Community Nutrition

• determinants of health


  income and social status

  education

  physical environment

  employment and working conditions
• income and social status


  higher income and social status are linked to better health
• education


  low education levels are linked with poor health, more stress, and lower self confidence
• physical environment


  safe water and clean air, healthy workplaces, safe houses, communities and roads all contribute to good health
• Employment and working conditions


  employed person healthier, particularly those who have more control over working conditions
• Social support networks


  greater support from families, friends and communities is linked to better health
• factors influencing behavior change

  predisposing factors

  enabling factors

  reinforcing factors
• predisposing factors


  Knowledge, beliefs, and attitudes based on life experiences as well as gender, age, race, socioeconomic background
• enabling factors


  Skills and abilities, resources available
• reinforcing factors


  Presence or absence of support, encouragement or discouragement from those around you
• ***approaches to changing behavior

  social marketing

  nutrition education

  nutrition counseling
• ***social marketing


  promote healthy behaviors using marketing techniques to create public service campaigns
• ***Nutrition education


  formal process to impart knowledge to group or individual
• ***Nutrition counseling


  collaborative activity between counselor and client, typically in a healthcare setting
• designing an intervention


  -characterize behavior of target population

  -identify the theoretical underpinning for the intervention

  -identify strategies/tool to influence behavior

  -design how you are going to measure the effect of the intervention
• model and theory constructs

  abstract concepts that cannot be measured/observed directly
• model and theory variables


  operational forms of constructs
• national cancer institute


  provides definitions of major theoretical constructs used in health behavior research
• ***social-ecological health model


  from broad to specific

  public policy

  community

  organizational

  interpersonal

  individual
• ***individual-level models/theories


  improved understanding of why and how intervention strategies work to achieve better individual outcomes
• ***interpersonal-level model

  social cognitive theory


  suggests some knowledge acquisition can be directly related to observing others within the context of social interactions, experiences, and outside media influences
• *** organizational and community-level models

  diffusion of interventions

  explains how, why, and at what rate new ideas and technology spread
• *** the heath belief model


  theory- components necessary to adopt a new health behavior

  -perception of a threat to health

  -expectation of certain outcomes related to a behavior

  -benefits

  -self-efficacy
• *** transtheoretical model


  based on three assumptions

  -behavior change involves a series of different steps or stages

  -common stages and processes of change across a variety of health behaviors

  -tailoring an intervention to the stage of change in which one is at is more effective than not considering the stage people are in
• ***transtheoretical model


  precontemplation

  contemplation

  preparationn

  action

  maintence
• precontemplation


  unaware of or not interested in making a change
• contemplation


  thinking about making a change in the near future
• preparation


  actively decides to change and plans a change very soon
• action


  trying to make the desired change; has worked at it for less than six months
• maintenance


  sustains change for 6 months or more
• ***impact evaluation


  measure long-term effects of program
• ***process/implementation evaluation


  measure activities of program, program quality, and who it is reaching
• ***summative evaluation


  measure effect of intervention on target group
• ***goal of RE-AIM


  address program elements that can improve sustainable adoption and implementation of effective, generalizable, evidence-based interventions
• ***five steps of RE-AIM

  Reach- target population

  Effectiveness

  Adoption-by target community

  Implementation

  Maintenance-of intervention
• nutrition education


  Instructional method to impart information individuals can use to make informed decisions about food, dietary habits, and health
• levels of a nutrition intervention


  1) build awareness

  2) change lifestyles

  3) create a supportive environment
• what makes an effective intervention?


  -grounded in sound behavior change theory

  -use good instructional design and learning principals

  -meet the specific needs of the target audience
• six principals of effective programs


  message

  format

  environment

  experience

  participation

  evaluation
• needs assessment


  part of the education plan as helps one develop awareness and anticipated hoe the target audience will receive the program activities