Community Nutrition Needs Assessment PDF

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prof- L. Trone...

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DIE4310 17 September 2020 Lecture 5- Community Nutrition Needs Assessment What is a community needs assessment?  Collecting data what provides an accurate picture of both community needs and values  Process of evaluating the health and nutrition status of a community o Identify places where needs are not met  Provide better understanding of how the community functions and how it addresses the public health and nutrition needs of its citizens  Questions o Who has needs that are not being met? o What programs and services exist? o Why do existing programs fail to address needs? o How do the community env, background factors, and culture affect the ease and desirability of making healthy choices? o What can be done to improve the health and nutrition of the population? Using community ADIME  Assessment- identify nutrition problems to be addressed o Patient-focused o Community level assessments incorporate state, county, or community data o Data is obtained from government agencies  Local websites  State gov websites o 5 components  Food and nutrition intake  Anthropometric measurements  Body comp, growth rates, weight history  Biochemical data, medical tests, procedures  Diabetes, heart disease  Lab data  Nutrition focused physical exam  Blood pressure, weight/height, skin disorders  Client history o What is the CAUSE of the problem?  Diagnosis- aim and type of nutrition interventions o Reflects a problem that is shared by population rather than individual  Often a deficit in knowledge, prevalence of a condition, problems related to food access or suppliers o After assessment, dietitian formulates a preliminary diagnosis and considers which intervention to propose  Initial diagnosis can be modified o 3 areas  Intake

 Includes food, beverages, macro and micronutrients Clinical  Obesity, malnutrition, disease  Behavioral-env  Food and nutrition  Physical activity  Resistance to change  Food safety  Access to food Intervention- use data to monitor and evaluate if intervention was successful (action plan) o Often reflects educational offerings or intervention related to policies that will impact population o Collaboration with other health care professionals o Include more traditional individual nutrition care provided in social programs  WIC o Method used by dietitian assists patient in achieving Nutrition Prescription  Stipulates patient’s optimal nutrition intake and physical activity level o Nutrition Prescription in necessary to Frame key recommendations  Communicate nutrition info to other health care professionals  More people involved the better o Domains  Nutrition Prescription: sample related to public health or community nutrition related to adult weight management  Ex- define target servings per food group  Food and/or nutrient delivery: alteration in macro or micronutrients to help population  Ex- increase protein intake at meals  Nutrition education  Nutrition counseling: adding behavioral change onto education  Support generated by community  Coordination of nutrition care by professional: referral to RDN with different expertise  Population based nutrition actions  Population Theoretical Framework o Social ecological method: identify env factors that contribute to healthy behaviors o Community organizing: support of community orgs  Ex- community garden, hiking club, farmers markets  Need to find people that can help o Diffusion of innovations  Share reports of successful strategies o Social marketing: who is the target audience?  Identify what info they need, how to receive it 

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o Organizational change theory: quality improvement programs addressing issues o Mass communications: creating and testing messages related to attaining goals, then deploy them through media o Political action: work with local, state, or national policy makers  Might be assistance program that can be incorporated  Population Strategies o Environmental change: work with community to impact food env  Get resources available to everyone  Change cultural norms and attitudes o Organizational change: work with local employers to support goals o Public policy change: work with law makers to advocate for restaurant codes, city gardening ordinances, menu labeling  Population Settings o Residential: work to enhance sidewalks for safety and walkability o School: work to create healthy food env on campus o Workplace: policies for healthy low energy offerings in cafeterias or vending o Recreation and sports: work with local physical activity resources to offer more types of physical activities  Ex- YMCA o Food production and provision: work with food pantries o Service o Government o Community at large  Population sectors o Agriculture: increase availability to fresh fruits and veggies o Education: school boards… o Government o Healthcare: work with insurance companies to provide incentives o Food and beverage Monitoring and Evaluation- framework is useful in proposing population-based nutrition interventions o Same data used for assessment  May be supplemented with surveys of individuals from target population o Patient and dietitian together determine criteria to measure whether goals are being achieved

Criteria should be specific, measurable, actionable, realistic, and time limited (SMART)  Several clear outcomes/indicators are selected that reflect both short-term and long term  Used to measure the effectiveness of the approach and strategies o How do we know that what we did WORKED? o Outcomes/indicators/measures  Schedule regular consolations  Short term- more frequent ADIME summary o Assessment- data collection o Diagnosis- define what problem is o Intervention- goal setting, action plan o Monitoring/evaluation- follow-up, success of program? 

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Needs Assessment Steps (8):  Set parameters of assessment o Define target pop  Large population- use sample group  Small population- can target more specific concerns  Find “problem” o Goal/what you want to achieve  Broad compared to objective  Nutrition prescription is an objective  Goal is to obtain info  Develop data collection plan o Start with bigger picture o 1- community data  Demographics, economic factors, health o 2- community env/background factors  Social and cultural norms, food access o 3- target pop data  Food preferences, surveys o What data do you need? o Is there current data?  Pre-existing data  Can find trends, available programs  May not be specific enough for target pop, or outdated o What new data do you need?  Collect data o Creating new data- surveys, workshops, interviews o Interviews advantages  Can be more specific  Useful for getting stories or quotes  Good for personal topics

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o Interview disadvantages  Hard to find diversity of opinions/ask right questions  Time consuming  Requires skilled interviewer o Survey advantages  Quick and interpretive  Easy to prepare o Survey disadvantages  Could be biased  May not be large enough sample size to generalize community o Creating a survey  Need to look at  Quantitative (numbers) o What are you measuring? o How will it translate to measurable results? o What are you comparing data to? o Tracking progress  Qualitative data (words)  Ask clear, simple questions- tick box  Keep them under 5 minutes  Explain what questions are being used for  People are more likely to answer  Confidentiality  Ask questions that can be answered  Not too personal  Only ask one question at a time  Pretest your questions on other people  Give possible answers, avoid positive/negative answers Analyze and interpret data o Identify gaps in data o What did you learn about the community?  Background  Needs/wants  Nutrition status o What is the best way to intervene? Share the findings (diagnose) o Make list of people who need to be included o People who can make interventions possible Set priorities o Find 1 or 2 priorities for action plan o Do they correlate with national nutrition priorities?  DGA, Healthy People Choose plan of action o What are you going to do to solve the problems in the community? o Advocate for change in policy

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Follow-up o Monitoring goals to determine is plan is effective...