Nutrition Counseling and Behavior Change Melissa Millerschoen Brooke Barley
1. PRESENTATION OUTLINE Theories of Behavior Change
Transtheoretical Model
Social Cognitive Theory
Motivation Theory Diversifying Dietetics
Changing field
Necessary Competencies
2. TRANSTHEORETICAL MODEL Stages of Change
Precontemplation Contemplation Preparation Action Maintenance Drop Out
Possible Processes of Change Consciousness raising Dramatic relief Helping
relationship Stimulus control
3. TRANSTHEORETICAL MODEL Lessons Not everyone is at the same readiness level for
behavior change Need programs tailored for each stage of stage Appropriate programs
should apply processes of change to stage of change
4. SOCIAL COGNITIVE THEORY
5. Self efficacy “I feel that I can…” Outcome expectations What happens next? From
previous experiences Ex. You know that if you reduce your daily calorie intake you will lose
weight. Outcome values How much does the outcome mean to you? Ex. How important
is it to lose weight?
6. MOTIVATION THEORY Types of Motivation Intrinsic Curiosity Mastery of a task
Stimulating experiences “Rewards from within” External Avoid punishment Tangible
rewards
7. MOTIVATION THEORY Applications Find out how students/clients are motivated
Greater intrinsic motivation=greater adherence rates Help students to integrate behavior
into their vision of self Ex. Those who define themselves as exercisers/healthy eaters/goal-
oriented students are more likely to stick to a behaviour
8. THEORIES ONLY GO SO FAR... Several theories are used to achieve behavior change, but
understanding the client and his or her background is crucial to success There is no one
process that will work for every client Each client is very unique, and understanding a
person’s culture is necessary to developing a plan for change
9. MULTICULTURALISM IN DIETETICS Because nutrition counselors are evaluated on their
ability to produce desirable behavioral changes in clients, connecting with their culture is
essential Nutrition counselors shouldn’t view multicultural competence as a luxury or a
specialty but as a requirement Need to be knowledgeable about diverse diet
10. DIVERSIFYING DIETETICS Diversity in counseling may include differences in: ethnicity
religion group affiliation socioeconomic status The population of Registered Dietitians is
currently one of the least diverse fields Reflect “Salad-Bowl” population Gap between
provider and public
11. SKILLS FOR EFFECTIVE COUNSELING Be aware of culturally appropriate and
inappropriate practices when applying medical nutrition therapy Be aware of how your own
cultural background, experiences, attitudes, values and biases affect counseling Value and
respect differences According to the 2000 U.S. Census, whites make up 75.1% of the total
U.S. population; Hispanics, 12.5%; blacks, 12.3%; and Asians, 3.6%.
12. CULTURAL COMPETENCY Understand food selection, preparation, and storage in a
cultural context Have knowledge of family traditions, celebrations and special concerns such
as fasting Stay up to date on latest food practices and problems facing various ethnic and
racial groups
13. Relation to Education “Teachers need to know how to connect what is taught to the
experiences, needs, attitudes, and expectations of those they teach.” Majority of teachers
are white and middle class in classrooms that are more becoming more racially and
linguistically diverse Establishing a Culturally Appropriate Practice accepting learners
experience, value and taste acknowledging culture of all groups altering instruction to fit
learns needs and learning styles
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