physical environment, individual capacity and resources) # Sustainable food practices # Primary, secondary and tertiary prevention and palliative care # Health promotion strategies (e.g. community development, lobbying, advocacy, healthy public policy, social marketing, etc.) # Community health and human service programs, community mobilization and organization, and federal, provincial and local governmental structures and processes # Trend tracking, issues management, strategic planning # Current and emerging public health and community nutrition issues # Political considerations involved in agency planning and decision making and the legislative basis (policy) for public health and public health nutrition programs # Research design and methodology including quantitative, qualitative, and survey research, grant and contract management, funding sources, and statistical analysis # Personnel management including recruiting, staffing, supervising, performance appraisal, and staff development # Financial management and budgeting # Quality improvement methodology, accreditation of programs, administrative audits, cost/benefit and cost/effectiveness analysis # Information technology (e.g. computers, Internet) # Communication issues - channels, group dynamics, negotiation, group process techniques, conflict management, interviewing and counseling, writing (public, technical, scientific, plain language), speaking (individual, groups, public, professional) # Program planning - needs assessment, priority setting, goals and objectives, strategies for designing and implementing programs, program evaluation, resource development # Professional issues - ethical principles, self-assessment and self-evaluation, professional involvement, continuing professional education, time management, entrepreneurship, leadership Skills: # assessing # prioritizing # planning # developing # coordinating # implementing # marketing # evaluating # educating # advocating # managing # leading # counseling # advising # communicating # writing (public, technical, professional) # negotiating # facilitating # researching # analyzing/interpreting # interacting # supporting # collaborating # partnering # budgeting # mentoring/preceptoring # training
public speaking
being an effective writer
1.9 Typical Job Description
There is not typical daily job description - depends on position.
1.10 Resources and Tools Used by Community/Public Health Nutritionists
Resources are tools that enable us to better do our job.
Resources:
contribute to our knowledge and understanding of various issues
give us ideas and suggestions
prevent us from always “reinventing the wheel”
Resources need to be evaluated and used appropriately.
Just because a resource exists doesn’t mean it should be used.
Agencies – Government: • Health Canada*** • Canadian Food Inspection Agency • Agriculture Canada • Saskatchewan Health – Non-Profit Organizations • Canadian Cancer Society • Canadian Diabetes Association • World Health Organization • Food and Agriculture Organization • Professional Organizations – Canadian Public Health Association – Saskatchewan Public Health Association – Dietitians of Canada – National Nutrition Institute – Organization for Nutrition Education – Society for Nutrition Education (U.S.) • Nutrition-Related Resources – RNI’s, DRI’s – Canada’s Guidelines for Healthy Eating – Canada’s Food Guide to Healthy Eating – Food Labeling – Food Composition and Nutrient Data Bases – The National Plan for Action for Nutrition – Infant Nutrition Guidelines; Nutrition in Pregnancy Guidelines • Journals – Canadian Journal of Dietetic Practice and Research** – Journal of Nutrition Education and Behavior – Public Health Nutrition – Journal of the American Dietetic Association – American Journal of Clinical Nutrition – Nutrition Reviews – Health Education – Health Education Quarterly – Canadian Journal of Public Health – American Journal of Health Promotion – Health Promotion International
Newsletters: • Rapport (NIN) – O.N.E. Bulletin (ONE) – Practice (DC) – University of California at Berkeley Wellness Letter – Nutrition Action – Nutrition and the M.D. – Tufts University Diet & Nutrition Letter – Others • Books: – Key books you will consult: • Basic and advanced nutrition • Lifecycle nutrition • Community Nutrition • Clinical nutrition • Research – methods, stats, quantitative, qualitative • Marketing • Business and management • Program planning and evaluation • Foods • Cookbooks • Books for the lay public (reputable and non- reputable) • Computer programs • Audiotapes; videotapes; films • Posters; pamphlets • Games; activities • Food models – paper, rubber • Manuals; workbooks; programs; curriculums • Newspapers; magazines (Cooking Light, Eating Well, Bon Appetit, Gourmet, etc.)
There are many ways in which public health documents from local, provincial, federal or
other organizations can be used. Here is how two specific documents might be used by
community/public health nutritionists.
Healthier Places to Live, Work and Play: A Population Health Promotion
Strategy for Saskatchewan
• To understand the province’s population health promotion strategy
• To know priority issues for population health promotion
• To review population health promotion concepts and principles
• To know the short, medium and long term strategies
• To help nutritionists understand “upstream” approaches to addressing root causes
• To suggest guiding principles for health promotion strategies
• To learn about provincial and national initiatives
• To help differentiate between traditional and population health approaches
• To give ideas and suggestions for population health approaches
• To encourage collaboration and partnerships
Health Disparity in Saskatoon: Analysis to Intervention (Summary Report)
• To serve as an introduction to health disparities in Saskatoon, if one is new to his
or her position in Saskatoon (orientation)
• To encourage readers to think more broadly and deeply about health disparity
issues
• To encourage readers to think about the root causes of disparity
• To overcome misconceptions that readers may have about health disparity issues
• To encourage action on the part of health professionals and policy makers
• To encourage program and policy initiatives
• To serve as support and justification for program and policy initiatives
• To provide evidence for program and policy initiatives
• To provide ideas and suggestions for program and policy initiatives
• To serve as a comparison to health disparities in other regions and provinces
• To share initiatives from other countries
The Well-Read Community Nutritionist
Ten Good Arguments for Reading Journals Consider the following ten good reasons for reading journals regularly:1 1. To impress others 2. To keep abreast of professional news 3. To understand pathophysiology 4. To find out how a seasoned health practitioner handles a particular problem 5. To find out whether to use a new or an existing diagnostic test, survey instrument, or educational tool with your patients or clients 6. To learn the clinical features and course of a disorder 7. To determine etiology or causation 8. To distinguish useful from useless or even harmful therapy 9. To sort out claims concerning the need for and the use, quality, and cost-effectiveness of clinical and other health care 10. To be titillated by the letters to the editor
Public health nutrition:
Advancement opportunities
job satisfaction
consultants
travel
Advancement opportunities
Provincial public health nutritionist position Consultants
Senior public health nutritionist Senior management positions
Specialty areas in public health nutrition
Job Satisfaction
Health promotion and disease prevention focus Travel
Developing programs for communities and populations Writing, public speaking
Diversity of work Influencing change
Helping communities through capacity building, policy development, etc.
“Big picture” thinking
Working with a diversity of people, organizations, agencies and health professionals
Opportunity to be creative and flexible
INTEREST IN COMMUNITY NUTRITION
Do you think you would…
like promoting health in groups, communities and populations?
enjoy public speaking (if not, are you willing to learn how to public speak?)?
like playing many different roles (educator, advocate, planner, counselor, manager, etc.)?
be a self-starter, an independent worker and a team player?
like resource development, research, planning and evaluating programs?
be creative and innovative?
enjoy supervising others?
enjoy less structure in your day? enjoy flexibility?
like interacting and collaborating with many people, groups and organizations?
be able to work on many different projects at once?
enjoy writing? for the public? for health professionals?
cope well with the unexpected? With delays? With demands put on your time?
