ENACT: Enhanced Nutrition Assessment Certifier Training

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ENACTEnhanced Nutrition Assessment Certifier
Training

• 2015

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Providing Quality Services

• Taking nutrition assessment to the next level!

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Assessment

• What is it?
• Why is it important?

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Key Components of Nutrition Assessment

• A Anthropometrics
• B Blood tests
• C Clinical (health)
• D Diet (nutrition)
• E Environmental

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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?

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5 steps for a complete 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

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Ask questions to go deeper instead of just
skimming the surface
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Engaging a participant

• Card Sort Activity

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Card Sort Instructions

• 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 childs 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?

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Card Sort Discussion

• When would using this tool be helpful?
• How could this tool help explore a parents
  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?

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Using PCE skills to engage participants
Watch for PCE skills in the assessment section of
the following video

• https//www.youtube.com/watch?vILEh5SlH_4windex
  2listPLDD1C70B55714C447

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Video Debrief

• 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?

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OARS review

• Underline Open ended questions
• Circle Probing questions
• Checkmark Affirmations
• Place a star next to Reflections
• Draw a box around Summaries

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Reflections

• What are the advantages of using reflections
  during assessment?
• Practice reflections
• The doctor said my child was overweight.
• I dont know much about prenatal nutrition.
• I didnt think mealtime would be like this.
• My baby is really picky.

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Reflections

• Reflecting is something to practice many times
  until it becomes a part of your way of being
  with other people.
• -Molly Kellogg

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Summaries

• 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?

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Putting it all together

• Planning for Practice and Observations

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Updated TWIST questionnaires

• Local agency staff recommended changes
• to help support quality assessment

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Health History

• What is the same?
• One questionnaire for each category
• Many questions remain the same

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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 womens 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

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Diet Assessment

• 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
•  

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Diet Assessment

• What is new for Children?
• Topic categories called Prompts have been added
  on the childrens 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

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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 yearfocus on providing nutrition
  education!

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Questions?

• Talk with your training supervisor
• Contact your state nutrition consultant
• Contact Vernita Reyna
• 971-673-0047 or vernita.d.reyna_at_state.or.us