Nutrition Intervention Programs (PHNU 652) PDF

Nutrition Intervention Programs (PHNU 652) For MPH in Nutrition students By- Ahmed Muhye (Ph.D.) phone- 0912040176 email- [email protected] 1  Module Title: Nutr...

Nutrition Intervention Programs (PHNU 652) For MPH in Nutrition students By- Ahmed Muhye (Ph.D.) phone- 0912040176 email- [email protected] 1  Module Title: Nutrition Intervention Programs Module code: PHNU 652 Credit value of module: 3.5 ECTS Module Duration: 2 weeks Pre-requisite module: PUBH 612 (Basics of Human Nutrition) and PHNU 622 (Nutritional Assessment) Course Objectives: At the end of the course, students will be able to: ⦁ Define types of nutritional intervention programs ⦁ Understand growth monitoring and promotion programs. ⦁ Describe essential nutrition action programs. ⦁ State emergency nutrition intervention programs. ⦁ Design, plan and monitor nutrition intervention program. ⦁ Evaluate a nutrition intervention program. 2 Course contents 1. Introduction to nutritional interventions approaches 2. Types of nutritional interventions ⦁ Growth monitoring and promotion ⦁ Supplementary feeding programs ⦁ Nutrition education or communications for behavior change (IEC) ⦁ Essential Nutrition Actions (ENA) ⦁ Emergency nutrition interventions 3. Nutrition intervention programs in Ethiopia 3 4. Designing Nutrition Program ⦁ Planning nutrition intervention programs ⦁ Causal model and other models 5. Nutrition Project Monitoring and Evaluation Developing & Implementing a Monitoring and Evaluation Plan Frameworks Indicators (Calculating, Interpreting and Utilizing) Evaluation Designs (Including Impact Evaluation) 4 References Belachew, T. (2019). Human Nutrition in the Developing World. CABI Publishing. Otten, J. J., Hellwig, J. P., & Meyers, L. D. (Eds.). (2006). Dietary reference intakes: The essential guide to nutrient requirements. National Academies Press. Berdanier, C. D., Dwyer, J. T., & Heber, D. (Eds.). (2017). Handbook of nutrition and food (3rd ed.). CRC Press. Myhrvold, N., Young, C., & Bilet, M. (2011). Modernist cuisine: The art and science of cooking. The Cooking Lab. Francis, F. J. (Ed.). (2003). Wiley encyclopedia of food science and technology (4 vol. set). Wiley-Interscience. Bender, D. A. (2014). A dictionary of food and nutrition (2nd ed.). Oxford University Press. Albala, K. (Ed.). (2011). Food cultures of the world encyclopedia. ABC-CLIO. Millstone, E., Lang, T., & Nestle, M. (2014). The atlas of food: Who eats what, where, and why. University of California Press. 5  Brain storming questions 1.Why nutrition is a massive unfinished agenda? 2.What is the Nutrition Care Process (NCP)? 3.What are the steps of the NCP? 4.What are the specific roles of Dietitian and/or Nutritionists in NCP? 5.What are the current guidelines for the NCP in the Ethiopians? 6.How is the NCP implemented in Ethiopia through documentation and effective communication with the healthcare team? 6  Introduction Fig. Timeline of global commitments in nutrition 2003–2016 Despite these global efforts and commitments, it has become apparent that progress to improve nutrition 7  Introduction … Nutrition is considered a massive unfinished agenda for several compelling reasons: 1. Global Malnutrition Rates 4. Cultural and Behavioral Factors Persistent Hunger Cultural Beliefs Simultaneously rising Obesity Behavior Change 2. Economic and Social Inequalities 5. Environmental Influences Access to Nutritious Food Food Systems Education and Awareness Climate Change 3. Inadequate Policy Frameworks Insufficient Government Support Coordination Challenges 8  What is the Nutrition Care Process (NCP)? is a systematic framework that is designed to guide workers in providing high-quality, individualized nutrition care to clients, whether individuals, families, or populations. It uses the best available evidence to make decisions while taking the client's needs and values into consideration. The NCP was created by the American Dietetic Association (ADA), now known as the Academy of Nutrition and Dietetics (AND), in 2002. 9  What are the steps of the nutrition care process (NCP)? The Nutrition Care Process Model (NCPM) (Figure below) is a visualization of the workflow of nutrition/dietetic professionals and the steps namely ADIME: nutrition assessment, nutrition diagnosis, nutrition intervention, and nutrition monitoring and evaluation. The NCPM also shows the internal and external factors that impact the application of the NCP. 10 [The Nutrition Care Process Model (NCPM), 2008] 11 (ADIME)  Steps of the nutrition care process (NCP) Use of the NCP does not mean that all patients get the same care. Rather, the NCP provides a framework for practitioners to customize care — taking into account the client's needs and values and using the best evidence available to make decisions. Use of the NCP can lead to more efficient and effective care, nutrition research and greater recognition of the role of credentialed nutrition and dietetics practitioners. The four steps of the NCP described above are unique but interconnected. The steps are not sequential, and the process cycles through ADIME until the nutrition goals are accomplished. The process may involve one or more cycles. 14 15  Group work: Case Study 1 A 58 y.o. male was admitted for management of poorly controlled type 2 DM. He has a history of hypertension and hyperlipidemia. He has reported a weight gain of 10 pounds over the past month. His blood glucose levels have been consistently above target. He states that he often skips meals and frequently consumes fast food. He does not monitor his blood glucose levels at home and has never received formal nutrition education. How do you manage this case? 16  Case Study 2 An 80 male was admitted for evaluation of unintentional weight loss and malnutrition. He has a history of chronic obstructive pulmonary disease (COPD) and depression. He has lost 15 pounds over the past two months and reports a poor appetite. He primarily eats processed foods and has difficulty preparing meals due to fatigue. He has not been monitoring his weight and has never received nutrition counseling related to his condition. How do you manage this case? 17 20 21  1. Nutritional interventions To address or at least improve the identified nutrition problem or problems, the third step of the NCP involves deliberate planning and designing of actions aimed at modifying the client's nutrition-related behavior, risk factor, environmental condition, or aspect of health status (Lacey and Pritchett, 2003). Directed at the etiology or effects of a diagnosis An intervention is a specific set of activities and associated materials used to address the problem 22  1. Nutritional interventions … Nutrition interventions are customized to meet the specific needs of each client based on the nutrition diagnosis and its etiology. The role of the RND in this step is to select appropriate evidence-based and up-to-date interventions tailored to the client’s needs to address the nutrition diagnosis, targeting directly the root cause of the nutrition problem and aimed at alleviating the signs and symptoms of the diagnosis. 23 Ensure that your intervention is: 1) Realistic, 2) Patient approved, 3) Time sensitive. 24  Benefits of Nutritional Interventions Decreases mortality and morbidity Increases cognitive, motor, and socio-emotional development Increases school performance and learning capacity Decreases obesity and non-communicable cases Improves early childhood development reducing infectious disease burden and improving treatment adherence (Kenworthy, 2017; Null et al., 2018) 25 Thank you! 26