Principles Of Dietetics - topic B: education, communication and technology Flashcards
components of the educational plan
targeted setting and clientele - multicultural awareness
targeted setting and clientele - ineffective communication
can result in incorrect diagnoses and noncompliance with treatment
targeted setting and clientele - cultural communication styles differ
- rate, pitch volume of the voice
- eye contact: direct gaze or avert eyes as a sign of respect
- expression restrained, emotional, focused
- speech: slow and soft, loud and fast
- greetings: handshake firm, mild
targeted setting and clientele - spatial relationships & communication
vary among cultures and among individuals
- personal zone: 18” - 4’ when giving instructions or working closely with others
targeted setting and clientele - working with clients with limited English skills
Use common terms and avoid slang, acronyms, and shorthand. use short simple sentences
targeted setting and clientele - how to speak to client
always speak directly to the client
needs assessment - pedagogy
art and science of teaching children; teachers are authority figures
needs assessment - andragogy
adults are mutual partners in learning, more problem-centered than subject-centered, motivation is more internal than external, self-directed learned
needs assessment - very poor
short term planners, more concerned about current issues first
needs assessment - elderly
decreased attention span; audience participation to maintain interest; control questions to stay on topic; prefer written material
- 30 min sessions
- control input
- bullet pts, easy to read and follow
- educational material based on clientele
educational plan - DEVELOP goals and objectives - objectives
what it is (action), who it is (target), when or time frame, measure of outcome (of intervention); specific, measurable, attainable, relevant, time bound.
educational plan - develop goals and objectives - consonance
is a fit between the program and the expected outcomes based on the objectives - will your objectives lead to the expected outcomes
educational plan - content - instructional media
-instructional media selected depends on the teaching goals, the size and learning style of the audience, the physical facility, the equipment and time available
computers, programmed instruction materials can substitute for instructors in certain aspects of the learning process
- used to learn purely cognitive (factual) info; leaves instructor more time to develop affective and psychomotor learning
educational plan - evaluation criteria
what is the purpose (why), timing (when), and the specific outcome (what)? what will you evaluate, when and how?
educational plan - evaluation criteria - norm referencing
compares students with the norm of a group
educational plan - evaluation criteria
- criterion referencing
measures performance against a standard or defined objective
educational plan - budget development
periodic budget reviews help control resources and help adhere to the planning schedule
educational plan - program promotion - tools
tool: advertising, sales promotion, personal promotion and public relations
- advertising - purchased print or electronic media. targeted message to carefully defined audience
- sales promotion - short term incentives to encourage purchases (coupons)
- personal promotion - formal/information presentations, health fairs, cooking demonstrations, media interviews. direct contact provides positive feedback
- public relations (publicity): organized effort to promote a favorable image through news coverage or goodwill.
educational theories
types or domains of learning
- includes: cognitive, affective, and psychomotor
educational theories - cognitive
acquisition of knowledge or subject matter (factual information)
educational theories - affective
acquisition of attitudes and values, growth in feelings or emotions - subjective learning
educational theories - psychomotor
acquisition of muscular skills (exercises, food prep)
educational theories - Bloom’s taxonomy - objectives for the hierarchy of learning
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? educational sessions begins with what do they know?
educational theories - educational readiness assessment
how to teach depends on the needs and readiness of the learner
educational readiness assessment - motivational level
affects attention span
educational readiness assessment - educational level
not always related to amount of formal education
educational readiness assessment - situational assessment
- inexperienced: young children, some adults lacking nutrition training, need thorough introduction and background
- moderately experienced: teachers, health educators, patients already instructed. emphasize review of material, reorganize it for better use, move on to more complicated concepts
- very experienced: limit audience participation at first, establish yourself as the expert, cite credentials, lecture format/AVs
- economics, time needed, availability, environmental
behavior modification - change strategies
techniques are based on a cause and effect explanation of behavior
behavior modification - change strategies - 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
encourages repetition of a given behavior - praise them for changes their making
- should be specific and immediate; meaningful attention from superiors
behavior modification methods - avoidance learning
learn to escape from unpleasant consequences
- avoid future criticism by improving future performance
behavior modification methods - 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 stage
- determine stages to assess readiness to change
- tailoring intervention to their stage of change is more effective
- pre-contemplation, contemplation, preparation, action, maintenance
transtheoretical stages of change model - pre-contemplation
unaware or not interested in making a change “I did not know salt had any effect on my blood pressure”
transtheoretical stages of change model - 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….”
transtheoretical stages of change model - preparation
decides to change and plans the change
“I bought a cookbook on low salt cooking”
transtheoretical stages of change model - action
tries to make the change
“I removed the salt shaker from the kitchen table”
transtheoretical stages of change model - maintenance
sustains the change for 6 months or longer
“I found a website that helps me plan family low sodium meals”
health belief model
- 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 - then they will engage in the behavior
diffusion of innovation
how an innovation, an idea, or behavior spreads
- models all assess where person is now and go from there
communication principles
- motivation eases transition to new behaviors; key is success and support
- involve learner in an active way (prevents greatest retention); application of the info and active involvement of the learner permits the greatest retention (select menu items) - have person perform task
- offer alternatives provisionally rather than dogmatically (commanding)
- message should be clear, complete, concise, concrete, correct (5 C’s)
communications principles - listening responses
clarification: pose a question after an ambiguous client message; used to make previous message explicit
active or reflective listening: paraphrase or repeat back what was just said
- focus on the thoughts and feelings of others rather than on their own personal reaction
- absorb what is being said and respond to the person’s concerns
communication principles - legitimation statement & feedback
- a legitimation statement acknowledges that there was a reason for a behavior, indicating that the response from the client was legitimate - “you have a right to feel upset, anybody would”
- feedback - info client gives back to you as you are discussing and questioning; lets you know what he knows and what he understands about what you are saying
communication principles - environment
psychological - openness, encourage questions, informal, supportive
physical - comfortable temperature, lighting, chairs; maintain eye contact; free from outside noise
confidentiality must be respected
communication principles - method of instruction
is based on the size of the group and the educational and motivational aspects of the group’s members
- the discussion method of teaching helps master higher-level cognitive objectives
- small group discussion - some lecture plus interaction; beneficial in clinical setting; teacher needs to remain in control; 3-5 people with similar needs; learn from each other
communication principles - group process, group dynamics, skills to develop as a group leader
- relieve social concerns of the group; all must feel accepted
- tolerate silence - after introductions, state purpose of gathering, state your intentions not to participate, sit patiently
- guide and encourage interactions; don’t become focus
- know when and how to resume control
- reinforce “multi-sided” nature of conversation; ‘How do you feel about that?”
- exercise control over talkative participants; encourage silent members
- halt side conversations by engaging the distractors; discourage wisecracks
- help group stay on topic; avoid showing your preference
negotiating techniques: - plan strategy in advance - know what you are willing to accept
- don’t start with the hard issues; be direct, clear, calm, patient, tolerant
communication principles - group process - synergy
the groups product (decision) is superior to what the most resourceful individual within the group could have produced by working alone - collective decision is superior
implementation - interviewing - steps
- requires strong listening and verbal communication skills
- preparation - before the interview itself - collect background information
- build rapport when face to face with client
- collect data: begin with open-ended, nonjudgmental questions
implementation - interviewing - kinesics
- kinesics - non-verbal/physical communication
- arms folded across chest - dislike, avoidance
- clenched fists - anxiety, anger; crossing and uncrossing legs - anxiety
implementation - interviewing - nonverbal communication - paralinguistic
how the client’s message is delivered
- hesitations, stuttering - sensitivity, anxiety
- whispering- difficulty in disclosing
implementation - interviewing - nonverbal communication - proxemics
personal space
- moves away- discomfort; moves closers - seeking more interaction
- sits behind or next to an object - seeks protection
implementation - counseling techniques
- listen first to assess prior knowledge
- reinforce correct knowledge, clarify misinformation
implementation - counselor’s responses to client - evaluative
make judgment about persons feelings, or imply how he should feel. leads to offering of advice, not problem-solving, seldom helpful.
“If you eat too much ice cream, I suggest you stop buying ice cream”
implementation - counselor’s responses to client - hostile
uncontrolled anger or frustration; may antagonize or humiliate client
“maybe you are not losing weight because you are not trying hard enough”
implementation - counselor’s responses to client - reassuring
may make it difficult to solve the client’s problem or discuss it further. Suggests the problem does not exist. client is prevented from working through feelings. little attempt is made to understand the needs of the client. “don’t worry about making changes… it just takes time”
implementation - counselor’s responses to client - probing
attempt to clarify or gain more information as they recall details. may encourage conversation. “can you tell me more about that?”
implementation - counselor’s responses to client - understanding
one of the best ways to respond, try to recreate the persons message in your own frame of reference. may lead to more client cooperation. helps client feel accepted and safe in expressing their feelings. “you seem to be saying that you are feeling….”
interviewing - CBT (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
interviewing - MI - motivational interviewing
helps clients recognize and begin to resolve their concerns and problems. the goal is to increase motivation so that clients are able to express the rationale for the changes that need to be made. people make changes only when they are ready to change. it is a client-centered method for enhancing intrinsic motivation, guides rather than directs, and does not give advice to the client
interviewing - methods of communication - written
- more formal and authoritative: email, texting, handouts
- keep reading level of materials around the 8th grade for the general population and the 6th grade for audiences of lower literacy abilities
- procedure for determining readability: SMOG index gives grade level of written text by determining the average number of polysyllabic words
interviewing - methods of communication - verbal
more personal, encourages two-way communication
- most critical barrier: poor listening skills
evaluation of educational outcomes
evaluate each step in the educational process: assessment- assess learner, planning- evaluate plan in each phase of the process, implementation and evaluation of outcomes
evaluation of educational outcomes - formative
made early or during course of education, can change direction
- how should we do this?
- helps pinpoint parts mastered and parts not mastered
- allows for revision of plans and methods to improve the process
- 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
evaluation of educational outcomes - summative
- designed at planning stage but conducted at end
- did we achieve what we planned?
- example: post-test
- considered final; purpose may be grading, or evaluation of progress
- have client perform a task using new information
- did it result in desired changes?
- uses quantitative approaches to appriase results, outcomes, or quality
evaluation strategies are developed once objectives are established - formal
- objective test - not well-suited for clinic or community setting (multiple choice) - doesn’t work well
- performance test - client asked to complete task based on learning objectives - perform what they’ve learned, active involvement helps retention
evaluation of educational outcomes - evaluation of effectiveness of educational plans
- did it alter patient knowledge, behavior or attitude? rate of lapse or relapse?
- timeliness, appropriateness, accuracy? within budget? degree of growth?
- meet specific targeted needs? quality of presentation?
evaluation of educational outcomes - documentation
- documentation of employee education and training is essential for safety issues and the correct use of all equipment
- the joint commission requires documentation of nutrition services to evaluate medical nutrition therapy and for any legal issues that may arise
evaluation of educational outcomes - client information
all medical and financial information is confidential
healthcare and nutrition informatics systems/technologies - 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 (clinical data, images, sound, video) which can be retrieved by another site for clinical evaluation
- reimbursement for telehealth services varies among payers. each payer determines the current procedural terminology (CPT) codes they will recognize for reimbursement
healthcare and nutrition informatics systems/technologies - 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
healthcare and nutrition informatics systems/technologies - altmetrics
presentation of amount of activity from Twitter, Facebook, science blogs, mainstream news and other sources over time
healthcare and nutrition informatics systems/technologies - NCP National Consumer Panel
data helps manufacturers understand consumer preferences on specific brands; enables retailers to stock the right item assortment for their local markets
public policy advocacy and legislation - the legislative branch
congress, senators, representatives may introduce and enact a law and can override a veto by the executive branch
public policy advocacy and legislation - the executive branch
(President) may veto legislation or sign it into law
public policy advocacy and legislation - the judiciary
may discard a law if it considers it in violation of a person’s basic rights and freedoms
public policy advocacy and legislation - stages
- legislation enters as a bill or a resolution
- the bill is sent to committees which schedule public hearings where testimony is taken from bill’s sponsors. nutritionist can present views here or in earlier planning stages
- it needs approval from both houses (house of representatives and 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-fund legislation
- regulations are written by staff members of the agencies charged with enforcing the regulations
operating and enforcement agencies that carry out the law - FTC (federal trade commission)
- regulates content of food ads; enforces truth-in-labeling; challenges product claims when product crosses state lines
- things that are sold
operating and enforcement agencies that carry out the law - FDA
ensures safety of some domestic and imported food products
operating and enforcement agencies that carry out the law - FCC (federal communications commission
licenses radio and TV
public policy advocacy and legislation - resources - federal register
notices of public hearings, proposed and final rules, agency decisions, published weekly; lists changes in USDA food programs
public policy advocacy and legislation that affects nutrition education programs - Child Nutrition Reauthorization
covers NSLP, SBP, CACFR (Child and Adult Care Food Program), SFSP (summer food service program), SMP (special milk program), and WIC
public policy advocacy and legislation that affects nutrition education programs - The Farm Bill
covers national and international nutrition education, research, funding.
public policy advocacy and legislation that affects nutrition education programs - The Older Americans Act
funds nutrition programs in the community
