Shifting the focus of WIC nutrition education to a client centered modelAmy ElsasserDietetic Intern, The Sage Colleges

Current education model

• Didactic model- educator provides information and direction to the participant1

• Traditional teacher-student relationship• Generally successful at conveying information

and increasing nutrition knowledge• Less successful in motivating participants to

translate new knowledge into healthy behavior

Participant-Centered Education1

• Elicit and support the client’s motivation to change while respecting their thoughts and actions• Focus on client’s capabilities,

strengths and needs • More effective and enjoyable

for client and educator• Greater technology use to

reach more participants

Using learner centered education to improve fruit and vegetable intake in California WIC participants2

• “Finding the Teacher Within (FTW)” training program- help agencies integrate LCE • 3 agencies used traditional education methods/3

agencies used FTW material• FTW approach was more successful, with women

learning things that were more “immediately meaningful”

Innovative Tools Help Counselors Discuss Childhood Obesity with Parents3

1. Nutrition and Activity Self-History form (NASH)

Innovative tools

2. Report Card/Action Plan (ReCap)- provides a visual summary of child’s health status

Innovative tools

3. Talking tips tool: Used when time is limited/ client is reluctant to pick a goal.

Innovative tools

4. Healthy weight poster

Results

• Nutritionists and interviewers liked the tools and used them often• Tools facilitated discussion about weight • Old tools were available to use, but staff

preferred these• Patient outcomes were not monitored

Hispanic overweight and obese children: thirty cases managed with standard WIC counseling4

• 30 children: Hispanic, age 2-4.5 years, BMI ≥ 85th percentile

• Nutritionist counseled all children for 6 months• 15 had traditional counseling methods/15 had MI

counseling after nutritionist had MI training• At the beginning and end parents filled out a NASH

to assess if any changes were made

Results

• MI sessions were shorter• MI participants picked more lifestyle goals • MI not significantly associated with goal

achievement• No statistically significant difference in SSB, fruit

and milk intake or in physical activity• Statistically significant in vegetable intake• Both groups had statistically significant in BMI

Technology changes• “Food safety education using an Interactive

Multimedia Kiosk in a WIC setting: Correlations of client satisfaction and practical issues”5

• Found many clients enjoyed using online modules to learn, felt they learned more and found it easy to use

Technology changes

• “Impact of Internet vs traditional Special Supplemental Nutrition Program for Women, Infants and Children education on fruit and vegetable intake”6

• Clients preferred online education and progressed through stages of change faster • At initial follow up, internet group had better

retention and behavior changes; decreased over time

Accessibility and preferred use of online web applications among WIC participants with internet access7

• A study in the Western Region to determine preference for using new technologies to interact with WIC• Survey measured demographics, cell phone, Internet,

Facebook use and current and future WIC services• Responses showed support for an increase in

technology to reach participants, especially for nutrition education and breastfeeding support

Conclusion

• PCE often had better results than traditional education methods• Participants enjoyed learning this way• Educators felt more comfortable and confident

in discussions with caregivers

• Many participants support the increased use of technology in WIC• From scheduling appointments online to taking

online learning and increased use of social media to connect with support

References1. Participant centered education: Building a new WIC nutrition education model. K.

Deehy, et al. Journal of Nutrition Education and Behavior, 42(3S): s39-s46. 2010. 2. Using learner centered education to improve fruit and vegetable intake in

California WIC participants. D.E. Gerstein, et al. Journal of Nutrition Education and Behavior, 42(4):216-224. 2010.

3. Innovative tools help counselors discuss childhood obesity with parents. J. Herrera, et al. Childhood Obesity, 9(2):144-149. 2013.

4. Hispanic overweight and obese children: Thirty cases managed with standard WIC counseling. L.C. Ogu, et al. Infant, Child & Adolescent Nutrition, 6(1):35-43. 2013.

5. Food Safety Education using an Interactive Multimedia Kiosk in a WIC setting: correlates of client satisfaction and practical issues. M.J. Trepka, et al. Journal of Nutrition Education and Behavior, 42(3):202-207.2010.

6. Impact of Internet vs traditional Special Supplemental Nutrition Program for Women, Infants and Children nutrition education on fruit and vegetable intake. R.J. Bensley, et al. Journal of the American Dietetic Association, 111(5):749-755. 2011.

7. Accessibility and preferred use of online web applications among WIC participants with internet access. R.J. Bensley, et al. Journal of Nutrition Education and Behavior, 46(3S): s87-s92. 2014.

What I did while here

Practice with Drupal Topics A-Z and

education database: deleted outdated information, found new resources

Evaluated new resources for clarity, appropriateness and helpfulness

Used Google Analytics to understand what pages were not needed due to poor usage

Baby behavior Worked on the alpha review for the new

baby behavior online learning Helped edit the course text Created scenarios Created handouts to go along with the

course

Webinars Attended webinars on:

Dairy and weight control in minority populations

HIV programs VENA

Connecting with others Answering the phone- lots of

troubleshooting Skillsoft! Answering emails in the WIC Works box Finding resources for the 2014 FNIC

Childhood Obesity Resource List

Farmers’ Market Will have a table at the USDA farmers’

market Focuses on the importance of eating

more fruits and vegetables Food models will show the health

benefits of eating less meat and more produce

Vegetarian recipes will be provided