Public Health-Community Nutrition-Nutrition Intervention Mind Map

Consider baseline knowledge, literacy level, language barriers and lifestyle factors.

NUTRITION EDUCATION CONTENT (E-1)
Instruction or training intended to lead to nutrition-related knowledge.
 

Content related nutrition education (E-1.1)
Defined as instruction intended to lead to nutrition-related knowledge.

Defined as instruction intended to lead to knowledge about the association between nutrition and health and disease status.
·   Explain the diet-disease relationship
·   Explain risks associated with overweight/obesity; hypertension, type 2 diabetes, etc
·   Explain benefits of weight reduction

 

Physical activity guidance (E-1.3)
Defined as instruction intended to lead to physical activity–related knowledge and change physical activity related knowledge and change.

NUTRITION COUNSELING THEORETICAL BASIS/APPROACH (C-1)
The theories or models used to design and implement an intervention.

Nutrition counseling based on social learning theory approach (C-1.3)

NUTRITION COUNSELING STRATEGIES (C-2)
Selectively applied evidence-based methods or plans of action designed to achieve a particular goal.

Nutrition counseling based on social support strategy (C-2.5)

·  Increased availability of social support for dietary and physical activity behavior change.

·  Support may be generated among church groups, school, co-workers, health clubs or community.

   -   Identify community support

   -   Utilize modeling, skill training, respondent and operant conditioning

   -   Conduct education in a group

COLLABORATION AND REFERRAL TO NUTRITION CARE (RC-1) 
 

Referral to RDN (Registered Dietitian Nutritionist) with different expertise (RC-1.2) 
·  Consider the benefits of multidisciplinary weight management
 

Collaboration with other providers (RC-1.4)
·  A general-practice dietitian may choose to refer on to a specialist dietitian
 

Referral to community agencies/programs (RC-1.6)
·  Interdisciplinary involvement—consider referral to family doctor/psychologist/physical therapist

Using the terminology for counseling intervention, select the
Population Theoretical Framework (P-1), Population Strategies (P-2), Population Settings (P-3) and Population Sectors (P-4).

Refer to the eNCPT for examples

POPULATION THEORETICAL FRAMEWORK (P-1)
No single framework approach is better than another in treating obesity. In the long term, the community is most likely to achieve a pattern of sustained weight loss by using various approaches in combination

Social ecological model (P-1.1)
·   The goal is to identify environmental factors that contribute to healthy behaviors and select leverage points from different levels of influence to target, select leverage points at two or more levels (interpersonal, intrapersonal, institutional, community, or policy)
    -   Develop change strategies that enhance positive impact of environmental factors on behaviors that lead to lower energy intake and more physical activity and decrease negative impact of environmental factors that discourage healthy eating and physical activity

Community organizing (P-1.2)
·  Support  formation and maintenance of community organizations for projects that support healthy behaviors, e.g. Community gardens, farmers markets, walking and hiking clubs

Diffusion of innovations (P-1.3)
·  Share reports of successful strategies, e.g. State Action Guide for Fruit and Vegetable Intake,  State Action Guide on Physical Activity, U.S. National Physical Activity Plan, Action Guide for Child Care Nutrition and Physical Activity Policies 
    -   Actively support change strategies  for promoting healthy eating and physical activity using dissemination and implementation science techniques, e.g. identify early adopters and highlight their successes

Social marketing (P-1.4)
·   Select and analyze target audience and reaction to messages, channels and materials about weight management 
    -   Identify what information they need, how they like to receive the information (e.g. which television or radio stations, bulletin boards, social media platforms) and determine effectiveness of program
·   Create and deploy campaigns, e.g. VERB by CDC (2004-2006)  

Organizational change theory (P-1.5)
·   Quality improvement programs addressing issues related to obesity/overweight, e.g. discussion of weight during MD offices if BMI exceeds a threshold, improvement of registration for community programs

Mass communications (P-1.6)
·   Analyzing communication channels, creating and testing messages related to attaining a healthy weight or increasing physical activity, and deploying them through media, e.g. VERB Campaign of CDC included mass communications as one of the primary channels of dissemination

Political action (P-1.7)
·   Work with local, state or national policy makers to affect policies related to fruit and vegetable intake, farmers markets, food assistance programs, food service guidelines,  community planning, transportation, and land-use decisions
 

POPULATION STRATEGIES (P-2)
Environmental change (P-2.1)
·   Work with community to impact food environment to provide healthy lower energy food options, e.g. corner store offerings, vending company offerings, restaurant choices, pricing options
·   Work with community to impact built environment changes that increase physical activity, e.g. lighting in park and recreational areas, sidewalks, bike paths, actions to improve walkability to grocery stores and recreational facilities
·   Use of social marketing campaigns to change cultural norms, attitudes, values and expectations by target population toward attaining and maintaining healthy food choices, levels of physical activity and healthy weight

Organizational change (P-2.2)
·   Work with local employers to support worksite wellness programs focusing in decreasing energy intake and increasing physical activity

Public policy change (P-2.3)
·   Work with law makers to advocate for restaurant codes, city gardening ordinances, or menu labelling for energy content

 

POPULATION SETTINGS (P-3)
Residential settings (P-3.1)
·   Work to enhance sidewalks for walkability

School settings (P-3.2)
·   Work to create a healthy food environment on school campuses

Worksite settings (P-3.3)
·   Policies for healthy low energy offerings in worksite cafeterias or vending

Recreation and sports settings (P-3.4)
·   Work with local physical activity resources, e.g. YMCA, to offer more and varied types of physical activities

Food production and provision settings (P-3.5)
·   Work with food pantries to enhance healthy low energy food offerings

Service settings (P-3.6)
·   Work with vendors to meet policy requirements for healthy vending with low energy offerings

Government settings (P-3.7)
·   Work with policy makers on issues related to food and built environment that impact the ability of citizens to attain and maintain a healthy weight

Community at large settings (P-3.8)
·   Work with local newspapers or TV or Radio stations to support social marketing campaigns
 

POPULATION SECTORS (P-4)
Agriculture sector (P-4.1)
·   Work with commodity groups or farmer organizations to increase availabitiy to fresh fruit and vegetables

Education sector (P-4.2)
·   School boards or teachers, administrators and parent teacher associations

Government sector (P-4.3)
·   Work with local, county, or state food assistance programs

Healthcare sector (P-4.4)
·   Work with health insurance companies to provide incentives for healthy weights, with professional healthcare societies for support for community programs

Food and beverage sector (P-4.5)
·   Work through food retailers, wholesalers, restaurant chains to offer more low energy foods to consumers

Business and industry sector (P-4.6)
·   Work with local businesses for support for physical activity, e.g. articles of clothing as incentives, support for physical activity challenges

Social welfare sector (P-4.7)
·   Work with local food security and subsidy programs in initiatives to support attaining and maintaining healthy weight

Nonprofit sector (P-4.8)
·   Partner with local community service organizations and charitable organizations to support community activities around healthy food challenges, healthy weight challenges, or physical activity challenges

Communities, neighborhoods, families sector (P-4.9)
·   Partner and work with local community coalitions boards, social clubs or neighborhood associations to improve safety for walking and physical activity time in local parks