Huec 2019 Final - Ncp And Couseling

Front 1

What does counseling involve ? (5)

Back 1

listening, accepting, clarifying, helping clients to form their own conclusions, helping clients develop their own action plan

Front 2

to change peoples eating behaviors for the improvement of their health and the reduction in the development of chronic diseases

Back 2

the goal of nutrition counseling

Front 3

the use of specific nutrition services to treat an illness, injury or condition

Back 3

the goal of medical nutrition therapy

Front 4

Nutrition counseling --> ___ --> ____ --> ______

Back 4

Change in food choices, altered risk factors, better health

Front 5

an individualized intervention based on the assessment ; includes setting goals for clinical outcomes, problem solving, alternatives for the client to consider, negotiating dietary goals for change, enchaning self management, evaluate and follow- up

Back 5

nutrition counseling

Front 6

What are the objectives of the Patient Centered Counseling Model?

Back 6

Increase awareness of diet-related risks, provide nutrition knowledge, increase confidence to make dietary changes, enhance skills to promote long term changes in intake

Front 7

What are the 4 steps of patient-centered counseling ? (AAAF)

Back 7

Assess , Advise, Assist , Follow-up

Front 8

gathering information about the clients current and past eating patterns, history of health problems, readiness to change, reasons for wanting to keep current eating behaviors; discuss concerns about changing diet ( feelings about certain changes, past experiences with diet changes or attempts) , ask about strategies that may have/havent helped in the past

Back 8

Assess of Patient Centered counseling model

Front 9

use open ended questions ; how do you feel about your current diet? what problems have you had because of your diet? what would you liketo change about your diet now? what would motivate you to maintain your current diet? Have you ever made changes in your diet? What helped? What situation make it hard for you to acheive your goal?

Back 9

Assess of patient centered counseling model

Front 10

Offering advice ( needs to be specific to client's needs, include reasons for change, include the client's personal preferences, discuss the benefits for dietary change) Advice must be personalized and should validate what the patient is stating!!! builing of rapport and paraphraising

Back 10

Advise of patient centered counseling model

Front 11

Intervention( P of PES) Guidance and help given to patient, depends on their readiness to change(State of change) , Responsibility of the counselor ( provides nutrition information, corrects misunderstanding, addresses and validates feelings about dietary changes, provides support, optimistic and motivational in regard to change .... Ex: i know its hard to adhere to your dietary goals during vacation.

Back 11

Assist of patient centered counseling model

Front 12

visits are important, may need to revise goals, may need to implement new strategies, evaluating outcomes of behavior change

Back 12

follow up of patient centered counseling

Front 13

frame work for thinking and decision making, developed by ADA, provides stradardized launage

Back 13

Nutrition Care Process

Front 14

What are the 4 steps of the Nutrition care process?

Back 14

nutrition Assessment, nutrition diagnosis, nutrition intervention, monitoring and evaluation

Front 15

What is the purpose of the nutrition assesment in the NCP?

Back 15

to obtain information, verify information, interpret data ( needed to make decision about the nutrition related problem )

Front 16

needed to identify the nutrition diagnosis, the nutritional goals for change, the type of nutrition intervention need to achieve the goals, the evaluation of outcomes

Back 16

The need for assessment in the NCP

Front 17

What types of data should you collect during assessment?

Back 17

biochemical, anthropometric, physical examinations, food and nutrition historys, client or patient history

Front 18

gather data in ADVANCE about the pt that may impact treatment (medical record) ; anthropometric measurements, biochemical data, occupation, education level, cultural back ground, physical activity, functional status, housing situation

Back 18

1st step in nutrition assessment

Front 19

gather information from the interview (not avalible in medical record) can be self administered questionaire or collecting anthropometric and food and nutrition data through the interview ; should ask questions that would provide information on physical env, cognitive and mental env, social (support)env, cultural background or religion, economic issues.... trying to find out what factors influence their clients eating and lifestyle behaviors

Back 19

2nd step in nutrition assessment

Front 20

What should be done by the counselor after the data is gathered from the assessment? (4)

Back 20

determine which information is relevant to the problem, organize the data in a meaningful way, document the assessment, determine the nutrition diagnosis

Front 21

what the RD is treating (nutrition dx = excessive intake of K) standardized language. Documented in a PES statement

Back 21

Nutrition Diagnosis

Front 22

what does PES stand for?

Back 22

P = problem (from nutrition diagnosis sheet)
E= etiology, cause of the problem , risk factors ("related to")
S= Signs and symptoms, defining characteristics of the problem, or severity of problem("as evidenced by")

Front 23

What are the 2 phases of Nutrition intervention?

Back 23

1st = goal setting (includes selecting the nutrition intervention)
2nd= implementation

Front 24

the responsibility lies with the pt, the counselor can help with solving problems/helping with goals and plans, intervention should be based on the Self Management approach (client is involved in their own health care, actively involved in making the decisions)

Back 24

goal setting of the nutrition intervention

Front 25

What should you do before continuing with goal setting and intervention?

Back 25

Praise those behaviors that do not need changing! reinforce the current food choices that the pt is already doing right!!

Front 26

start by discussing what you see as the most important issues to address; then have the client discuss what they are willing to consider changing;
This stage involves listening, questioning, accepting, clarifying, helping clients find solutions to their problems, helping clients develop their own plan of action.

Back 26

Nutrition Intervention

Front 27

mutually negotiated based on
#1- the NCP
#2- desired clinical outcomes (wt loss, meeting my pyramid, meeting DG, lower FBS, lower lipid levels, decreased incidents of emotional eating, decreased waist circumference)

Back 27

Goal Setting of Nutrition Intervention

Front 28

What are some questions to ask to help with determining the focus for the goals? during Goal Setting of Nutrition Intervention

Back 28

Which os these alternatives or changes do you think you could try? what would be the easiest? the hardest?
Is this the right time to make changes?
Do you think you can succeed?
What food could you substitute?
How will things be better or worse after you make the change?
How do you feel about making the change?

Front 29

During what State of Change is it appropriate to apply goal setting?

Back 29

preparation, action, maintenance

Front 30

What are the 4 steps for Goal Setting?

Back 30

1. goal identification
2. goal importance assessment
3. goal roadblock analysis
4. goal implementation

Front 31

negotiate, allow client to choose 1 or 2 problems to address first ("which one of the changes do you think that you can make this week?" - this allows the client to accept the changes better, if they choose which problems to work on)
goals selected should be stated in positive, concrete terms - specific, measurable, reasonable, attainable.

Back 31

Goal Identification (step 1)

Front 32

"I will eat fruit instead of baked desserts today."

"I will walk for 20 minutes on Monday, Weds, and Friday this week."

are examples of short term goals that are 1 step away from the current behavior (a small step that can be progressively increased)
This helps with self-motivation and self - efficacy

Back 32

Goal Identification (step 1)

Front 33

Before moving on to the second step in Goal setting what should the counselor do?

Back 33

after the client chooses 2 obstacles to work on write 3 to 4 goals that would address those obstacles

Front 34

RD must assess which goals the pt thinks is important (if not perceived as important by the client, then will probably not be achieved)
On a scale from 1 to 10 how important is this goal to you?

Back 34

Goal Importance Assessment (2nd step)

Front 35

What are the 3 factors that affect Goal commitment of the Goal Importance Assessment (2nd Step)?

Back 35

1. the value the person places on the activity
2. the perceived attainability of the goals
3. Binding pledges people make to other concerning their future performance

Front 36

"What problems do you see in achieving this goal?"
"What might interfere?"
Includes lack of knowledge, lack of skills, inability to take risks, lack of social support at home

Back 36

Goal Roadblock Analysis (step 3)
- your job is to give advice on how to overcome these obstacles if they can be overcome - if not identify another goal

Front 37

client discusses what specific steps they plan to take to achieve the goal ;
achieving goals = increased motivation, knowledge, skill, and interest
the motivation comes from the evaluation of the pt's own behavior
(having standards to measure performance helps motivation to continue: wt loss or lowered BP)

Back 37

Goal implementation (step 4)

Front 38

also known as the trans theoretical model; used to understand a client's readiness to change

People progress through 6 stages: contemplation, contemplation, preparation, action, maintenance, termination

Back 38

Stages of Change Model

Front 39

In the Stages of Change Model the decision to move to another stage occurs when __________________________

Back 39

the advantages of a behavior outweigh the disadvantages

Front 40

The Key to successful counseling and education = ________

Back 40

assess and identify the stage of change

Front 41

The _______ step is based on the stage of change

Back 41

intervention

Front 42

unaware that a problem exists, in denial of the problem, not interested in change, has no plans to change eating habits or lifestyle in the near future, usually has no intention of changing in the next 6 months

Back 42

precontemplation stage

Front 43

What can I do to help? What do you know about diabetes and its relationship to cardiovascular disease? How do you feel about making a change?

Back 43

Precontemplation Questions

Front 44

intends to change but not soon, aware that problem exists, does inted to do better eventually, however no serious commitment to make a change, keeps putting it off, maybe discouraged by past failures, may be other barriers to trying ( money, effort...)

Back 44

contemplation stage

Front 45

What changes have you been thinking of?
What are the advantages or disadvantages to making the change?
What would be the result of making the change?

Back 45

Contemplation Questions

Front 46

more determined to change, intends to take action soon(possibly within a month or 2), may already report some small changes in the problem behavior(reading food labels, drinking low fat milk, adding one veggie at dinner) , can plan goals during this stage

Back 46

preparation stage

Front 47

What changes have you already made?
how will you make additional changes?
How will your life be improved if you change?

Back 47

Preparation Questions

Front 48

actively modifying food choices, behaviors, environments....
requires alot of pt dedication, help your client get to this stage, offer support for those in it, can plan goals

Back 48

action stage

Front 49

what are you doing differently?
what problems are you having?
what do you do instead of the former behavior?

Back 49

action stage questions

Front 50

stabilize changes made(behavior becomes a habit), has maintained changes for at least 6 months (maintains wt, activity level...) this stage can continue for months years or lifetime, now working with pt to prevent relapse providing support
can plan goals

Back 50

maintence

Front 51

What challenges have you encountered?
How have you solved them?
What are your next or continuing steps to maintain the new behavior or results?

Back 51

Maintenance (support ) Questions

Front 52

changes have been maintained for 5 years
some lifestyle changes require a lifetime of maintenance(wt, blood glucose..)
can plan goals

Back 52

Termination

Front 53

consciousness raising - focus on the benefits of the change (personalize)
Goal: to have the client think about the problem
Provide nutrition information about the benefits of the change (oral written internet)
no goal setting

Back 53

Precontemplation - Interventions Based on Stages

Front 54

unsure, low confidence
Goal: build their confidence
find out why they dont have the confidence or unsure if they can make the changes
examine the pros and cons (activity to do with the client)
discuss any past successes overcoming barriers
provide positive feedback about other behaviors and abilities
encourage to build support networks
no goal setting

Back 54

contemplation - interventions based on stages

Front 55

Goal setting,
Motivate: positive feedback, reinforcement of changes, models, risks of behaviors
Practical recommendations
Encourage client to make public the intended change

Back 55

Preparation - interventions based on stages

Front 56

motivated
negotiate action plan (goal setting , get clients ideas )
praise positive behaviors

Back 56

Action - interventions based on stages

Front 57

Goal setting, stimulus control, reinforcement management, self-monitoring techniques, recipe modification, coping responses, developing a social support system

Back 57

Action and Maintenance - interventions based on stages

Front 58

____ is the follow up step
____ is the comparison step(can compare to last visit or to a standard)
Purpose: determine progress, modify recommendations, change goals

Back 58

Nutrition Monitoring and Evaluation of NCP

Front 59

the measured result of the counseling process; a way to asses the benefits of MNT

Can evaluate he success of the client in the following goals set and implementing new eating behaviors, the degree of success of the nutrition intervention, own personal skills as a counselor.

Back 59

Out come of the Nutrition Monitoring and Evaluation of the NCP

Front 60

What should you discuss with client at a follow up visit (Nutrition Monitoring and Evaluation of NCP)?

Back 60

1st - what went well (success with goals)
2nd- examine any self monitoring records (jointly discuss the records)
3rd - discuss any difficulties or problems that came up ( discuss and determine how to overcome)
4th - if progrss is made establish new short - term goals (based on stage of change)

Front 61

What should be included int he documentation of the MNT in the Soap notes?

Back 61

the total assessment
the measurable goals set and plans to acheive them
the nutrition intervention
the evaluation

Front 62

uses standardized terminology to make a nutrition dx; write the nutrition dx in the form of a PES statement placed in the A section of soap notes

Back 62

The Nutrition Care Process

Front 63

What elements are included in the Communication Model? (5)

Back 63

sender, receiver, message (verbal/nonverbal), feedback(verbal/nonverbal), interference

Front 64

receiver interprets 2 _____ simultaneously:
Actual verbal and Nonverbal(from the sender and the environment)

Nonverbal includes (tone of voice, facial expressions, dress/appearance)

Back 64

messages of the Communication model

Front 65

reaction to a message (surprised, boredom or hostility)
helps determine if the receiver has the correct message

Back 65

feedback of communication model

Front 66

factors that affect the interpretation of messages (room size, temp, color, furnature arrangement, crying baby, etc) & physchological interferences ( can cause distortions of the message(bias, prejudice, close minded, fear of illness, cultural differences)
ITs the job of the sender to sense these _________

Back 66

interferences of communication model

Front 67

actual words selected by the sender

Back 67

verbal communication

Front 68

communication environment
manner and style the communication is delivered
internal qualities int he sender receiver that influences their interpretation

These are all forms of _________

Back 68

non verbal communication

Front 69

What are the Guidelines for creating a supportive environment? (5)

Back 69

discuss problems descriptively rather than evaluative, describe situations with a problem orientation rather than in a manipulative way, offer alternatives provisionally rather than dogmatically, treat clients as equals, be empathetic rather than neutral or self centered

Front 70

describe the facts objectively instead of evaluating the situation;
ex. you are continuing to eat 4 pork chops and 1/2 lb of chocolate a day, this is frusterating for me, what can we do?

Back 70

descriptive rather than evaluative

Front 71

orient clients to the problem ; client may not reveal the real reasons for not following meal plan until they feel secure that they will not be humiliated

Back 71

problem oriented rather than manipulative

Front 72

giving advice ___ = RD could change options if other facts emerge
(keeps the door open for the clients to add info)
offering advice in a dogmatic (rigid) manner= threating atmosphere
should say things like...
"here is one thing you may want to consider"
"there may be other ways of handling this problem, and you may have some ideas also."

Back 72

provisional rather than dogmatic

Front 73

regard the client as equal
any verbal or non verbal behavior can be interpreted as an attempt to emphasize superiority
collaboration is more effective than trying to persuade the client to do something ; people feel more obligation to uphold the solutions that they particiated in designing

Back 73

Egalitarian rather than superior

Front 74

put yourself in the client's shoes, demonstrate desire to understand what it is that the client is feeling
The listener sends the message that he/she wants to understand the words the speaker is saying and their feelings towards the changes; this allows the client to realize that the RD is listening

Back 74

Empathetic rather than "neutral"

Front 75

verifies that the message is being understood or interpreted correctly
essinital only when the discussion is centered on critical information that must be understood
often leads to additional info (longer session)

Back 75

Paraphrasing (verbal comm)

verbal message is usually deliberate

Front 76

critical skill for RD's to develop
keep your language clear and simpe

Back 76

paraphrasing

Front 77

tend to be more influential, generally unconscious
the image of a person projects accounts for over half of the total message conveyed

Main forms:
facial expressions, tone of voice, eye contact, gesture, touch

Back 77

Nonverbal comm

Front 78

first nonverbal trait noticed - a relaxed/pleasant ___ is congruent with a supportive climate

Back 78

facial expression

Front 79

calm, controlled, energetic, and enthusiastic ________ is congruent with a supportive climate

Back 79

tone of voice

Front 80

assures interest and desire to communicate _____ ""

Back 80

eye contact

Front 81

lean somewhat towards the person, not away is congruent to a supportive climate

Back 81

posture

Front 82

works positively in 2 ways :
can communicate instantly a desire to solve a problem (shows concern faster than verbally)
a vehical for feedback(can reveal nervousness and insecurity)

Back 82

touch

Front 83

communication between two people to exchange or obtain information (guided by questions)

Back 83

interviewing

Front 84

Goal of _________ to collect valid and accurate info from the respondent while maintaing an interpersonal environment conducive to disclosure

Back 84

interviewing

Front 85

What are the two types of interviews?

Back 85

Nutrition Interview and Pre-employment interview

Front 86

consists of gathering information on food habits, preferences, eating behaviors, other factors influencing food intake

Back 86

nutriiton interview

Front 87

What are the 4 purposes of Initial Nutrition Interview?

Back 87

identify diet and lifesyle factors that may affect the diet/health, to make a complete assessment of health status , to identifiy problems that may affect which goals are set for the client, to help RD to suggest alternatives to current practices, continue to build rapport, to discover any nutritional problems that need to be addressed in plan, to provide baseline data to help monitor changes

Front 88

What are the 4 types of nutrition interviews?

Back 88

Food record & 24 hr recall (daily food consumption methods)

Diet history & food frequency questionaire (usual or average food consumption)

Front 89

What are the advangtages of a 24 hr recall?

Back 89

quick, easy, nonthreating, recording isnt needed

Front 90

What are the 24 hr recall limitations?

Back 90

things tend to be left out, relies on memory, pt may with hold info, only getting one day(not usual)

Front 91

What can give you better results in your 24 hr recall?

Back 91

ask detailed questions, do more than 1 day/various days, weekend/weekday, multiple pass

Front 92

What are the advantages of a Food record or Diary?

Back 92

can track hunger, activity, etc
involves client
can focus on portion size
doesnt rely on memory

Front 93

What are the limitations of a food record or diary?

Back 93

may alter diet, time consuming analysis on dietitian (labor intensive)

Front 94

What are the advantages of a FFQ?

Back 94

usual diet, lower demand on pt, self administered

Front 95

What are the limitations of a FFQ?

Back 95

culturally sensitive, some answers arent avalible

Front 96

What are the advantages of a diet history?

Back 96

requires 3 day food record and multiple pass 24 hour recall so it provides a usual diet

Front 97

What are the limitations of a diet history ?

Back 97

time consuming, pt must be cooperative

Front 98

What are the 9 conditions to facilitate an effective interview?

Back 98

clearly define purpose of the interview, attentiveness, rapport, freedom from interruption, psycholigical privacy, physical surroundings, emotional objectivity, personal context of the respondent, note taking

Front 99

helps client to undersand why so many questions ; explain that so many questions are needed to make accurate assessment

Back 99

clearly define purpose of the interview

Front 100

helps create a cliemt for ease in communicating, RD needs to develop listening skills, listen with empathy rather than to talk extensively, RD assits interviewees in gathering and communicating their thoughts and feelings, RD must listen to verbal message while observing the nonverbal behavior

Back 100

atterntiveness

Front 101

should be established early in the interview, put interviewee at ease and relieved of anxiety and uncertainty of what is planned, builing of a warm and supportive climate, smooth flow of conversations in a nonjudgemental atmosphere

Back 101

rapport

Front 102

the personal relationship established bettween the interviewer and the respondent

Back 102

rapport

Front 103

smiling when appropriate, approving facial expression, nodding approval, giving undivided attention, speaking confidently, making people feel that you are interested in what they are saying

Back 103

are positive nonverabl actions to help estblish rapport

Front 104

gives the impression that you are genuenly concerned about the person being interviewed

Back 104

freedom from interruptions

Front 105

interviewee and interviewer should be alone, stress that the conversation is confidential and will not be repeated

Back 105

psychological privacy

Front 106

comfortable (proper furniture, temp, lighting, plesant)
Good distance between parties (optional distance 3 to 4 ft)
Seating arrangements ( round table is less formal when materials need to be viewed(aviods the hea d of the table position - the fewer furniture barriers the better))

Back 106

physical surroundings

Front 107

personal feelings and preferences should be controlled; the goal is to understand behavior not to judge it.
RD needs to learn about understand and accept the cultural differents and lifestyles of other groups
RD needs to be able to control their expressions and avoid nonverbal behaviors recealing their prejudices

Back 107

emotional objectivity

Front 108

be aware of the client phsycial and emotional state(pt had a heart attack, pt is scared, angry) RD may need to allow client to vent their feelings and acknowledge them before going on with the interview;
Good to have some background info on interviewee before the meeting
pt info (in medical record if in hosp setting)
martical status, age, occupation, medications, wt. ht, medical history

Back 108

personal context

Front 109

tell the perpose of the ________, take breif notes, maintain eye contact, learn abbreviations, use key words or phrases, Comprehensive notes should be dictated or written immediately following the interview
Waiting 15 minutes longer could result in forgetting vaubale information

Back 109

Note taking

Front 110

What are the 3 parts of an interview?

Back 110

opening, exploration, closing

Front 111

the questions asked should require client to talk ________ of the time

Back 111

60 to 70%

Front 112

What are 3 types of interview questions?

Back 112

Open/closed, primary/secondary, neutral/leading

Front 113

What are some open questions?

Back 113

"can you tell me a little about yourself?"
can you tell me about your eating habits?
what about your meals?
what diet have you been folowing?
what did the doctor tell you about your diet?

Front 114

What are some closed questions?

Back 114

who cooks the food at home?
can you tell me about any snack you eat between meals?
what skills do you have that are important for the job?

Front 115

What is an example of a primary question?

Back 115

now that we have discussed the food you eat at home, tell me about what you eat in restaurants

Front 116

what is some examples of secondary questions?

Back 116

how much orange juice do you drink?
what do you use in your coffe?
how many times do you eat in resturants each week?

Front 117

what are leading questions?

Back 117

you eat breakfast, dont you?
you arent going to eat desserts anymore are you?
What do you eat for breakfast? an egg or toast?

avoid these try to use working that is more neutral

Front 118

beings with broad open questions and proceeds to more restrictive questions
"tell me about the food you eat during the day."
"what do you have for snacks between meals?"
"we havnt discussed alcoholic beverages, what about them?"

ask questionsthat begin with "what" or "tell me about..." want people to tell a story

Back 118

sequencing questions

Front 119

What are the 6 interviewer responses ?

Back 119

evaluative , hostile, reassuring, probing, understanding, confrontation

Front 120

"I suggest that you stop buying those cookies Mrs. Jones." Gives advice not information

Back 120

evaluative response

Front 121

"youre not acting very mature mrs jones. Ive told you before to avoid all sweets and desserts if you want to lose weight."
"how do you know about dieting?look how thin you are."
Destroys pt RD relationship
the RD's frestration is uncontrolled

Back 121

Hostile Response

Front 122

"dont worry about it mrs jones. it takestime to adjust to new eatin gpatterns. you'll do better next week."
Implies that a problem does not exist or the RD does not want to discuss it.
More difficult tosolve the client's problem
"Blowing off" the problem

Back 122

reassuring response

Front 123

attempt to clarify or to gain additional information
examples of details : food quantities, added ingredients,preparation methods and snacks
should be nondirective, nonthreating and nonjudgemntal
"so you think the diet doesnt work. Mrs. Jones, I wonder if you could tell me a little more about that?"

Back 123

probing response

Front 124

"you are feeling concerned because you havnt lost any weight, Mrs. Jones, and you are wondering if it was something you ate, or a problem with the diet."
assist in clarifying what was said
RD should focus on the clients feelings and attitudes thather than just on content
paraphrasing helps
understand the client rather than judge them

Back 124

understanding responses

Front 125

tactfully call to the person's attention some inconsistency in the story or words and actions
"im a bit concerned . you say you have no problem with the diet and yet you have not lost any weight for a month. what do you think is the problem?"
challenges and envourages the person to recognize some aspect of behavior that needs to be examined should be nonjudgemental and discussion driven
use when good rapport has been established

Back 125

confrontataion

Front 126

What are the ABC's of Behavior Modification?

Back 126

Antecedents, behavior, and consequences

Front 127

behavior change stategies focusing on ________ often concentrate on physical avalibility, social, emotional, psychological; these strategies can either focus on avoiding the cue or altering the cue

Back 127

Antecedents

Front 128

provides incentives by addressing the end of behavior chain --> consequenc ( - rewards - self compliments encouraged - tangible rewards provide motiation)

Back 128

reinforcement rewards

Front 129

use when client needs structure and accontability (-everything should be clearly defined)

Back 129

contracting

Front 130

makes for credibility (-well received-sends notes/ cards/emails/lhug)

Back 130

encouragement

Front 131

pathway to actually performing behavior (-provides a series of succesess)

Back 131

goal setting

Front 132

these people/things outside of sessions also influence behaviors - some of our behaviors rae learned by observing/.imitating others

Back 132

modeling

Front 133

identify road blocks- eliminate their impact
-can be lack of knowledge /skill risk taking/social support
-RD main point in counseling

Back 133

barrier counseling

Front 134

Issues that could affect the counseling session between people of different cultures? (5)

Back 134

client can take offence to direct questions, client may think that personal questions are invaisive/unnessicary, misinterpret way quesiton is asked, RD may not understand client response, lanugage differences

Front 135

preschool aged children
-who is major influence?
-who do you need to work with?
-teach through what?
-what is a big influence?

Back 135

family, parent/caregivers, 1.storytelling 2. songs 3. parties, 4. puzzles
TV

Front 136

School aged chilren
-easy to establish ___ and ___ and ____ habits during childhood
-determine __ stage/_____pattern
-remember meal times
-family is what?

Back 136

healthful diet/ exercise
developmental/ activity
check mark
good role models

Front 137

Adolescents
what is increasing?
____ is often central to social life with peers --> gain _______
discuss connections between ______ practices and health
internvetions should target ___/____
in competitive sports who can influence eating patterns to improve athletic performance?

Back 137

o besity
food/independence
dietary
feelings/attitudes
coaches

Front 138

Adolescent girls
pregnancy:
-need enough _______ and _____ education to support both mom and baby
-girls believe in ______ ____

Back 138

nutrition/nutrients
frequent dieting

Front 139

older adults
-goodnutrition improves ____ of life
-counseling is ___
-need to recognize ____ b/t sensory and physical abilities
-print handouts larger font
slow pace of ___/____ volume
-they have their own ___ of food

Back 139

quality
individualized
difference
check mark
speech/increased
myth

Front 140

name the 8 behavior change strategies

Back 140

cue management, countering, reinforcement-rewards, modeling, contracting, encouragement, goalsetting, barrier counseling