Return-Path: <root> Received: (from root@localhost) by literacy.nifl.gov (8.10.2/8.10.2) id f7VBut411375 for health-archive@nifl.gov; Fri, 31 Aug 2001 07:56:55 -0400 (EDT) Resent-Message-Id: <200108311156.f7VBut411375@literacy.nifl.gov> Received: from nt_domino.mrmc.mcleodhealth.org ([209.198.59.20]) by literacy.nifl.gov (8.10.2/8.10.2) with SMTP id f7OIFSf16861 for <nifl-health@nifl.gov>; Fri, 24 Aug 2001 14:15:28 -0400 (EDT) Received: by nt_domino.mrmc.mcleodhealth.org(Lotus SMTP MTA v4.6.7 (934.1 12-30-1999)) id 85256AB2.00629E3B ; Fri, 24 Aug 2001 13:57:10 -0400 X-Lotus-FromDomain: MCLEOD From: "Sandra McMillan" <smcmillan@mcleodhealth.org> To: nifl-health@nifl.gov cc: awhite@nal.usda.gov Message-ID: <85256AB2.00629CFC.00@nt_domino.mrmc.mcleodhealth.org> Date: Fri, 24 Aug 2001 13:57:04 -0400 Subject: Re: [NIFL-HEALTH:3298] Humor/health literacy/nutrition ed Content-type: text/plain; charset=us-ascii Content-Disposition: inline Resent-From: root@literacy.nifl.gov Resent-Date: Fri, 31 Aug 2001 07:56:55 -0400 Resent-To: health-archive@nifl.gov Status: O Content-Length: 5049 Lines: 82 Alicia - I am a Registered Dietitian, and fairly new subscriber to the listserv. For dietetic interns, real-life examples of nutrition education/health literacy "blunders" will help make your point with humor. I could probably come up with many more, but my favorite personal example is from about 15 years ago when I was a new dietitian, teaching a lady newly diagnosed with diabetes about the exchange lists (uuggh.) When I was going over the starchy vs. non-starchy vegetables, I was explaining that "beans and peas that you shell" were starches, such as lima beans, English peas, etc. She said that she bought her English peas in a can, so they must be non-starchy. Wow! I realized then and there that I must really pay attention to what I said and how I said it, and not take anything for granted when educating patients. Unlike other therapists with their various physical treatments, medical nutrition therapy's cornerstone is education. If we don't do a good job here, we've missed our boat. The most important message I have about nutrition education is that we must first LISTEN to our patients and learn about their lifestyle, motivation, and prior knowledge. Then THAT should be the starting point of nutrition education -- NOT the diet manual or the handout or the "canned" presentation. Bottom line -- no exceptions -- any other way of educating is unacceptable and pretty darn worthless. Dietitians tend to want to make our handouts all-inclusive and meticulously detailed. Writing for our audience is much different from writing for our nutrition professors. From a patient's perspective, the "finer points" don't mean a thing, and they have MUCH difficulty discerning the bigger-bang-for-the-buck recommendations from the it-really-isn't-going-to-make-that-much-difference part. For example, technical information about "trans fatty acids" is not only hard to remember, but pretty useless and irrelevant, too. What will make a bigger bottom-line impact on a person's health is useful and relevant information such as describing good heart-healthy ways to season vegetables. Another example -- a list of high-salt foods that seems to put saltines on par with bologna isn't effective in emphasizing the vast sodium content of bologna versus the virtually insignificant sodium content of a saltine. Because a saltine looks salty and tastes salty, they'll latch on to this information easily and spend more time avoiding the crackers than getting the message about all the processed meats they're eating. We need to remember, also, to evaluate materials not only for accuracy and relevance, but also for reading ease (plain language, limited or no abbreviations, symbols, etc.) Even for "literate" audiences, messages about unfamiliar topics are much better understood at lower reading levels. Another personal example ... my sister read some occupational therapy patient instructions left in my grandmother's hospital room once, and called me to see if I knew what they meant. She had read the material 5 times and didn't have a clue what it was trying to say. Now my sister doesn't have a lick of health literacy, but she DOES have a Master's degree in READING. Something is wrong here; we can do better. Another thing we dietitians are famous for that I would point out to the interns is *quantifying.* All through school they've been learning that limiting or including "x" amount of this or that in the diet will have a certain effect on one's health. Quantifying is absolutely essential for research and hospital diet manuals, but means very little as people make food choices on a day-to-day basis. Now I do think that carb counting is wonderful for people with diabetes (counting *1* thing is so much better than counting 6 things), and there are additional times when it is helpful or necessary to quantify dietary components. But I feel strongly that we should keep useless numbers out of our presentations of nutrition information -- a thousand times more so for limited-literacy audiences. For example, telling people to limit cholesterol intake to 200 mg per day might be science-based, but it also has the potential to make them paranoid and confused about choosing foods ... and THEN guess what happens? (You know, of course.) Unless I can help people make long-range choices that are compatible with their lifestyle and goals, I'm wasting my time and theirs ... a "diet" that lasts a week isn't going to add one minute to anyone's life. One last reminder for the interns ... while I was researching for a nutrition education/health literacy presentation to dietitians in my area recently, I came across a wonderful quote by Albert Einstein. Although we sometimes tend to think (especially the younger, freshly-educated among us) that using "plain language" is somehow degrading to our own intellect, Einstein said, "If you can't explain something simply, you don't understand it well." Sandra McMillan, RD Saint Eugene Medical Center Dillon SC 843-841-3311 smcmillan@mcleodhealth.org
This archive was generated by hypermail 2b30 : Fri Jan 18 2002 - 11:28:39 EST