1. Nutrition Counseling and Behavior Change Melissa Millerschoen Brooke Barley

2. PRESENTATION OUTLINE Theories of Behavior Change  Transtheoretical Model  Social Cognitive Theory  Motivation Theory Diversifying Dietetics  Changing field  Necessary Competencies

3. TRANSTHEORETICAL MODEL Stages of Change  Precontemplation  Contemplation  Preparation  Action  Maintenance  Drop Out Possible Processes of Change  Consciousness raising  Dramatic relief  Helping relationship  Stimulus control

4. TRANSTHEORETICAL MODEL Lessons  Not everyone is at the same readiness level for behavior change  Need programs tailored for each stage of stage  Appropriate programs should apply processes of change to stage of change

5. SOCIAL COGNITIVE THEORY

6. Self efficacy  “I feel that I can…” Outcome expectations  What happens next?  From previous experiences  Ex. You know that if you reduce your daily calorie intake you will lose weight. Outcome values  How much does the outcome mean to you?  Ex. How important is it to lose weight?

7. MOTIVATION THEORY Types of Motivation  Intrinsic  Curiosity  Mastery of a task  Stimulating experiences  “Rewards from within”  External  Avoid punishment  Tangible rewards

8. MOTIVATION THEORY Applications  Find out how students/clients are motivated  Greater intrinsic motivation=greater adherence rates  Help students to integrate behavior into their vision of self  Ex. Those who define themselves as exercisers/healthy eaters/goal- oriented students are more likely to stick to a behavior

9. THEORIES ONLY GO SO FAR... Several theories are used to achieve behavior change, but understanding the client and his or her background is crucial to success There is no one process that will work for every client Each client is very unique, and understanding a person’s culture is necessary to developing a plan for change

10. MULTICULTURALISM IN DIETETICS Because nutrition counselors are evaluated on their ability to produce desirable behavioral changes in clients, connecting with their culture is essential Nutrition counselors shouldn’t view multicultural competence as a luxury or a specialty but as a requirement Need to be knowledgeable about diverse diet

11. DIVERSIFYING DIETETICS Diversity in counseling may include differences in:  ethnicity  religion  group affiliation  socioeconomic status The population of Registered Dietitians is currently one of the least diverse fields  Reflect “Salad-Bowl” population  Gap between provider and public

12. SKILLS FOR EFFECTIVE COUNSELING Be aware of culturally appropriate and inappropriate practices when applying medical nutrition therapy Be aware of how your own cultural background, experiences, attitudes, values and biases affect counseling Value and respect differences According to the 2000 U.S. Census, whites make up 75.1% of the total U.S. population; Hispanics, 12.5%; blacks, 12.3%; and Asians, 3.6%.

13. CULTURAL COMPETENCY Understand food selection, preparation, and storage in a cultural context Have knowledge of family traditions, celebrations and special concerns such as fasting Stay up to date on latest food practices and problems facing various ethnic and racial groups

14. Relation to Education “Teachers need to know how to connect what is taught to the experiences, needs, attitudes, and expectations of those they teach.” Majority of teachers are white and middle class in classrooms that are more becoming more racially and linguistically diverse Establishing a Culturally Appropriate Practice  accepting learners experience, value and taste  acknowledging culture of all groups  altering instruction to fit learns needs and learning styles

15. QUESTIONS?