Community Education

Intervention Project
Serving Size and Mindful Eating
Be Well For Life
Be Well For Life
Priscilla Bloom
ARAMARK Dietetic Internship
2014
Overview
Be Well for Life is a 16-week long program focused on improving the health of its
participants. It is a program open to the community and to those employed at Blessing Hospital.
Through this program several participants have lost weight, lowered their cholesterol, and
lowered their blood pressure. A program like this is very important in the city of Quincy, Illinois
as the adult obesity and diabetes rate is slightly higher than the overall rate for the state. By
providing the city with this type of program more nutrition education can be provided to the
community to prevent chronic diseases.
As part of the 16 week program participants are required to attend several classes
focused on nutrition education. The nutrition education is geared towards consuming a more
Mediterranean type diet. The classes also provide the participants with the ability to try different
recipes and to try to use certain recipes to cook together as a group. Participants have the ability
to ask questions and collaborate with one another.
One of the classes the participants are required to go to focuses on proper serving size
and mindful eating. The participants viewed a PowerPoint over the topic and the created a
recipe together. The recipe allowed the participants to work together, chopping, cutting, and
mixing, to complete the recipe. At the end of this process the participants divided the recipe into
proper serving size and started the associated activity in which they had to take a bite and wait
20 seconds before their next bite. The participants verbally stated how much this activity really
helped them slow down while they ate and how the flavors seemed to be more pronounced as
they focused more on their food. The lesson plan and the associated materials can be found in
the Appendix section.
Nutrition Assessment
Client History:
Be Well For Life is a 16-week program provided through Blessing Hospitals outpatient
center in Quincy, Illinois. The program focuses on improving overall health and does so by
providing the following
1
Health risk assessments
Physician consultations
Wellness coaching sessions
Group nutrition education
Individual nutrition consultation with a Registered Dietitian
Group therapy with an outpatient cognitive behavioral therapist
Stress management training
Yoga classes
Exercise prescriptions
Tobacco cessation counseling
Results indicate that Be Well For Life participants have drastically improved their health. Of the
participants that needed to 93% of participants lowered their body mass index, two out of three
reduced their total cholesterol level, and five out of seven lowered their blood pressure. Be Well
For Life is opened to the community and to those working at Blessing Hospital. Quincy, Illinois is
14.6 square feet and houses 40, 798 residents. Programs like Be Well are very beneficial in this
community as the rates for adult obesity and diabetes are slightly higher than those for the state
of Illinois, with diabetes at 9.4% and obesity at 25.7%.
2
Knowledge/Beliefs and Attitudes
Religion statistics shows that Catholics make up 39%.
2
Looking at the large catholic
population in Quincy and their views on healthcare, an article by the Park Ridge Center suggest
most Catholics take on a holistic approach to healthcare. Most devout Catholics believe that
suffering possess meaning. Although suffering may posses meaning in the Catholic faith the
patient is not expected to endure pain and can seek medical attention.
4
Education statistics
indicate that 89.1% of the population graduated high school and, although Quincy is home to a
university and a community college, only 21.5% of the population has earned their bachelors
degree.
2
Food/ Nutrition-Relates Food History
The racial demographics of Quincy, Illinois suggests the Caucasian population makes up
89.7% of the population and correlates with those who participate in the Be Well program.
2

According an article entitled Race, Location Big Factors in American Diets found on HealthDay,
data showed that Caucasian Americans typically followed a traditional or sweet diet. Traditional
diets tend to feature ready-to-eat or convenient foods. These processed foods tend to be
nutritionally poor foods that are higher in calories, fat, and sodium.
3

Those who participate in the Be Well program must attend several classes as part of the
program. The classes taught by the dietitian educate the participants on healthy eating and
promote implementing the Mediterranean diet into their daily routine. Information covered in
these classes range from whole grains, fruits and vegetables, lean protein, mindful eating and
serving size, and many more topics on how to improve the diet. These classes not only educate
the participant but they also allow for hands on experience as participants are involved in
cooking demonstrations
Factors affecting access to food and nutrition-related supplies
Those who participate in the Be Well for Life program dont typically present with food
insecurity. All participants express accessibility to everything they needed. The dietitian,
however, is very knowledgeable on the resources in the community that can assist with food
insecurity if need be!.
Nutrition Diagnosis
PES Statement
Food and nutrition related knowledge deficit related to undesirable food choices and lack of
prior exposure to nutrition-related information as evidence by the need for nutrition education,
cooking demonstrations, and participating in the Be Well For Life Program.
Nutrition Intervention
To address the nutrition diagnosis, the Be Well program requires participants to attend all
nutrition education classes taught by the dietitian.
Healthy People 2020
Healthy People 2020 was developed to improve the overall health of those living in the
United States. This 10-year agenda improves the Nations health by establishing several goals
and objectives, identifying nationwide health improvement priorities, increasing public
awareness, and engaging multiple sectors to take action.
5

One of the goals found at Healthy People 2020 is to increase the quality, availability, and
effectiveness of education and community-based programs designed to prevent disease and
injury, improve health, and enhance quality of life. One of the objectives for this goal is: Increase
the number of community-based organizations (including local health departments, Tribal health
services, nongovernmental organizations, and State agencies) providing population-based
primary prevention services injury (ECBP-10.1).
5
In 2008 76.6% of community health
organizations provided prevention services. Healthy People 2020 strives to increase that
number by 10% to 84.3% by 2020. More nutrition education provided within the community
would be very beneficial in preventing and managing diseases. The objective follows SMART
criteria, as a 10% increase in 10 years is specific, measurable, attainable, realistic and timed.
Lesson Plan
Mindful eating/serving size.
As part of one of one of the requirements participants must attend a class on mindful
eating and appropriate serving sizes. This class involves creating a meal together along with
education on why portion control is important and what is mindful eating. (Lesson plant template
in Appendix A)
Marketing
The curriculum established prior to the begging of the program determines what the
classes will discuss. The participants are notified on the required classes as the beginning of
each session. The classes are not so much marketed as they are required but each participant
gets some information on each class before the go. Be Well For Life is marketed on the Blessing
Hospital website, through flyers around the hospital campuses, through word of mouth from the
employees that have gone through the program.
Resources
The class needs several materials to meet the objectives of the class: ingredients for the
recipe, the designated PowerPoint that goes along with the class, handouts, plates, napkins,
utensils. Handouts, utensils, plates, and napkins will all be provided by Blessing Hospital. The
dietitian buys all the ingredients needed and is reimbursed by Blessing. The dietitian did not
specify a specific budget for each class but does try to choose recipes that are budget friendly.
The money spent for the ingredients came out to $20.
Nutrition Monitoring and Evaluation
Evaluation of the effectiveness of the class was done in the form of participant feedback
the end of the class. All the participants verbally stated how they felt at the end of the class and
what they learned. Many participants stated that the mindful eating activity was very beneficial.
They struggled with the activity in the beginning but towards the end appreciated what they
learned. As the mindful eating activity focused on taking your time while you ate the participants
stated the activity helped them slow down and as result the flavors in the salad they ate were
more noticeable.
In the future, since there are multiple classes, I would suggest testing the participants at
the start of each class about the information that was learned in the previous class. This would
allow the dietitian understand how much was retained from each class. The only other
suggestion would be to change the recipes so that they match the seasons and the fruits and
vegetables that go with each season. All in all the dietitian was very pleased with how the class
went and plans on continuing the activities in this class in the future.
Appendix A: Lesson plan template
Lesson plan template
BE Well for Life
Lesson plan: Mindful eating/serving size
Target audience: Be Well for Life participants
Duration: 45 -60 minutes
Additional
Notes
Concept/Topic


Appropriate serving sizes and mindful eating behaviors


Objectives










By the end of this class participants will identify correct portion
sizes of at least 3 common foods and will identify 5 habits
essential to mindful eating.

Introduction






RD will introduce themselves and what participants will be
learning

Content










Begin with serving sizes Powerpoint. Explain to participants
what a balanced plate looks like, how many of each food
group they should consuming daily, and what portions look
like. (15 minutes)

After completing the first PowerPoint allow participants to
begin working on the recipe. Divide the work so that the group
can work together in completing the recipe. As the participants
work on the recipe begin the mindful eating PowerPoint. This
PowerPoint is focused on habits to form during meal times.
(15 minutes)










Once you have gone through all of the slides and the
participants finish the recipe divide the recipe into appropriate
servings, making sure each participants gets a portion. It is at
this time that you can begin the mindful eating activity. Instruct
the participant to chew their food until the timer goes off (20
seconds). Participants are not allowed to take another bite
until the timer goes off. Encourage participants to converse
with each other. (5 minutes)
Handouts
Provided

WebMd Portion Size Guide, WebMd Portion-Size Guide
(Wallet size), University of Nebraska Lincoln Extension Avoid
Portion Distortion, Mindfulness Training: Eating Tips, Garden
Pasta Salad recipe, Three-day sample menu (handouts were
not created by intern, these handouts were already existing
handouts the dietitian in charge of the class provided to the
participants)

Evaluation











Participants should be fully engaged throughout education,
asking many questions. Participants will also be able to
identify correct portion sizes and mindful eating habits.

Conclusion









Allow time for participants to express how they felt after the
activity and for any questions they might have (10 minutes)



Materials: PowerPoint, ingredients for recipe, handouts,
Lesson plan resources:
Recipe: Garden Pasta Salad. Eating Well. Available at:
http://www.eatingwell.com/recipes/garden_pasta_salad.html Accessed on May 16, 2014.

Garden Pasta Salad
Ingredients:
- 2 cups whole-wheat rotini, (6 ounces)
- 1/3 cup reduced-fat mayonnaise
- 1/3 cup low-fat plain yogurt
- 2 tablespoons extra-virgin olive oil
- 1 tablespoon red-wine vinegar, or lemon juice
- 1 clove garlic, minced
- 1/8 teaspoon salt
- Freshly ground pepper, to taste
- 1 cup cherry or grape tomatoes, halved
- 1 cup diced yellow or red bell pepper, (1 small)
- 1 cup grated carrots, (2-4 carrots)
- 1/2 cup chopped scallions, (4 scallions)
- 1/3 cup slivered fresh basil

Directions:
1. Bring a large pot of lightly salted water to a boil. Cook pasta, stirring occasionally, until
just tender, 8 to 10 minutes, or according to package directions. Drain and refresh under
cold running water.
2. Whisk mayonnaise, yogurt, oil, vinegar (or lemon juice), garlic, salt and pepper in a large
bowl until smooth. Add the pasta and toss to coat. Add tomatoes, bell pepper, carrots,
scallions, olives and basil; toss to coat well.

Makes 6 servings, 1 cup each

Notes on Recipe
1. Make sure to rinse and wash all of your vegetables before you begin the recipe.
2. You can use any of your favorite vegetables or any of the vegetables you already have in
your fridge such as:
a. Broccoli
b. Cucumber
c. Asparagus
d. Summer squash
e. Zucchini
f. Celery
g. Artichoke hearts
h. Mushrooms
i. Cauliflower
3. Thro in some canned light tine, cooked chicken or flavored tofu to add some protein.
4. Covered and refrigerate this recipe can easily be made 1 day ahead of time.

References
1. Be Well For Life. Blessing Health System. Available at
http://www.blessinghealthsystem.org/bewellforlife. Accessed on May 1, 2014.
2. Quincy, Illinois. Available at http://www.city-data.com/city/Quincy-Illinois.html. Accessed on
April 20, 2014
3. Storrs, C. Race, location big factors in American diets. Healthday. 2012.
http://health.usnews.com/health-news/news/articles/2012/03/13/race-location-big-factors-in-
american-diets. Accessed April 20, 2014.
4. Hamel R, ORourke K. The Roman Catholic Tradition: Religious Beliefs and Healthcare
Decisions. Park Ridge Center. 2002: 1-28. Available at
http://www.che.org/members/ethics/docs/1271/Roman%20Catholic.pdf Accessed on April 20,
2014
5. Healthypeople.gov Available at http://www.healthypeople.gov/2020/default.aspx. Accessed on
May 5,2014.