The purpose of this page is to share the steps of my rotation process as I worked through my supervised practice in Community Nutrition. Prior to the start of this rotation, 50 hours of alternative practice experiences were completed. While completing this rotation, I was also taking a class in Entrepreneurship which bolstered my creativity in program planning. The following modules comprise various competencies required to meet dietetic registration eligibility across the registration exam domains.
Note: text which appears GREEN is a link to an associated document or resource. Click any image to enlarge.
Module 1, explains a bit about my site placement and rotation plans.
Module 2 outlines my professional participation, development plans, and my affiliation with The Academy of Nutrition and Dietetics.
Module 3 shows my commitment to the profession through advocacy.
Health Promotion and Wellness is a large component of community nutrition, and it is reflected through my work in Module 4.
Module 5 shows that I can develop and utilize nutrition educational materials as well as practice appropriate motivational interviewing techniques.
Lastly, Module 6 demonstrates my competency at performing evidence based research, a critical aspect of designing an appropriate intervention for a community or population.
Each section below provides a short explanation with associated materials. Program checklists are included at the bottom of this page to verify execution of projects and fulfillment of rotation goals.
Table of Contents
Module 1 - Introduction
The start of my dietetic internship journey began at Iona Senior services in Ward 3 of Washington, DC. Iona Senior Services is a non-proit organization which is funded by both grants from the DC Department on Aging and Community Living as well as private donations. Iona supports and advocates for residents experiencing the challenges and opportunities of aging; they provide referrals to services and offer programs which promote aging well.
What is aging well? Aging well means maintaining autonomy as we age. This means being free of chronic disease and disabilities, maintaining mobility, functioning at full mental capacity, and living longer. With this mission, Iona Senior Services is a lead agency serving adults over the age of 60 in Ward 3 of DC. In DC as a whole, over 244,000 adults are in this age category.
My placement video explains a bit more about Iona and my goals for this rotation. I would like to thank my preceptor, Rose Clifford, RDN, for making my experience as fun and enlightening as possible. Special thanks to the Iona team for their support during my rotation.
Module 2 - Ethics and Professional Development
Several ethical case studies were completed as part of my Marywood Internship orientation June 22nd to 26th, 2020.
Professional development goals were set using Goal Wizard. These goals guide my internship experience choices and activities. Associated experiences are recorded in my Activity Log to track progress towards those goals. The rotation timeline gives a concise overview of my progression.
During this rotation, I also attended the Virtual National Food Policy Conference with speakers such as FDA Commissioner Dr. Stephen Hahn, author Eric Schlosser, Senator Cory Booker, and several notable others. Major topics revolved around food insecurity, food system changes and interim solutions as well as the future of policy needed to respond to these issues.
The following month, I also attended an interactive webinar hosted by Georgetown University regarding Healthy Aging in the District and the Role of Nutrition in Older Adults.
I have been a member of the Academy of Nutrition and Dietetics since 2018. The attached certificate reflects the current renewal. Click images below to enlarge.
Module 3 - Legislative and Public Policy
An important aspect of professionalism in dietetics is advocacy. Public policy drives change by impacting health status of the population. Taking an active role in policy advances the profession as well as the mission and goals of the Academy of Nutrition and Dietetics.
To get started, I performed a Legislative Survey, and I noted several food and nutrition related bills I could act on. Using the Action Center of the Academy of Nutrition and Dietetics, I wrote a letter to my US Senators to request their support of the HEROES Act, as this bill would increase SNAP benefits 15% to be more in line with food cost and need. Senator VanHollen’s office responded.
Click images below to read more:
Module 4 - Health Promotion and Wellness
The first step of developing a health promotion project is doing a needs assessment for the community in which you are planning an intervention. When researching the residents and assessing needs of people in Washington, DC, I found that rates of obesity are highest in the lower income population. About 1 in 5 residents in DC are obese. Additionally, Washington DC residents over the age of 60 have a higher prevalence of both hypertension and high cholesterol compared to those in the same age range in the rest of the nation. However, sharp disparities also exist in DC throughout the eight Wards. I was not able to reach the wards with greatest need within the scope of this project. My reach was in Ward 3, one of the most affluent and educated areas of DC with little lack of access to healthy food. For this reason, I designed an intervention around improving heart health.
Click here to view the Needs Assessment (references in document).
During this rotation, opportunities for a health promotion project were virtual only. For my Health Promotion Project, I chose to focus on reducing the rates of high blood pressure and high cholesterol in Washington, DC residents by providing Heart Healthy educational Zoom cooking sessions marketed to over 60 residents of the Washington DC area.
Marketing was provided by Around Town DC, and I wrote copy for their event calendar site to promote my free sessions. People had two weeks to sign up for the education sessions, and I had about 50 people in attendance each session. I think the marketing was an overall success. Special Thanks to Lena Frumin for making this possible.
Click images below to view the marketing for each session.
To increase heart healthy choices, I held the Zoom education sessions from my home. Goals of the education sessions were to increase vegetable, whole grain, fruit, and fiber consumption while decreasing sodium intake. In order to achieve these goals, I used a social cognitive approach to build skills in the participants while modeling the desired choices. In my sessions, I addressed how to include more vegetables, whole grains, and healthy fats into meals. I also talked about reducing meat consumption and how to read nutrition labels.
Click here to read my Health Promotion Project Report, and here to view my lesson plans.
Since this education was conducted virtually, all materials were distributed to participants on the morning of the scheduled class time. I developed recipes and handouts. I also created pre and post tests to measure the effectiveness of the intervention. Prior to each session start, the Wellness Program Manager at Around Town DC emailed registered participants with the materials packet as well as links to the pretest. However, I needed to make sure the materials I developed were readable and easy to understand.
I conducted a SMOG analysis on my most complex materials. Other handouts provided were published by the Academy of Nutrition and Dietetics as well as Oldways.
I conducted a SMOG analysis on the following handout, and here are the results. From left to right: first draft, evaluation, final draft. Click to enlarge:
Heart Healthy Eating by the Academy of Nutrition and Dietetics
Cooking Grains Guide and Store Shopping Guide from Oldways
Mediterranean Meal Planning from the Academy of Nutrition and Dietetics
Session One:
90% of participants will identify 3 diet related changes which can improve heart health.
90% of participants will describe 2 lifestyle changes which improve heart health.
75% of participants will be able to formulate one goal for themselves for improved hearth health.
90% of participants will score at least one point higher on the post test than the pre test.
Session Two:
90% of participants will identify at least 3 key features of the Mediterranean eating pattern.
85% of participants will identify at least 3 foods that are good sources of fiber.
85% of participants will identify 3 foods containing unsaturated fats.
90% of participants will score at least one point higher on the post test than the pre test.
Click to view both pretests and their results.
Click here to see both post tests and their results.
Click here to see the evaluation of my Group Education.
Check out the finished meals below! Clockwise from the top left:
Thai Portobello Lettuce Wraps served with Roasted Curried Cauliflower, Cold Peanut Noodles and Easy Mango Mousse
Mediterranean Salmon Buckwheat Bowls with Arugula, topped with Yogurt and Feta, Chocolate Avocado Pudding for dessert, topped with Crushed Pistachios and Raspberries
Alternate dessert option: Roasted Plums with Goat Cheese, Toasted Almonds, and Honey Drizzle
Click images to enlarge:
Module 5 - Public Communication and Motivational Interviewing
During this rotation, I had an opportunity to work with a client who approached me with diet-related questions. Outside of the Heart Healthy Zoom demographic, she was a 31-year-old married mother of two boys under the age of 5. She had questions about how to maintain weight loss and leave a prepackaged meal diet program. However, her habits prior to the diet program concerned her, as he felt she did not know how to plan healthy meals, nor did she feel confident in cooking healthy meals. Initially, she asked for a “plan” she could follow. However, we were able to talk about healthy options for the whole family and ways to achieve it her way and with little resistance. She also asked me to address a constipation issue.
Education I provided:
Vegetable and fruit suggestions and amounts per day.
Building meals and snacks to include more vegetables.
Including fiber in the diet, amounts, and where to find it.
The importance of hydration.
Materials provided:
Healthy Meal Planning and Shopping from the Academy of Nutrition and Dietetics
Click here for to see preceptor feedback.
Module 6 - Evidence Based Research
For links to evidence-based materials created for the main health promotion project, please refer to links within Module 4 and 5.
I also made this Heart Health PSA video during this rotation:
Additionally, I created a mailer targeted at DC residents for Iona Senior Services. It was based on many of the same resources used for the Heart Healthy Zoom research. I adhered to Iona’s style guide to fit their organizational identity. Click here for list of resources.
