Ahaa, ito pala si Jayme ang batang payatot!

Interventions

“Ako si Jayme. Payatot at malungkot!

Behavioural “PICKY EATER”

m8m malnutrition TB Hemorrhagic stroke

breadwinner Caregiver (controlling) Index patient

Parenting Style and Family Meals: Cross-Sectional and 5-year Longitudinal Associations Parenting style has the potential to impact eating behaviors Parenting style has the potential to impact eating behaviors Authoritative parenting style predicted higher frequency of family meals Authoritative parenting style predicted higher frequency of family meals Child BMI was also positively associated with parental stimulation of healthy intake Child BMI was also positively associated with parental stimulation of healthy intake High parental control over child eating interferes with children's self-control over their intake thus leading to a deviant eating style High parental control over child eating interferes with children's self-control over their intake thus leading to a deviant eating style

FAMILY APGARFM 1FM 2 ADAPTATIONI am satisfied that I can turn to my family for help when something is troubling me 12 PATNERSHIPI am satisfied with the way may family talks over things with me and shares problems with me 22 GROWTHI am satisfied that my family accepts and supports my wishes to take on new activities or directions 22 AFFECTIONI am satisfied with the way my family expresses affection and responds to my emotions, such as anger, sorrow or love 22 RESOLVEI am satisfied with the way my family and I share time together 22 OVERALL ASSESSMENT 910 Highly Functional

Parameterresourcepathology SOCIALThe family has a good relationship with each other and also among the members of the community because the parents have a lot of relatives in the community Although they have good relationships with each other. The father is always out for work which would impair their relationship with each other in the future. Also, the extended family does not share with the family’s success. They even envy and try to bring each other down. CULTURALThe family has good kinship practices, they can rely on each other. They believe in traditional practices which make them bonded with the community Some practices, like hilot, are not helpful in treating severe conditions and a lot of times, it will make the illness worse. ReligiousThe family members are all Roman CatholicsThe family is not active with their practice and does not go to church regularly EconomicIn the economical aspect, the family can pay and provide for their basic needs The family’s resources are only enough to provide their everyday necessities but when emergencies or crises happen, their finances may not be able to cover for them. EducationalThe family is able to finish basic education and has access to health education in the health center. Even though they have this basic education, they have health misconceptions which prevent them from seeing the gravity of their health situation. Their knowledge of basic health is inadequate the protect them in their environment. MedicalThe family lives near the health center which makes it easily accessible for them. Also, the Ilugin local government and NGO’s have good programs that they can access. The mother is enrolled to Philhealth. For now, there are medical programs which are advantageous to the people and good, but when the time comes that there serious illnesses which cannot be handled by the health center, the family does not have enough resources to seek help from other institutions.

Interventions

Transtheoretical Model of Change by Prochaska & DiClemente, 1983.

Pre-Contemplation Increasing awareness Increasing awareness Does the family recognize the need for a change? Does the family recognize the need for a change? Educate the family on the importance of a healthy lifestyle and diet Educate the family on the importance of a healthy lifestyle and diet Do they understand the consequences of unhealthy eating habits and opposing parenting styles? Do they understand the consequences of unhealthy eating habits and opposing parenting styles? Teach them about the short term and long term effects of being unhealthy Teach them about the short term and long term effects of being unhealthy Do they see the benefits of living a healthy lifestyle? Do they see the benefits of living a healthy lifestyle? ‘Quiz’ them on their learnings ‘Quiz’ them on their learnings

Contemplation Re-affirm the family’s decision to make changes Re-affirm the family’s decision to make changes Praise the family’s decision to commit to change Praise the family’s decision to commit to change State, once again, the benefits that they will gain from it State, once again, the benefits that they will gain from it Assure that you support their decision Assure that you support their decision

Preparation Target and build specific knowledge and specific skills Target and build specific knowledge and specific skills Make a list of objectives Make a list of objectives Set achievable goals for the family Set achievable goals for the family Start with small, realistic goals that are easy to attain Start with small, realistic goals that are easy to attain

Action Child Child Start slowly but surely Start slowly but surely Introduce vegetable and fruits one at a time Introduce vegetable and fruits one at a time Encourage but not coerce Encourage but not coerce Use of coercive control tactics to counter children’s resistance during mealtimes resulted to problematic eaters (Sanders, et. al., 1993) Use of coercive control tactics to counter children’s resistance during mealtimes resulted to problematic eaters (Sanders, et. al., 1993)

Action Child Child Set simple cognitive rules Set simple cognitive rules Vague instruction giving was particularly likely to be associated with increased food refusal and decreased chewing (Sanders et. al, 1993) Vague instruction giving was particularly likely to be associated with increased food refusal and decreased chewing (Sanders et. al, 1993) “When, then” rule “When, then” rule

Action Parents Parents Establish a unified parenting style Establish a unified parenting style Authoritative parenting style Authoritative parenting style Communicate with one another Communicate with one another Set an example to children Set an example to children

Maintenance Are they aware of the change they have achieved? Are they aware of the change they have achieved? Are they aware of the things that they may tempt them to revert in their old behavior? Are they aware of the things that they may tempt them to revert in their old behavior?

Maintenance Operant conditioning: creating an environment that will support healthy eating habits and reduce exposure to bad eating healthy habits Operant conditioning: creating an environment that will support healthy eating habits and reduce exposure to bad eating healthy habits

Maintenance Availability of high fat, high sugar foods are considered antecedent of poor eating habits (Bowmann and Pratt, 2008) Availability of high fat, high sugar foods are considered antecedent of poor eating habits (Bowmann and Pratt, 2008) o Discourage buying junkfoods, chocolates and candies o Discourage buying noodles and other unhealthy alternatives

Maintenance Reinforce positive behavior by commending good behavior Reinforce positive behavior by commending good behavior Associate healthy eating with happiness. Make eating time a pleasurable activity Associate healthy eating with happiness. Make eating time a pleasurable activity Be involved in community programs that motivate them to continue the change. Be involved in community programs that motivate them to continue the change.

Maintenance Addressing other issues that will contribute to the problems (e.g. finances) Addressing other issues that will contribute to the problems (e.g. finances)