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20152015
Taking nutrition assessment to the next level!
Providing Quality Services
ENACTENACT
WIC staff making connectionsWIC staff making connections
Assessment
What is it?
Why is it important?
A = Anthropometrics B = Blood tests C = Clinical (health) D = Diet (nutrition) E = Environmental
Key Components of Nutrition Assessment
Completing a diet assessment
How do I know when a diet assessment is complete?
What can get in the way of completing a full diet assessment?
1. Ask about feeding behaviors
Attitudes Actions Supplementation
2. Use PCE skills & probing questions to learn more
3. Assign dietary risks 4. Use critical thinking to review information 5. Document in TWIST
5 steps for a complete diet assessment
Ask questions to go deeper instead of just skimming the surface
Engaging a participant
Card Sort Activity
Set the stage : Acknowledge that feeding children can be
both challenging and rewarding Offer a set of cards: Note that they contain some
common concerns related to their child’s age Ask the parent to sort the cards into two piles:
One for things that are going well and one for areas that are challenging
Celebrate the successes: Affirm things that are going well
Address the challenges: Ask which cards have been the greatest challenge, ask clarifying questions, consider NE options
Offer education and support: What would it take to move one challenge to the pile of things that are going well?
Card Sort Instructions
When would using this tool be helpful? How could this tool help explore a parent’s
feelings about feeding their child? What does it look like when a parent is
engaged? What would happen if a parent put all the
cards into the “no challenges” pile and says “everything is fine”?
Card Sort Discussion
Using PCE skills to engage participants
https://www.youtube.com/watch?v=ILEh5SlH_4w&index=2&list=PLDD1C70B55714C447
Watch for PCE skills in the assessment section of the following video:
What PCE skills were demonstrated in the
video? How did those PCE skills help with
assessment? What might the parent have said went well or
did not go well? Would she return to WIC in the future?
Video Debrief
OARS review
• Underline Open ended questions• Circle Probing questions Checkmark Affirmations• Place a star next to Reflections• Draw a box around Summaries
What are the advantages of using reflections
during assessment? Practice reflections…
The doctor said my child was overweight. I don’t know much about prenatal nutrition. I didn’t think mealtime would be like this. My baby is really picky.
Reflections
Reflecting is something to practice many times
until it becomes a part of your way of being with other people.
-Molly Kellogg
Reflections
What are the advantages of using summaries
during assessment? Practice a summary…
What are the key points of this in-service so far? How can that information be used to identify what
more needs to be addressed and help us transition to the next section?
Summaries
Putting it all together
Planning for Practice and Observations
Updated TWIST questionnaires
Local agency staff recommended changes to help support quality assessment
What is the same?
One questionnaire for each category Many questions remain the same
Health History
What is new? For all:
The risk number is being added after each question that could generate risk
Several existing questions were reworded for clarity The “medical conditions” question is now mandatory The “smoking inside of your home” is no longer
mandatory For Women:
The confusing “previous pregnancy” question on the women’s questionnaire was removed
Screening for drugs and alcohol is now mandatory For Children and Infants:
A question about dental health was added for children A question about infant growth was added for infants
Health History
What is the same? Breastfeeding questions remain mandatory
What is new for Infants and Children? Age appropriate questionnaires have been added to address
specific needs at different ages from birth to five years
For Infants: Birth to 5 months 6 to 9 months 10 to 12 months
For Children: 13 to 23 months 24 to 35 months 36 to 60 months
Diet Assessment
What is new for Children?
Topic categories called Prompts have been added on the children’s questionnaires to help guide conversation. Sample questions under each prompt are related to the age of child.
What is new for All? The “Risks assigned?” question has been
removed and the first question on each questionnaire will be mandatory in addition to the breastfeeding questions
A food safety question has been added Several existing questions have been reworded
Diet Assessment
Next Steps
Changes in TWIST questionnaires implemented on August 1
Updated Nutrition Risk and Dietary Risk training modules available on the Oregon WIC website by June 1
Coming next year…focus on providing nutrition education!
Talk with your training supervisor
Contact your state nutrition consultant
Contact Vernita Reyna: 971-673-0047 or [email protected]
Questions?
