Community Nutrition >>>-
J O Wyatt Clinic - Outpatient Gestational Diabetes and Pediatric Counseling
(Northwest Texas Health Care System)
J O Wyatt Clinic is an outpatient facility within the Northwest Texas Health Care System that serves mostly low-income clients. I went there every Thursday afternoon to counsel pregnant women with gestational diabetes and kids with nutrition-related problems such as overweight and picky eating.
For clients with gestational diabetes, I always obtain 24hr diet recall at the beginning of the session to get an idea of their baseline diet. I then explained to them about carb counting and provided with an individualized carbohydrate meal plan based on their height, weight, and gestational age. The carbohydrate meal plan serves as a guide to show clients how many carbohydrate servings they can have at each meal. I usually aimed to adjust only the portion size of carbohydrate food instead of introducing unfamiliar foods to the client. I am hoping that this will not only show respect towards clients' cultural food practices but also lower the barrier for clients to make changes.
Most of the pediatric clients were referred to me due to obesity. Since children were usually accompanied by their parents during the session, I strived to keep my language concise and engaging, so that children and parents can both participate. To promote behavioral changes, I utilized motivational interviewing to bring out realistic goals for both children and parents.
This work experience allowed me to sharpen my counseling skills. I enjoyed the process of helping clients nail down the specific difficulties that were hindering them from following a healthier diet. I also loved working together with the client to design practical goals to induce behavior changes. It was always a great feeling to see clients walk out of the room with some confidence on their faces. At the same time, talking to clients kept me updated about some of the nutrition issues that this society still contains, such as food insecurity. It reminded me that many challenges need to be overcome on the road towards a healthier community, and it propelled me to work harder to make more positive impacts using the skills I have.
Dietetic Internship Experience
Scripps Mercy Hospital
Women, Infants, and Children Program (WIC)
The WIC program is a supplemental nutrition program that provides nutrition education, referrals, and food to nutritionally at-risk women, infants, and children that qualifies specific criteria. (Link to official website)
Picture source: dhhs.saccounty.net
The Scripps WIC program offers 15-minute counseling sessions. By observing counseling sessions, I learned about the different nutrition guidelines for infants, children, and women (pregnant and breastfeeding). I also learned about how to identify nutritional risks, such as anemia and underweight, among these specific populations. By the end of my rotation, I was able to hold or monitor counseling sessions to clients. In addition, I also had the opportunity to teach several group classes to WIC participants (clients). The classes I taught include the “Welcome to WIC” introductory course (45min) and a class to teach children and parents about berries (5-10minutes). The audience size of these classes ranged from 1 to 10. Each class was presented with a PowerPoint and some handouts. The following sections include some of the projects I completed during this rotation.
Breastfeeding Barriers Observation and Solution
During my rotation at the Scripps WIC program, I observed many counseling sessions and learned about the many barriers that moms could encounter when it comes to breastfeeding. The following report summarized the most common breastfeeding barriers from both the mom and the counselor’s aspect. Suggestions to relief each barrier are included. Please click on the following link to take a look at the written report.
Worksite Enrichment Cost-Benefit Analysis
Knowing that there are always busy hours and slow hours at any WIC office, this project aimed to identify the general staff workload patterns and client wait times at the Scripps WIC sites and to derive suggestions to enrich the time lapses of both staff and clients. Workload patterns were subjectively observed, and client wait times were collected from a number of clients at the Scripps WIC sites. To depict the findings in a visual way, this report converted raw data points into color-coded graphs. Several time-enrichment suggestions were given accordingly. Please click on the following link to take a look at the written report.
Scripps Whittier Diabetes Institute
This is institute belongs to the Scripps Health System, and provides provides outpatient counseling and education on diabetes and other nutrition-related health issues. (Link to official website)
The Scripps Whittier Diabetes Institute usually sees patients with all types of diabetes, including type I diabetes, type II diabetes, and gestational diabetes. During rotations there, I observed many outpatient counseling sessions. I obtained a solid grasp on carbohydrate counting, as well as the dietary recommendations and blood glucose goals for each type of diabetes. I also encountered many patients who wanted to lose weight or undergo gastric bypass surgery. From these counseling sessions, I learned about the heart-healthy diet (or the Dietary Approaches to Stop Hypertension Diet – DASH Diet) and counseled three clients in 1-hour sessions using the knowledge I gained. I also taught several healthy eating sections of the Diabetes Management Training courses to clients.
Carbohydrate Counting Guide
During my rotation at the Scripps Whittier Diabetes Institute, I designed a carbohydrate counting guide. This guide aims to help counselors explain the concept of carbohydrate counting to patients in a visual way during counseling sessions. It also serves as a tool to help patients manage their carbohydrate intake at home. This guide was adapted and pieced together from a couple of existing handouts from the Scripps Whittier Diabetes Institute, as well as the Academy of Nutrition and Dietetics. It talks about carbohydrate food and carb counting examples, ways to measure portion sizes by hand, serving suggestions, label reading, and sample meal plans. You can click on the following link to take a look at this guide.
University of California, San Diego
- Center for Community Health (UCSD CCH)
This is a university-based, community-oriented organization aimed at improving community wellness through multidisciplinary programs. (Website)
Picture source: ucsdcommunityhealth.org
Faith-Based Program - Best Practice Summary
The purpose of this project was to justify the positive impact that faith-based programs could have on people’s health. This 1-pager compiled examples of successful faith-based health programs from the latest literature. This report will be included in the action plan to be used as a tool to persuade the County of San Diego to allocate more focus on developing faith-based programs in San Diego. Please click on the following link to take a look at the summary.
Harvest of the Month Initiative Classroom Activity - Cost-Benefit Analysis
This project focused on analyzing the cost-benefit relationship of holding the Harvest of the Month classroom activities at Foothill Oak Elementary School in Vista, California during the school year of 2015-16. For this project, I compared the cost of holding the activities with the benefits that students received from the activities. What I found was that although the benefit of these activities might not immediately translate into monetary savings, this public health program could guide children to develop healthy eating habits and potentially relieve the national healthcare bill in the long run.
Picture source: harvestofthemonth.cdph.ca.gov
Live Well Community Market Program - Communication Plan
In order to increase people’s awareness of community food markets and stores, this project outlined the steps to help local store owners promote their business by utilizing Facebook’s advertising features. Please click on the following link to access the communication plan.
Letter to the Local Legislator
During my stay at the San Francisco Bay Area, I noticed that the lunch periods in some local K-12 schools were fairly short and that students were dumping their lunch before they could finish their meal. As an effort to help students eat in a healthier way, and to potentially reduce food waste, I proposed a public policy change to the local legislator on the issue of school lunch period length. In the letter, I presented the facts that I observed and provided several suggestions to correct the problem. Please click on the following link to access the letter, as well as some background information of how I came up with the letter.
Nutrition Program Evaluation & Design
During my community nutrition class in fall 2015, I was introduced to a variety of nutrition-related issues that currently exist in the US. I also learned about the various public policies that are designed to relieve these problems. As part of the coursework, I assessed existing nutrition programs, evaluated the feasibility of the Supplemental Nutrition Assistance Program (SNAP) and designed a social media campaign with peer students using our knowledge of need assessment and program planning. The following links include some of my work samples.