Life Span Nutrition
Chapter 1.3

** Promoting Dietary Change **
Factors that Facilitate Change
On average, about 50% of patients adhere to long-term medical regimens and only 30% adhere to dietary regimens
Client variables (gender, age, income, ethnicity, etc.) and environment contribute 40% of improvement
Relationships (between educator and client): contribute 30%
Expectancy and placebo effect: 15%
Techniques (provide structure/focus): 15%

Client Variables and Environment
Self-efficacy important
Don’t preach
Mutually agreed upon (client & educator) goals & solutions
Prioritize changes
Set clear, attainable, short-term goals
Increase number and complexity of goals with each success
Develop winning team (family/friends)
Peer support groups can be very helpful

Relationship Factors
Positive relationship is important
Establish rapport and build trust
Communicate liking and respect for patient
Assess what client is thinking & feeling
Determine and address patient fears, concerns, expectations

Expectancy & Placebo Factors
Treatment should instill a sense of hope, be oriented to the future, and enhance a client’s perception of self-control
Explain “What’s in it for me?”
Avoid information overload (focus on important and relevant info)
Focus on positive - stress foods the patient can eat
Emphasize improvement, not perfection
Technique Factors
Techniques provide needed structure & focus
Particular technique or model used is less important than the degree to which the technique is consistent with the client’s expectations
Principles of Learning/Teaching
Recipient must value information
Environment should be conducive to learning
Provide adequate follow-up
Adults prefer problem solving information
Solicit frequent feedback
Maintain good eye contact
Audiovisuals as appropriate (font size, color)
Encourage questions
Offer praise
How Do People Successfully Change Their Own Behaviors?
Time, Effort & Energy
Process of Change -- 5 Stages
1. Precontemplation: does not intend to change or take action in the next 6 months
2. Contemplation: intends to change or take action within the next 6 months
3. Preparation/Determination: intends to take action in the next month
4. Action/Willpower: has made specific modifications in lifestyle within past 6 months
5. Maintenance: continued commitment to new behavior. Trying to avoid relapse
Relapse: Falling back into old ways may occur any stage.

Process of Change cont.
Path is not linear and usually involves some ‘backward’ motion (relapse to a previous stage)
Progression may move faster for some due to previous experience
Stages 1 & 2 represent consciousness raising……. personal testimony, role playing
Stages 2 & 3 represent self-re-evaluation
Record keeping, self-envisionment
Stages 4 & 5 represent contingency mgmt and stimulus control
Rank order tasks from easiest to hardest
Establish cues/rewards
Stress coping skills
Reward behaviors
Remove or minimize contact with triggers