Introduction

This ePortfolio is for a course that I am doing this semester, Community Nutrition. The aim of the exercise is to discuss my attainment of Council on Education for Public Health learning objectives using examples from my course this semester. Each post contains one objective, an example of my work, and a discussion of my strengths and weaknesses pertaining to the competency. Many pieces come from a nutrition education project I developed for children in grades 4 to 6.

Select and use appropriate assessment techniques

Competency:   Select and use appropriate anthropometric, biochemical, clinical, dietary, functional, and socioeconomic assessment techniques to identify and prioritize nutritional problems and needs of populations and communities.

My piece: This piece is a document that summarizes fruit and vegetable intake estimates in Warren County from various sources.

Assessment exercise

  • How does this piece/sample relate to the competency?

The summary uses dietary assessment techniques to provide estimates of intakes. The assessment was used to identify local areas of need in terms of nutrition and health behaviors for the community.

  • What are the strengths and weaknesses of this piece/sample?

The piece uses data from various sources to make the nutritional assessment and identify problem areas. Any nutritional assessment should integrate data from various sources to make the best estimate of nutritional problems, their causes and health effects on populations.

A weakness of the assessment was that it was difficult to locate published data on the issue. Perhaps the health department of Warren County had better data because they had reports for 2008 and 2009 on their website however the report from 2010 was not on the website. The information was also very general and did not identify populations at greater risk of nutrition deficiency.

  • What did I learn from reviewing and reflecting on this piece/sample?

I learned that I needed more specific data to make a better assessment. Prioritizing nutrition problems must be done to direct limited resources to the area of most health impact in the community. This means that target groups for nutrition interventions need to be correctly identified during the assessment phase.

  • What do I need to work on in the future to more fully meet this competency?

To more fully meet this competency, I should integrate dietary data with other types of nutritional assessment data. I also should include demographic and socioeconomic data to identify areas of nutritional concern. For example, although many Warren County citizens in my piece did not consume recommended levels about fruit and vegetables based on surveys, I could integrate biochemical carotenoid blood levels and also access to supermarkets in the community to my assessment to be able to target communities within the county with a greater need for nutrition education.

Develop intervention strategies

Competency: Develop intervention strategies to correct nutrition problems in target populations.

My piece: This piece is a graphical presentation of my lesson plan for my community nutrition education session.

  • How does this piece/sample relate to the competency?

Before developing the lesson plan, I had identified some nutrition education gaps in my target group, namely that children in the county do not consume enough fruits and vegetables and may lack nutrition knowledge in general. The lesson plan attempts to introduce children to the concepts in the USDA’s MyPlate, focus on a fun activity with fruits and vegetables, design/coloring in a meal that meets the MyPlate guidelines, and offers a chance for them to receive positive feedback.

  • What are the strengths and weaknesses of this piece/sample?

The strengths of the lesson plan were that when implemented, both the interactive activity and meal design were successful. The children were enthusiastic about naming various fruits and vegetables and really enjoyed providing input.

The weakness of the lesson plan was that the introduction was too general and some of the children wanted to know more why certain food groups were important. If I were to develop this lesson further, target group evaluation would be necessary to ensure that the material was age-appropriate and provide enough detail for the children.

  • What did I learn from reviewing and reflecting on this piece/sample?

After reflecting on this piece, I realize the importance of tailoring nutrition information to the target audience. I left the presentation feeling like the children wanted to know more, which I could have provided to them in the time that I had left. In this case, I know some people with children in grades four to six and I could have discussed the information I was going to present with them at the outset, and consulted them later when I had worked more on the information that I wanted to say before giving my presentation to the 30-40 children during my nutrition education project.

  • What do I need to work on in the future to more fully meet this competency?

To more fully meet this competency, I should conduct pilot assessments of any educational materials to adequately tailor the needed information to the target audience. This will ensure that the audience receives information that they find useful, and that they will learn something new.

Reference: USDA. 2010. USDA’s MyPlate.gov – Food Groups. http://www.choosemyplate.gov/foodgroups/index.html accessed October 6, 2011.

Describe role of organizations

Competency: Describe the role of agencies, advisory bodies, and professional organizations responsible for development and dissemination of technical information and for formulation of nutritional policies.

My piece: This piece contains a summary of the most recent nutrition advice from the United States Department of Agriculture (USDA) and United States Department of Health and Human Services (HHS), two government agencies responsible for providing nutrition recommendations to the public. I created it for a case study about how guidelines are translated into food choices for consumers.

Describe role of organizations

  • How does this piece/sample relate to the competency?

This sample relates to the competency because it gives an example of how the USDA and HHS disseminate technical information and  nutrition policies. The agencies release technical information at the same time as the report is issued, in a policy document (USDA, 2011). This document explains the background to the recommendations that I summarized.

  • What are the strengths and weaknesses of this piece/sample?

This piece gives an overview of the main nutrition advice from the USDA and DHHS. I had to read the guidelines to extract the most important points from the document. The document explains the roles of the USDA and HHS in the formulation of nutritional policies. My piece does not explain fully the role of these agencies in disseminating the information and policy formation, although I kept this information in mind when I put together the piece.

  • What did I learn from reviewing and reflecting on this piece/sample?

On reflecting on this sample, I realize the importance of national organizations in creating and implementing nutrition policy. While nutrition policies in different countries draw on the same resources (nutrition research) for their creation and widespread use, they differ in their structure and implementation due to cultural differences and the role of the organization that puts the policy together. This also affects the community nutritionist in the resources at hand for bringing recommendations to target populations.

  • What do I need to work on in the future to more fully meet this competency?

To more fully meet this competency, I need to put more effort into understanding local organizations’ roles providing technical information and formulating policies. I am expecting an international move during the course of my degree and this provides me with a unique opportunity to learn from how different countries provide nutrition information and guidance.

Reference: USDA Center for Nutrition Policy and Promotion. Dietary Guidelines for Americans, 2010. January 2011. http://www.cnpp.usda.gov/DGAs2010-PolicyDocument.htm accessed December 9, 2011.

Identify relationships

Competency: Identify the relationships among local, national, and global nutritional and public health problems.

My piece: I reviewed information about the World Food Programme (WFP) for the Nutrition Program Resource Fair in the following summary.

Identify relationships

  • How does this piece/sample relate to the competency?

In this piece, I discuss the relationship between the WFP, which is a global organization that acts on the local and national level to address food emergency situations and assist in providing strategic food-related development aid.

  • What are the strengths and weaknesses of this piece/sample?

The strengths of this piece include that it provides a comprehensive overview of the role of the WFP and how it works with other countries. As such, it does not provide a deep understanding of how the organization works in the countries that it operates.

  • What did I learn from reviewing and reflecting on this piece/sample?

From reflecting and reviewing this piece, I thought about how difficult it is with various political interests to provide aid where it is needed, yet contribute to the development of countries in need. The global economic crisis has meant that countries have to look critically at monetary donations and this is reflected in the graph below, which shows donations declining since a peak in 2008.

  • What do I need to work on in the future to more fully meet this competency?

In my piece I provided some general information about the WFP mainly based on information on their website. A useful addition would be a case study describing how the WFP implements its emergency and development aid, perhaps through someone working in the field, for example from an non-government organization working together with the WFP to distribute food aid.

Translate results

Competency: Translate results of nutritional research to different target populations (public, peers, parents, etc.).

My piece: A powerpoint presentation I made to present the results of my nutrition education project to fellow students.

Translate results – presentation

  • How does this piece/sample relate to the competency?

This piece relates to the competency because it shows firstly how I developed a nutrition education project for children in grades 4 to 6, and secondly I presented my completed project and evaluation to my colleagues.

  • What are the strengths and weaknesses of this piece/sample?

This piece gives examples of how my project was implemented. Strengths include standard formatting and text that was easy to read. Some weaknesses relate to the content. I did not present very much information about the results of my literature review into the health status of children in Warren County, New Jersey. I also forgot to include the main goals and objectives of my project. It lack more specific information about how nutrition guidelines were translated for the students who received the nutrition education.

  • What did I learn from reviewing and reflecting on this piece/sample?

After reviewing and reflecting on this piece, I need to work more on determining key messages from my presentation and ensuring that they are emphasized in my presentation. I think that the inclusion of photographs helped people to be able to visualize how my nutrition education project was run – I did not have much time to present this and the photographs gave more information than simply trying to explain.

  • What do I need to work on in the future to more fully meet this competency?

Ideally, I would use SMART objectives (LearnMarketing.net) at the outset when putting my presentation together to identify what the goals are of my presentation and which points I want my audience to remember.

Reference:
LearnMarketing.net. 2011. Smart Objectives. http://www.learnmarketing.net/smart.htm accessed December 10, 2011.

Integrate knowledge

Competency: Integrate knowledge in nutrition, public health, and other disciplines for the identification and evaluation of nutritional problems and the development and implementation of guidelines and policies.

My piece: During a discussion on the obesity epidemic, one of my fellow students asked a question about the relationship between poverty and obesity in my state. This resulted in the creation of a graph showing a surprisingly clear relationship between obesity rates in counties and per capita income in two states in the US.

  • How does this piece/sample relate to the competency?

In this piece, I integrated public health nutrition information (obesity rates) with financial information provided by government bodies to help illustrate the relationship between obesity and income. From this graph, I infer that the burden of obesity-related disease is carried by people with lower incomes. There is also a large difference in average incomes in the two states that I investigated. Data presented like this show the potential of increasing total wealth and reducing the income gap between the wealthy and poor could be one strategy in reducing the obesity epidemic.

  • What are the strengths and weaknesses of this piece/sample?

The strength of this piece is that the data were obtained from four different sources the relationship between income and obesity is clear for even laypeople. I was surprised that the relationship was so strong based on the data.

A weakness of this piece is that it attempts to show a linear relationship while the problem is much more complicated. Part of the relationship between socioeconomic status and obesity is derived from higher education levels, which contribute to both higher incomes and higher likelihood of receiving nutrition and health education. Education could therefore contribute to reducing obesity levels. On the other hand, there are many other factors that contribute to obesity, such as personal motivation, access to safe areas for recreation, provision of healthy food in supermarkets, and cultural factors, that are much more difficult to address in a nutrition intervention. This piece must be viewed in the context of a host of other information.

  • What did I learn from reviewing and reflecting on this piece/sample?

From reviewing and reflecting on this piece, I learned that nutrition problems are usually multifactorial. Developing policies to address these issues must therefore reflect their complex causality.

  • What do I need to work on in the future to more fully meet this competency?

In future, I need to research more fully the background to how nutrition issues arise in the community and effective policies to address these issues.

References:

Center for Health Statistics. 2008. Obesity Trends in New Jersey Counties: 1992 – 2006. June. http://www.state.nj.us/health/chs/documents/obesity_brief.pdf accessed November 16, 2011.

State of New Jersey Department of Labor and Workforce Development. 2010. Per Capita Personal Income for New Jersey, 2004 – 2009. http://lwd.dol.state.nj.us/labor/lpa/industry/incpov/pcicnty.htm accessed November 16, 2011.

CDC. Diabetes Data and Trends. County Level Estimates of Obesity — U.S. Maps http://apps.nccd.cdc.gov/DDT_STRS2/NationalDiabetesPrevalenceEstimates.aspx?mode=OBS accessed November 16, 2011

The Annie E Casey Foundation. 2009. Mississippi Per Capita Personal Income (Currency) – 2008. http://datacenter.kidscount.org/data/bystate/Rankings.aspx?state=MS&ind=3737 accessed November 16, 2011

Conclusion

The course Community Nutrition allowed me to work on some important objectives from the Council on Education for Public Health. In particular, I need to work on investigating the role of organizations in the development, promotion and implementation of nutrition-related activities. The use of case studies can help me work out better how programs are run at the local level. My lack of direct contact with people working face-to-face with clients could be enhanced through meeting with local nutrition workers.

I learned a lot during this course and I will continue to make progress as I progress through the rest of my degree. Thank you to Dr Patsy and my colleagues for their support and ideas during this course (and to my supportive husband!). I couldn’t have done it without you!