There are 3 major focuses of community nutrition, what are they
People, policy and programs
Health promotion focuses on healthful ____, ____, regular ____, develop ____ activities, strong ____ networks, and balance among ____. Focuses on people who do not have this lifestyle.
diets, activity, rest, leisure, social, family
Three types (levels) of PREVENTION EFFORTS:
Primary prevention is________, preventing disease.
Secondary prevention is ____ disease or illness early through screening and risk appraisal.
Tertiary prevention is aimed at ____ or treatment of illness and rehab.
controlling risk factors, detecting, recovery
What are some social and economic trends for community nutrition:
In 2000, 25% of the workforce were ________, by 2020 more than 55% of the workforce is expected to have completed college.
Traditional family norms and structures are changing rapidly with more ____ in the workforce.
40% of the population have a ____ or condition.
The fastest growing segment of population consists of people over the age of ____ years.
Community Nutritionists need to learn to change and evolve with these growing groups and demographics.
As ________ move into their retirement age, they are expected to seek out information and opportunities to live healthier longer lives. The aging population will place many demands on the health care system. An estimated 46 million persons in the US including 8 million children are ____. Securing access to health and nutrition will be a challenge for growing nutritionists
college graduates, women, chronic disease, 65, baby boomers, uninsured,
what is a community needs assessment:
Describes ____-related problems that exist in the ____. Indicates the felt or perceived needs of the community and its desire for a ____. Establishes ____ and identifies ____ that exist to deal with the problem
nutrition, community, solution, priorities, resources
what does the process of a community needs assessment consist of ___ steps
7 principles (steps) of the community needs assessment:
(1) define the nutritional problem, (2) set the parameters for the assessment, (3) collect data (about community, background conditions, (4) the individuals who represent the target popultation), (5) analyze and interpret the data, (6) share the findings of the assessment, set priorities, (7) choose a plan of action
Entrepreneurship, 3 different areas:
________ - formal process to impart knowledge to group or individual.
________ - approach to promote healthy behaviors using marketing techniques.
________ - collaborative activity between counselor and client
nutrition education, social marketing, nutrition counseling
health belief model theory: based on ____ components for adopting ______
three, new health behavior
three components of the health belief model:
the perception of a threat to health, expectations of certain outcomes related to a behavior (benefits), self-efficacy (the belief taht one can make a behavor change to produce outcomes)
assessing the nutritional needs of target population:
1: ____ the ____, ____, and ____ of the needs assessment.
2: ____ a set of ____ related to the target population's nutritional problem, how it ____, and the ____ that influence it.
3: ____ a ____ for obtaining answers to these questions.
review, purpose, goals, objectives, develop, questions, developed, factors, choose, method
data collection of target pop:
____, ____, ____, ____ groups, ____ with key informants, ____ assessment of nutritional status, diet ____ method,____ recall, diet ____ method, food ____ method, ____ methods, ____ methods, ____ methods
survey, health risk appraisal, screening, focus, interview, direct, history, twenty-four hour, record, frequency, laboratory, anthropometric, clinical
what are focus groups in community nutrition and what are they used for:
Usually consist of ____-____ people who meet in sessions lasting about ____-____ hours. The group members are brought together to talk about their concerns, experiences, beliefs or problems.
These groups are used to obtain advice and insights about new ____ and ____, research data and information about key variables used in ____ studies, and opinions about products or creative concepts such as advertising campaigns or program logos.
5, 12, 1, 3, products, services, quantitative
Issues in data collection (3)
practical issues, scientific issues - sensitivity vs. specifity and validity vs. reliability, cultural issues
ISSUES IN DATA COLLECTION:
PRACTICAL ISSUES: the number of staff available to collect and analyze data
a) two issues to consider when choosing an assessment method:
_____: the proportion of individuals in the sample with the disease or condition who have a positive test for it
_____: the proportion of individuals in the sample without the disease or condition who have a negative test for it
b) two questions arise when evaluating assessment methods:
______: accuracy, customary dietary intake over a period of time
______: ability to produce the same estimate of dietary intake both occasions
cultural evaluation assessment
sensitivity, specifity, validity, reliability
when assessing target population, have to look at cultural issues: ____ systems, ____ rituals, ____ and social customs, ____ communication
belief, food, etiquette, nonverbal
what are the triggers that call for program planning in community nutrition:
The decision to develop a nutrition program is usually made in response to a ________ event. Examples could include results of community ________, ________, government policy, availability of new funding, etc.
precipitating, needs assessment, research findings
steps in program planning, what is something one would look at in own organization before developing or modifying a program:
Community nutritionist always review their ________ before developing a program. Which is a broad statement or declaration of an organization's purpose or reason for being. The community nutritionist ensures that all programs ____ their organization's mandate.
mission statement, fulfill
Steps for program planning are:
1. ____ of the community needs assessment
3. ____ a program ____
Design the ____
Design the ________ component
Develop the ____
4. ____ the ______ system
5. ________ sources
6. ____ the program
7. Evaluate program elements and effectiveness
review the results, define program goals and objectives, develop, plan, intervention, nutritional education, marketing plan, define, management, identify funding, implement
when designing the nutrition education component of a program, look at: ____, ____ ________, ____, ________, ________, and ____
needs, goals and objectives, format, program identifiers, marketing plan, partnerships
program evaluation process, what is the purpose and scope: The purpose is to ____ information for making decisions about redistributing ____, ____ program delivery, or ____ a program. Evaluations also serve to ____ the community at large about a program's success or failure. purpose and scope depend on the _____ being asked about the program.
gather, resources, changing, continuing, inform, questions
what are challenges one will face in a multicultural evaluation:
Evaluator must strive to remain neutral in the face of competing________. Evaluator must ____ and ____ the views and interests of the minority groups to ensure that their needs are being met. Evaluator must be ____ to the cultural differences that make implementing the evaluation difficult.
minority interests, search out, define, sensitive
**Steps in the nutrition care process**:
Step one: ________. The nutrition professional collects and interprets data from various sources in order to identify problems and concerns.
Step 2: ________. Clearly identify, label and describe an existing nutrition problem which can be resolved or improved through nutrition intervention.
Step 3: ________. Client driven method used to resolve or improve the nutrition problem or the underlying cause.
Step 4: ________. Routinely done to determine whether nutrition intervention goals and objectives are being achieved
nutrition assessment, nutrition diagnosis, nutrition intervention, monitoring and evaluation
what should be a part of one's NUTRITION EDUCATION PLAN:
The ____ of the target population, ________ for intervention, program ____, ____ plans, nutrition ____, ____ plan, ____, and ____ instruments
needs, goals and objectives, format, lesson, messages, marketing, partnerships, evaluation
lesson plan (difference between lesson plan and education plan):
Lesson plans: Identify ____ concern to be communicated, concentrate on end product for learner, include components such as: lesson ____, target ____, duration, ____ objectives, specific objectives, procedure, learning experiences, evaluation, ____ needed
Education plans: identify the needs of the target population, goals and objectives for intervention, program format, lesson plans, nutrition messages, marketing plan, partnerships and evaluation instruments
EDUCATION PLANS ARE _______
major, title, audience, general, materials
much more detailed
marketing nutrition and health promotion:
Marketing: process by which individuals and groups __________________________________
get what they need and want by creating and exchanging products and values with others
the 4 P's of marketing:
product, place, price, promotion
what is social marketing:
programs that seek to increase the acceptability of a social idea or practive among a target group
def of epidemiology: Epidemiology is the study of the ...
distributions and determinants of health-related states and events in a specific population and the application of this study to control health problems
what is hypothesis testing and epidemiological method:
Hypothesis testing: Once the specific research questions (hypothesis) has been formulated, the investigators design a study to obtain information that will enable them to ________________
The epidemiologic method includes ____, ________ or events, ____ cases or events to the pop at risk, making ____, developing the ____, ____ the hypothesis, drawing scientific ____, conducting experimental studies, ____ and evaluating
make inferences about the original hypothesis, observing, counting cases, relating, comparisons, hypothesis, testing, inferences, studies, intervening
what are the different types of studies:
ecological/correlational, cross-sectional/prevalence, cohort, case-controlled, controlled trials
Ecological or correlational studies: __________________________ with the per capita consumption of certain dietary factors.
compare the frequency of events in different populations (trans fat causing heart disease, sugar substitute causing cancer)
Cross-sectional or Prevalence studies: a group of people are followed ____ to see who develops a particular ____ and what ____ they have been exposed to. Much like a ________
over time, disease, risks, camera snap-shot
Cohort studies: Are like ____ of events occurring w/in pops. A group of people____________ is identified and examined. This group is called the cohort. The cohort is followed for months or even years and examined periodically.
moving pictures, free of disease or condition of interest
Case-controlled studies: A group of persons or cases ____________compared with a group of persons without the disease or condition.
with the disease or condition of interest are
Controlled trials: The randomized controlled trial or clinical trial conducted as a ____ experiment is the most ____ evaluation of a dietary hypothesis.
definition of policy making and process: Policy making is the process by which authorities decide which actions to take to address a problem or set of problems, and it can be viewed as a cycle.
problem definition and agenda setting, formulation of alternatives, policy adoption, policy implementation, policy evaluation, policy termination
emerging policy issues:
________, ________, ________, complementary and alternative medicine, biotechnology, bioterrorism and food safety
functional foods, human genome project, growing dietary and herbal supplement market
how can a community nutritionist influence policy making:
________ to the editor, become directly involved in policy making, ________, sponsor a referendum, ________, file a class action lawsuit in court, join a public action committee, ________, make effective telephone calls, work with the media
write a letter, run for office, join an interest group, lobby at state capitol
definition of managed care insurance: An approach to paying for health care in which ____________________, ________, ________. These health plans are subject to utilization review.
insurers try to limit the use of health services, reduce costs, or both
difference between Medicare and Medicaid: Medicare is a federally run entitlement program through which people age 65 or older and people in certain other eligible categories receive health insurance. Medicaid is a federally aided, ____-administered ____ program that provides medical benefits for certain ________ persons in need of health and medical care.
state, entitlement, low-income
what population is uninsured or underinsured: The uninsured are generally the ____, the ____, ____________, the unemployed, full time workers whose employers offer unaffordable insurance or none at all, and early retirees.
working poor, self-employed, part time and seasonal workers
what is healthy weight gain during pregnancy: Underweight=____ lbs Normal=____ lbs Overweight= ____ lbs Obese=____ lbs
28-40, 25-35, 15-25, 11-20
suggested weight gain during 1st trimester: ____ lbs
characteristics of adolescent pregnancy: Pregnant adolescents are nutritionally at risk for _____, _____ deficiency, _____, _____ birth, stillbirth, _____ infants, _____ labor
hypertension, iron, anemia, premature, LBW, prolonged
breast feeding recommendations: Helps protect against ____, protects against ____ development through increased immunological properties, favors normal tooth and jaw alignment, baby less likely to become ____, convenience and lower cost, aid in maternal ____, bonding btwn mother and infant, ____ availability-lower total amount, but more bioavailable to infant.
infection, allergy, obese, weight loss, iron
Breast milk contains what antibacterial agent?
What age do infants require iron supplement:____ months
barriers of breast feeding:________, absence of work policies and facilities, portrayal of________, ________________
lack of knowledge, bottle feeding as the norm, lack of support and incentives for low income women
two primary nutrition related problems of infancy:
food allergies and iron deficiency
WIC program is based on what 2 assumptions:
1. That ____________ and health behaviors of low-income women, infants and children make them vulnerable to ____________.
2. That ____________________ of growth and development will prevent health problems and improve the health status of participants
inadequate nutritional intakes, adverse health outcomes, nutrition intervention at critical periods
Is WIC federally or state funded or both?
federally funded; administered by the states
Who qualifies for WIC: Financial eligibility is determined by ____ (btwn 100 and 185% of the poverty guidelines or below)
what kinds of food are provided by WIC: iron-fortified ____________, iron fortified ___________, vit-C rich________, ____, ____, ____, ________, ____________, ________, and ____________.
New foods added include ____ tortillas, ____, ____ beverages, tofu, ____.
infant cereal and formula, breakfast cereal, fruit and vegetable juice, eggs, milk, cheese, peanut butter, dried beans and peas, canned fish, fruits and vegetables
whole grain, brown rice, soy, baby food
Is WIC an entitlement program: WIC ____ an entitlement program and therefore can serve only as many people as its annual appropriation from congress permits
Definition of SNAP: ________________ (food stamp). It is designed to ________ of people with ________ by providing benefits to cover part or all of the household's food budget.
supplemental nutrition assistance program, improve diets, low incomes
What is a commodity supplemental food program: CSFP is a ____________ providing supplemental ____ and nutrition ____. It provides supplemental foods to ____ and ____ and to ____, _____/____ women with low incomes.
direct food distribution program, food, education, infants, children pregnant, postpartum/breastfeeding
what is a nutrition related problem in adolescence: Prevalence of ____ among children and adolescents of all ethnic groups has increased substantially. ____ deficiency, ____, ____ caries, ____________are all problems
overweight, iron, undernutrition, dental, high blood cholesterol
some programs that help with adolescent nutrition:
national school lunch program, after school snack program, summer feeding program, snap, wic
what are the most important factors for aging people in nutrition:
To help consumers select diets providing enough ________________,
Varied in types of fat; moderate in total fat, sweeteners, sodium, cholesterol, and alcohol
Adequate in complex CHO and fiber
energy to maintain healthful weight, meet recommended intakes for all nutrients
Characteristics of baby boomers: Have the power to change the ____, make decisions based on ________, are constantly ________, look for ____ and ____ in their investments, will not age ____, like ____.
marketplace, personal beliefs, pressed for time, value, quality, gracefully, nostalgia
Primary nutrition-related problems of aging?
Functional capacity ____ in almost every organ system
Changes in ____ of nutrients
____, ____, ____, ____ factors
declines, absorption, chronic diseases, physiological, psychological, environmental, socioeconomic
What was the DETERMINE questionnaire used for: Determines whether or not there is a need for _____. Those identified as ____ should be followed up with more in-depth ____ and _____ of nutritional status.
services, at risk, screening, assessment
What are some nutrition programs that focus on older adults:
general assistance programs, programs of the usda and dhhs, the older americans act, cacfp
most cost effective nutrition service
breastfeeding important the first two or three days:
the breast produces ____, a premilk substance containing ____ and ____ from the mother's blood.
bifidus factor - ____________
colostrum, antibodies, white cells, favors the growth of "friendly" bacteria