1. Promoting Healthy Eating and Active Living
Foundations For
Community Health Workers
(2nd Edition)
(2016)
Berthold, T., Editor
San Francisco, C.A.: Jossey-Bass
Chapter Seventeen
Copyright ©  by John Wiley & Sons, Inc., or related companies. All rights reserved.
Promoting Healthy Eating and Active Living

2. Reflection of Last Session
What did you learn?
Share data you found about local chronic disease
Patient self-management
Role of CHWs
Have students review what they learned from the last session on these key topics.

3. What You Will Learn
Identify key challenges to changing diets and levels of physical activity
Explain the general guidelines for healthier eating and drinking
Explain the general guidelines for healthy levels of regular activity or exercise
Analyze why a focus on health rather than weight may be most effective in supporting a client’s well- being and in fostering positive relationships between CHWs and their clients
Take time to discuss the objectives for today.

4. What You Will Learn
Explain a five-step approach to providing health education about nutrition, physical activity, or other health topics
Describe how to apply client-centered concepts and skills for supporting clients to establish healthier patterns of eating and living
Take time to discuss the objectives for today.

5. Words to know Body Mass Index (BMI) Vegetarian Food Security Vegan
Food Insecurity
Weight-Cycling
Saturated Fat
Weight-Inclusive
Trans Fats
Weight-Normative

6. Healthy Eating and Active Living

7. Common Barriers to Changing Our Diets
Family & Culture
Pleasure
Time & Money
Lack of Confidence
Prejudice, Stigma, Low Self-Esteem, and Depression

8. Health Promotion and Weight
Traditional weight-normative approach identifies certain people as having normal weight and others as overweight or obese
Views weight as a key indicator of health
Health focus is on weight-loss and dieting
Often results in pattern of weight-cycling, that is harmful to physical and mental health
Weight-inclusive approach equally respects people of all body sizes and weight
Focuses on specific health issues, behaviors, and outcomes
Emphasizes client-centered practices
Shown to improve physical and mental health outcomes

9. Principles of Weight-Inclusive Approach to Health
Do no harm.
Appreciate that bodies naturally come in a variety of shapes and sizes, and ensure optimal health and well- being is supported for everyone, regardless of weight
Given that health is multidimensional, maintain a holistic focus
Encourage a process focus (rather than end-goals) for day-to-day quality of life

10. Principles of Weight-Inclusive Approach to Health (cont.)
Critically evaluate the evidence for weight loss treatment and incorporate sustainable, empirically supported practices in prevention and treatment efforts
Create healthful, individualized practices and environments that are sustainable
Where possible, work to increase health access, autonomy, and social justice for all individuals along the entire weight spectrum. Trust that people move toward greater health when given access to stigma- free health care and opportunities.

11. Key Arguments in Favor of the Weight-Inclusive Approach
The Weigh-Normative Approach may:
The Weight-Inclusive Approach can:
Influence clients to invest time and energy without long-term success
Set patients up for years of weight cycling
Shift attention away from more achievable health outcomes
Stigmatize and shame people
Undermine or damage clients’ trust in the professional relationship
Uphold CHW code of ethics
Avoid further stigmatization
Apply client-centered concepts to support autonomy and development of sustainable action plans
Support patients of all sizes to focus on key health goals
Support patients to significantly improve physical and mental health
Develop and maintain professional relationships that enable trust and mutual respect

12. Talking About Weight and Health: Role Play, Counter

13. Talking About Weight and Health: Role Play, Counter
What was the CHW’s approach to supporting this client?
How did the CHW address the issue of the client’s obesity?
How effective do you thin the CHW’s approach was for this client?
What information did the client provide about her experience with dieting, weight loss, and health?
What would be a more effective way to support this client to promote her health and well being?

14. Talking About Weight and Health: Role Play, Demo

15. Talking About Weight and Health: Role Play, Demo
How did the CHW address the issue of weight and health in this role play?
How effective was the CHW’s approach? How did the client respond?
What did you like that the CHW said or did in the role play?
What would you do differently in working with this client, and why?

16. Nutritional Guidelines
Copyright © 2011, Harvard University. For more information about The Healthy Eating Plate, please see The Nutrition Source, Department of Nutrition, Harvard School of Public Health, and Harvard Health Publications,

17. Practical Guidelines for Healthier Eating
Support clients to develop nutritional plans that are:
Affordable
Accessible
Realistic
With the Family in Mind
Enjoyable
Non-judgmental

18. Approaches to Providing Health Education About Nutrition
Determine what the client already knows
Determine their interest in learning more
Share general information
Keep culture – and cultural humility – in mind
Provide more detailed nutritional information
Keep the information practical and specific to the client’s life circumstances

19. Supporting Clients with Healthier Eating
Identify ways to make a meal healthier:
Not eating or drinking a particular item (example, drinking soda)
Eating less of a particular item (a smaller order of fries)
Eating or drinking more of an item (such as more vegetables)
Substituting one food or drink for another (water instead of soda)
Support clients to develop a plan for preparing a healthy meal. The plan should include:
Where the client will shop
A shopping list
A menu for the meal
Recipes (should be easy to follow, and shouldn’t require too many steps or ingredients)

20. Supporting Clients with Healthier Eating
Other options:
Visit the client’s home to talk about the foods they have on hand, and how those foods may impact their health
Join the client on a trip to the grocery store and talk about food choices
Keep sample packaged foods on hand. Together with clients, examine labels and recommended portion sizes, to enhance understanding of key ingredients, such as trans fat
Become an expert on local resources:
Educational and support groups related to healthy nutrition
Food pantries
Hot meal programs
Programs that teach people how to prepare healthy and culturally relevant meals

21. Hypertension and Healthy Eating Pt. 1: Role Play

22. Hypertension and Healthy Eating Pt. 2: Role Play

23. Hypertension and Healthy Eating Pt. 3: Role Play

24. Physical Activity
Physical activity is defined as anything that gets the body moving (even if you’re doing the activity while sitting down)
Health benefits:
Reduces risk of developing many chronic conditions
Helps manage chronic conditions
Strengthens bones and muscles
Improves mood and mental health
Associated with longer life-expectancy

25. Physical Activity Guidelines (CDC)

26. Supporting Clients to Increase Activity Levels
When helping clients to develop an action plan, keep the following concepts in mind:
Injury prevention
Gradual or Incremental Change
Realistic and Affordable
Accessible
Enjoyable
Non-judgmental
With Others, or On Their Own
Community Resources

27. The Value of Taking Small Steps: Interview

28. The Value of Taking Small Steps: Interview
What health issues and barriers did David say his client faced?
As a coach, what approach did David take to supporting this client to increase her level of physical activity?
What value did engaging in physical activity have for this client?
What did you learn that you may wish to apply to your work as a CHW?

29. Action Planning and Exercise: Role Play, Demo

30. Practice
Let’s get healthy! For the next week try to remove/reduce one unhealthy item from your diet or increase your amount of physical activity.
Complete Chapter 17 HW & DB in Blackboard
Read Chapter 18

31. Resources: Image on slide 2
digital-drugs-binaural-beats by digitalbob8 is licensed under CC BY 2.0
Image on slide 3
Bring Light Bulb is available in the public domain under CC0 Public Domain
Video on slide 5
Healthy Eating and Active Living: Making the Healthy Choice the Easy Choice (English) by American Cancer Society is licensed under a Standard YouTube License
Video on slide 11
Talking about Weight and Health: Role Play, Counter by Foundations for Community Health Workers is licensed under a Standard YouTube License
Video on slide 13
Talking about Weight and Health: Role Play, Demo by Foundations for Community Health Workers is licensed under a Standard YouTube License
Video on slide 20
Hypertension and Healthy Eating, Part 1: Role Play, Demo, Foundations by Foundations for Community Health Workers is licensed under a Standard YouTube License
Video on slide 21
Hypertension and Healthy Eating, Part 2 Role Play, Demo, Foundations by Foundations for Community Health Workers is licensed under a Standard YouTube License

32. Resources: Video on slide 22
Hypertension and Healthy Eating, Part 3 Role Play, Demo, Foundations by Foundations for Community Health Workers is licensed under a Standard YouTube License
Video on slide 24
Physical Activity Guidelines -- Introduction by Centers for Disease Control and Prevention is licensed under a Standard YouTube License
Video on slide 26
The Value of Taking Small Steps: Interview, Foundations by Foundations for Community Health Workers is licensed under a Standard YouTube License
Video on slide 28
Action Planning and Exercise: Role Play, Demo, Foundations by Foundations for Community Health Workers is licensed under a Standard YouTube License
Image on slide 29
Bike is available in the public domain under CC0 Public Domain

33. Acknowledgements: MoSTEMWINs
Adapted from the Foundations for Community Health Workers, 2nd Edition (Berthold) with permission from Wiley Publishing.
Unless otherwise noted this material by St. Louis Community College is licensed under a Creative Commons Attribution 4.0 International License.
This product is partially funded by the MoSTEMWINs $19.7 million grant from the U.S. Department of Labor Employment and Training Administration. The product was created by the grantee and does not necessarily reflect the official position of the U.S. Department of Labor. The Department of Labor makes no guarantees, warranties, or assurances of any kind, express or implied, with respect to such information, including any information on linked sites and including, but not limited to, accuracy of the information or its completeness, timeliness, usefulness, adequacy, continued availability, or ownership
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