The Digest Winter 2014 Issue

The
Digest
WINTER 2014
Message from the Chair

Public Health Nutrition through Technology
A skilled worker, regardless of the job
description, remains a treasure.
Madeline M. Kunin
Academy of Nutrition and Dietetics stands

at the forefront of using technology to
transform public health practice.
Greetings,
Moving forward, the Public

Health/Community Nutrition Practice
Group (PHCNPG) is enhancing the group
effort to offer high-quality continuing
professional education (CPE) opportunities.
In this issue, we are highlighting CPE
opportunities for PHCNPG members, as well
as addressing such questions as how can
technology be deployed to improve the
quality of healthcare delivery at a lower cost
and with a greater reach? What are the
challenges and opportunities that lie ahead
for those of us working in the public health
arena? We continuously learn about the
impact of todays internet conductivity and
(smart) mobile phone penetration, more
Wishing for you a joyous and happy holiday

season.
In the Winter issue of The Digest, we are
featuring several evidence- and practicebased articles on the role of technology in
Public Health Nutrition. The nation faces
unprecedented healthcare demands fueled
by an aging population, rising rates of
chronic disease, and persistent health
disparities. New technologies have the
potential to extend the reach of health
professionals while improving quality and
efficiency of care and reducing costs. The
INSIDE THIS ISSUE:

1-4 Messages from the DPG/Academy
Leadership
1 Message from the Chair
2 Message from the Student Committee
Chair
2 Free CPE Opportunities!
3 Message from the Delegate: Delegate
Update
3 Message from the Academys PHCN
Committee
4 CPE Opportunity from CDR!
5-13 Public Health Nutrition Through
Technology
10 Application of the Transtheoretical

Model for Weight Management
Interventions through the Use of Webbased Technology
11 Technology in Practice: Testimonials
from the Field
Using Social Media to Generate
Awareness about Global Issues
How the Use of Mobile Applications

Can Enhance Efficiency and
Productivity in Practice
12 Top Innovators in Dietetics Practice and
Education
14-16 PHCNPG @ FNCE 2014
5 Digital Health: Examples of EvidenceBased Health Technology
14 Summary of PHCNPG Events at FNCE
7 Costs and Benefits of Using Online Social

Networks to Promote Nutrition and
Physical Activity Behavior Change
15 Volunteers Provide Support for

Breastfeeding Mothers at FNCE 2014
9 Telehealth: An Internet-Based Tool for

Nutritional Assessment, Consultation,
and Monitoring of Diet-Related Health
Conditions
CPE Opportunity from FNCE!
16 Member Spotlight
2014 Academy Award Recipients

2014 PHCNPG Award Recipients
20 2014-2015 Executive Committee
than air travel, in

a world that is
now literally a
global village.
These
technologies
have
revolutionized
health service
delivery and act
as a game
changer for an
Bonnie J. Bradley
efficient and
people-centered healthcare system in this
present century. It is imperative that we
keep pace with the ever changing
information pathways by being on the
forefront of linking our members to
evidenced-based continuing professional
education resources.
At this time of year, it is also fitting to take a
backward look with gratitude and
thanksgiving for a very successful year.
Specifically, the Food & Nutrition
Conference & Expo (FNCE) 2014 was an
awesome experience for the PHCNPG, a
celebration of excellence! We recognized
and celebrated our successes both
individually and collectively. PHCNPG
members were honored as Medallion
Awardees, recognized for 50 years of
membership, presented educational
sessions, and promoted and staffed the
Mothers Room with students and DPG
volunteers during the entire Conference.
Refer to page 14 for more details.
Take time to read the Winter issue of
The Digest and learn about the impact of
modern technology in public health
nutrition as a potentially fruitful investment
in a rapidly evolving world of healthcare.
Happy reading and best wishes for a safe
and healthy Holiday Season!
Bonnie J. Bradley, MPH, RD, LD
PHCNPG Chair, 2014-2015
Message from the Student Committee Chair

Hello PHCNPG Student Members!
The last few months have been incredibly
busy as I have been working hand in hand
with the Student Committee and the
PHCNPG Executive Committee to enhance
your experience as valued members of our
practice group. The Student Committee
Chair position entails many responsibilities,
as well as numerous perks. One of my most
enriching experiences so far included
attending the 2014 Food & Nutrition
Conference & Expo (FNCE 2014) in
Atlanta, GA. I met many public health
nutrition professionals, leaders of other
practice groups, fellow PHCNPG student
members, as well as non-PHCNPG student
members with whom I was able to
exchange ideas, obtain advice from, and
mutually share experiences. Through
several activities, I also had the opportunity
to meet with PHCNPG Executive Committee
members who were eager to integrate me
into the dynamics of our practice group
meetings.
My experiences at FNCE 2014 gave me a
sense of direction as to where I see myself
in the future professionally, and I believe
I have a newfound confidence that the
future holds wonderful opportunities for
dietitians in public health and community

nutrition. Other student members had
great experiences at FNCE as well. Here are
some of their reflections:
I really enjoyed the PHCNPG reception and
the roundtable discussion that focused on
the future of public health nutrition! Both
were excellent opportunities to meet and
talk with leaders in the field. Randa
Meade, MS, MPH, Nutrition Graduate Student,
University of Tennessee.
I came back thoroughly inspired by the
field of dietetics. Ive always believed that
nutrition is my calling, and the direction
from which I can help people. Seeing so
many other amazing people doing just that
was incredibly encouraging for me.
I will definitely attend FNCE again!
Marielle Counts, Dietetic Intern, St. Louis
University.
What I liked most about FNCE 2014 was
that I met other students like me, and some
excellent nutrition professionals.
I loved the sessions I went to, and I enjoyed
visiting information booths from different
colleges where I could pursue my future
graduate studies. The experience of
meeting new people who gave me advice
about important
ideas on how to
improve my
future career as
a registered
dietitian was one
of my favorite
things, especially
at the PHCNPG
networking
meeting.
Lailiz Ortiz,
Mayra S. Crespo
Nutrition and
Dietetics
Student, University of Puerto Rico.
On another note, our goal to create a student
newsletter, The Student Digest, is on its way to
fruition as the first issue is expected to be
published in early 2015. Now, we need YOUR
feedback! We want to know what topics YOU
would like to read about! RD interviews?
Advice about applying for internships? Hot
topics for students in community nutrition?
We need your input as we are committed to
the development of our student members.
Feel free to write to us at mayra.crespo1@
upr.edu. We look forward to hearing from you!
Best regards,
Mayra S. Crespo Bellido, BS
Free CPE Opportunities

The following two articles published in the Journal of the
Academy of Nutrition and Dietetics are currently available for CPE
credit. Simply read an article, log in to the Academy website, and
take the journal quiz. You can earn 2.0 hours of CPE credit for
each article!
History Snapshot: Dietetics Student Experience in the 1940s
J Acad Nutr Diet. October 2014;114(10):1648-1662.
http://dx.doi.org/10.1016/j.jand.2014.08.001
CPE Credit: 2.0 hours
Quiz Expiration Date: 10/31/2015
Educational Objectives:
At the conclusion of this activity, the participant will be able to:
Outline some of the major societal changes which were taking
place in the 1940s; and
Discuss the evolution of dietetics education within the
context of the United States and international environments
of the 1940s.
The DigestWinter 2014
Dietetics Students Perceive Themselves as Leaders and Report

They Demonstrate Leadership in a Variety of Contexts
J Acad Nutr Diet. 2014 May;114(5 Suppl):S20-S25.
http://dx.doi.org/10.1016/j.jand.2014.02.024
CPE Credit: 2.0 hours
Quiz Expiration Date: 5/31/2015
Educational Objectives:
At the conclusion of this activity, the participant will be able to:
Understand self-reported leadership perceptions and
activities of dietetics students; and
Discuss factors which may impact leadership development in
future dietetics practitioners.
To take the Continuing Professional Education quiz for each
article, log in to www.eatright.org, click on myAcademy under
your name at the top of the homepage, select Journal Quiz from
the menu on your myAcademy page, click Journal Article Quiz
on the next page, and then click the Additional Journal CPE
Articles button to view a list of the available quizzes, from which
you may select the quiz for each article.
Message from the Delegate: Delegate Update

The House of Delegates (HOD) conducted a
mega issue dialogue on business and
management skills, and a current practice
issue discussion on the preceptor shortage
and limited supervised practice positions
on October 17-18, 2014 in Atlanta, GA.
As a result of the dialogue, two motions
were passed by the House. The following
activities have been requested:
HOD Motion #1: The HOD requests that
the House of Delegates Leadership
Team establish a task force with
representation from DPGs and internal
and external stakeholders. The task
force will review all of the HOD input
from the dialogue session to determine
a plan to assist members and students
with building, enhancing, and utilizing
skills and knowledge related to business
and management. The plan will need to
minimize impact on the Academys
budget. The plan will be submitted for
review by the House of Delegates in
May 2015.
HOD Motion #2: The HOD requests that

the Speaker communicate all of the
input generated by the HOD to the
Accreditation Council for Education in
Nutrition and Dietetics (ACEND), the
Commission on Dietetic Registration
(CDR), and Nutrition and Dietetic
Educators and Preceptors (NDEP) for
their consideration in addressing these
two critical issues facing the profession.
ACEND, CDR, and NDEP will report to
the House of Delegates on progress
to address these issues in spring and
fall 2015.
Many updates were provided to HOD
meeting attendees including
presentations from: Sonja Connor
(Academy President), Donna Martin
(Academy Treasurer), Terri Raymond
(Academy Foundation Chair) accompanied
by Katie Brown (Academys National
Education Director), Brenda Richardson
and Denise Andersen (Academy Political
Action Committee), and Julie Grim
(Nominating Committee).
The Speaker of the HOD, Elise Smith, issued

a challenge to have 100% of the HOD
donate financially to the Academys Political
Action Committee, and the challenge was
met. The HOD stands behind our profession
and supports the Academys policy efforts.
Following the Fall 2014 HOD Meeting,
27 delegates participated in the Atlanta
Food Bank Event helping to sort through
food and non-food donations and package
them for distribution to food pantries. The
delegates participated with other Academy
members to pack 6,192 pounds of food and
non-foods at the food bank, which resulted
in 5,160 meals for clients.
All materials related to Fall 2014 House of
Delegates Meeting, including the updates
from various Academy organizational units
and outcome materials, are located online
for members: www.eatright.org/hod > Fall
2014 HOD Meeting > Meeting Materials.
Shannon Looney, PhD, MPH, RD
PHCNPG HOD Representative
Message from the Academys PHCN Committee

A Public Health and Community Nutrition Committee Established within the Academy of Nutrition and Dietetics
Margaret Tate, MS, RD
Chair, Public Health and Community
Nutrition Committee, Academy of Nutrition
and Dietetics
Effective June 1, 2014, a new committee was
formed within the Academy of Nutrition and
Dieteticsthe Public Health and
Community Nutrition Committee. This
committees purpose is to increase
awareness of public health within the
Academy, as well as develop external
partnerships with the broader public health
community.
The Academy Board of Directors (BOD)
initially appointed a task force in fall 2011 to
begin examining ways to increase the
Academys knowledge of public
health/community nutrition practice. The
task force first met in January 2012, and
developed an action plan which was
approved by the BOD in March 2012. The
task force submitted a proposal to the
Academys House of Delegates (HOD) for a
mega-issue on public health and

community nutrition. The proposal was
approved and the session, Public Health:
Its Every Members Business, was held at
the HOD meeting on October 16, 2012.
Following the deliberations, the HOD
Leadership Team appointed a task force to
address the outcomes of the meeting. As a
result, a second plan was developed,
focusing on how to enhance public health
knowledge and skills in the membership.
The plan was approved by the HOD
Leadership Team in October 2013.
Following the HOD meeting, the task force
merged the two action plans and
submitted a proposal to the BOD to
approve a standing Public Health and
Community Nutrition Committee. The
proposal was approved and the committee
became effective in June 2014.
Why does the Academy need a committee
to move forward the area of public health
and community nutrition? The Academys
need to strengthen its public health focus is

driven by a number of external factors, such
as the Affordable Care Act, the aging of the
population, the escalation of food
insecurity resulting in the increased need
for community nutrition programs, and the
surge in nutrition-related chronic diseases.
Public health practice impacts the Academy
as a whole, with two Dietetic Practice
Groups (DPGs) having a public health/
community nutrition focus, namely Public
Health/Community Nutrition, and Hunger
and Environmental Nutrition. As a
committee, public health will play a more
prominent role as a resource in all areas of
the Academy.
Some of the Committees accomplishments
to date include:
Shared definitions developed by the
task force on public health and
community nutrition with both internal
and external partners.
Met with the Hunger and Environmental
Nutrition DPG leadership to discuss
strategies for working together on the

implementation of the Food and
Nutrition Security Task Force Action
plan.
Presented two sessions at FNCE 2014 in
Atlanta, GA, which included a general
session entitled Changing Environments,
Emerging Opportunities in Public Health
and Community Nutrition held on
October 20, 2014, and an open
discussion session on Your Role in the
Future of Public Health Nutrition held on
October 21, 2014.
Presented at selected DPG and Member
Interest Group (MIG) meetings at FNCE
2014 on the work of the committee.
Some of the Committees plans for the
2014-2015 membership year are to:
Develop the Public Health/
Community Nutrition Action Plan which
includes the combined BOD and HOD
Action Plan.
Develop and maintain a resource toolkit
to be housed on eatrightpro.org and
include key readings on public health
nutrition and community nutrition, and
links to other information and materials
developed by the Academy and other
organizations; include a section in the
toolkit for educators to enhance
understanding and promote
intersection of public health nutrition

and community nutrition competencies.
Provide oversight of the Food and
Nutrition Security Task Force Action
Plan.
Develop a proposal for a general session
on public health nutrition for FNCE 2015.
Develop a think tank bringing together
leaders in public health and community
nutrition to explore significant issues
impacting public nutrition programs
and positions.
Author an article on the Public Health
and Community Nutrition Committees
plans for publication in the Journal of
Academy of Nutrition and Dietetics.
Explore a possible certificate of training

in Public Health Nutrition/Community
Nutrition.
Develop a communication strategy to
public health practitioners who are nonAcademy members.
The Committee has many wonderful ideas
with a need for volunteers to make the
ideas a reality. If you are interested in
working on any of these exciting efforts to
strengthen the Academys focus on public
health, please let us know. For additional
information, please contact Diane Juskelis,
Director, DPG/MIG/Affiliate Relations
(djuskelis@eatright.org or 800/877-1600
ext. 4811).
2014-2015 Public Health and Community Nutrition Committee

Margaret J. Tate, MS, RD, Chair (AZ)
Helene M. Kent, MPH, RD, Vice-Chair (CO)
Jason Pelzel, MPH, RD, Member-Young Practitioner (DC)
Doris C. Fredericks, MEd, RD, FADA, Member- PHCNPG Representative (CA)
Karen Ehrens, LRD, Member Liaison to LPPC (ND)
Tiffani L. Grant, MS, RD, Member (MS)
Aida Miles, MMSc, RD, LD, Member HLT/BOD Liaison (MN)
Harold J. Holler, RDN, LDN, Academy Staff
Diane Juskelis, MS, RD, LDN, Academy Staff
Earn Continuing Professional Education Units from Your Computer

Do you need continuing education hours to fulfill your CPEU requirements?
CDR has the perfect CPEU opportunity for you.
CDRs Online Assess and Learn Series assesses the knowledge
and skills you currently have in a particular dietetics related area,
within the context of a case scenario. Feedback on your
performance is provided to assist you in determining your
current and future learning needs. Currently there are four
online Assess and Learn modules available:
Celiac Disease
Gerontological Nutrition
Sports Dietetics: Nutrition for Athletic Performance
Managing Type 2 Diabetes Using the Nutrition Care Process
Each module has been approved by CDR for 5 CPEUs and costs $45.99.
Forinformation,
information,please
please visit
visit CDRs website
For
websitecdrnet.org/products/assess-learn-online-continuing-education-modules
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Digital Health: Examples of EvidenceBased Health Technology

Graham A. Colditz, MD, DrPH
Hank Dart, MS
To improve public health in a meaningful
way, research must be translated into
action. New evidence suggests that
personal technology can serve as a gateway
of communication and intervention for the
general public. As smart phones and tablets
advance on a nearly daily basis, public
health researchers must keep up. In this
process, scientific research and publication
must not be viewed as the ultimate goal,
but as the first steps towards developing
useful and effective tools for the public.
At Washington University School of
Medicine, this drive to translate research
into effective tools has led to the
development of a suite of online risk
assessment tools. Two such popular tools
include the long-running Your Disease Risk
website (yourdiseaserisk.wustl.edu) and the
newer Zuum iPad app (tinyurl.com/zuum
app). Together, Your Disease Risk and Zuum
bookend the history of online health
toolsfrom the nascent days of the
Internet to todays near ubiquity of mobile
personal technology.
Your Disease Risk was conceived in the late
1990s and launched in January 2000. The
tool originated at the Harvard Center for
Cancer Prevention under the name, the
Harvard Cancer Risk Index. A working group
of Harvard epidemiologists, statisticians,
and communication science faculty used a
consensus approach to identify the cancers
included in the Index (they accounted for
80% of United States cancer burden), as
well as to develop the tools risk calculation
algorithms. A transdisciplinary team that
included writers, programmers, designers,
and psychologists then developed and
launched the online version of the Index
under the name Your Cancer Risk. It
included twelve cancers by the end of 2000.
In 2004, to emphasize that many chronic
diseases share common risk factors, the site
expanded to include heart disease, stroke,
diabetes, and osteoporosis. The site was
then renamed Your Disease Risk.
adopting healthy behaviors (see Figure 1).

An ongoing working group consensus
process is used for scheduled scientific
updates.
million unique visitors, and has often been

featured in popular media.5-8 Numerous
medical centers have adopted the tool for
either public outreach or for risk
communication research.
Analyses show that Your Disease Risk

provides valid estimates of cancer risk in the
general population. Discriminatory accuracy
for men is 0.71 for colon cancer and 0.72 for
pancreatic cancer where 1.0 indicates a
tool that perfectly predicts a disease, and
0.50 indicates a tool that poorly predicts
disease, like tossing a coin. For women,
discriminatory accuracy is 0.67 for colon
cancer, 0.59 for ovarian cancer, and 0.71 for
pancreatic cancer. These numbers exceed
the accuracy of many other popular,
published risk assessment tools.2-4
Validation studies of the heart disease tool
and the sites other non-cancer tools are
ongoing, with select results expected to be
published sometime in 2015.
Wide reach has been a long-term goal for

the Your Disease Risk tool and one that has
helped guide its development from
concept, through formative research in
diverse populations, and then into launch
and maintenance. In an analysis of lay colon
cancer information websites, Your Disease
Risk was assessed at a reading grade level of
9.0, well below the average of 12.8 for all
sites included in the study, making Your
Disease Risk more readily accessible by the
general public.9 The site has been used
successfully in low-income areas of Boston,
MA, as well as Ward 4 of Washington, DC.10
A Spanish language version of the tool
(Cuidar de su Salud) was live for many years.
The strong dual focus of Your Disease Risk on

science as well as communication has
created a tool popular with both researchers
and the general public alike. Since its launch,
Your Disease Risk has reached well over four
One limiting factor of the Your Disease Risk

tools, however, is their length. Though each
disease can be completed in just a few
minutes, completing multiple diseases at a
single session can add up to a significant
Figure 1. Your Disease Risk
In its current version, Your Disease Risk

provides visitors risk estimates for 17
distinct chronic diseases, personalized plans
for lowering risk, as well as a dynamic visual
that shows the risk-reducing benefits of
amount of time. Results for each disease are

also presented separately. While this gives a
great deal of power to the user to choose
the detailed results he or she wants to see,
it also provides separate disease results and
health messages which can lack an easily
gleaned overarching message. These two
qualities of Your Disease Risk can make it an
imperfect fit for a number of time-pressed
settings, such as health fairs, worksite
wellness sessions, and waiting rooms in
healthcare facilities. These are settings
where a risk assessment tool has great
value, but also where time and space issues
prevent use of the large-screen format and
the one-disease-at-a-time approach of Your
Disease Risk.
The Zuum iPad app was developed and
launched in 2012 specifically for such timepressed settings. Using the science and
framework of Your Disease Risk, Zuum uses a
short single questionnaire to provide results
for six major chronic diseasesheart
disease, stroke, diabetes, lung cancer, colon
cancer, and breast/prostate cancer.11 Similar
to Your Disease Risk, Zuum provides a
personalized prevention plan and a
dynamic risk visual showing the benefits of
adopting healthy choices (see Figure 2).
The entire experience of answering the
questionnaire and exploring risk results
takes as little as three minutes.
The multi-disease approach of Zuum makes
the tool unique among many health risk
assessments. Although many users are
aware that a sedentary lifestyle is a risk
factor for heart disease, diabetes, and
colorectal cancer, many online tools do not
provide a single, dynamic visual to show the
actual amount of physical activity needed
to lower personal risk for each of these
diseases simultaneously. Likewise, healthy
lifestyle recommendations that are part of
common health risk assessments are often
disease-specific. While Zuum offers
recommendations for each individual
disease, its primary prevention plan is
driven by overall chronic disease risk,
emphasizing shared risk factors, and
increasing awareness of comprehensive
disease prevention resulting from a healthy
lifestyle.
A prototype of Zuum was assessed in a
research project at Partners Healthcare in
Boston, demonstrating successful
integration into a primary care setting.12
Building on this, Zuum is now being studied
as a means to reach typically underserved
populations in low-income and rural
primary care health clinics.13 With funding
from the Aetna Foundations Digital Health
Initiative, the iPad app is being used by
patients in clinic waiting areas, who then

share results with their doctors at their
scheduled visits. For three months after the
visit, patients receive regular text messages
personalized to their app results. Initial
findings from the study are expected
sometime in 2015.
Many of the elements contained in Your
Disease Risk and Zuum are based on
research that shows how effective
approaches in communicating risk can help
foster behavior change. These include
providing personalized risk estimates and
information about the risk of the average
person, as well as demonstrating how
changes in behaviors may affect future
personal risk.14-20
Evidence-based tools like Your Disease Risk
and Zuum are likely to have an
indispensable place in the health landscape
that is becoming increasingly crowded as
professional and market opportunities for
developing health technologies expand. It
is truly an exciting time filled with great
potential to make meaningful differences in
the health of at-risk populations. At the
same time, it is important to remain focused
on the importance of scientific evidence,
and the evaluation and re-assessment of
these new technologies. Circling back to
these mainstays of public health will help
ensure that these modern tools actually
make a difference and arent just the latest
shiny things that lack solid scientific
backing and evidence of improvements in
health outcomes.
About the Authors
Dr. Graham A. Colditz is a Professor of
Surgery and Medicine, Chief of the Division
of Public Health Services, and Deputy
Figure 2. Zuum
Director of the Institute for Public Health at

Washington University School of Medicine in
St. Louis, Missouri. He also serves as the
Associate Director of Prevention and Control
at the Alvin J Siteman Cancer Center.
Hank Dart is a communications consultant
who works in prevention and control for the
Alvin J Siteman Cancer Center at Washington
University School of Medicine. He is currently
the project leader of the health risk
assessment website, Your Disease Risk.
References
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Andry A, Williams DH, Orav EJ, Haas JS, Getty
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Innovations to improve population health
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2014.302335. PubMed PMID: 25320886.
14. Edwards AG, Naik G, Ahmed H, Elwyn GJ,
Pickles T, Hood K, Playle R. Personalised risk
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Cochrane database of systematic reviews.
2013;2:CD001865. doi: 10.1002/14651858.
CD001865.pub3. PubMed PMID: 23450534.
15. Stacey D, Bennett CL, Barry MJ, Col NF,
Eden KB, Holmes-Rovner M, LlewellynThomas H, Lyddiatt A, Legare F, Thomson R.
Decision aids for people facing health
treatment or screening decisions. The
Cochrane database of systematic reviews.
2011(10):CD001431. Epub 2011/10/07. doi:
10.1002/14651858.CD001431.pub3.
16. Lerman C. Effects of individualized
breast cancer risk counseling: A randomized
trial. Journal of the National Cancer Institute.
1995;87:286-92.
17. Dillard AJ, Ubel PA, Smith DM, ZikmundFisher BJ, Nair V, Derry HA, Zhang A, Pitsch
RK, Alford SH, McClure JB, Fagerlin A. The

Distinct Role of Comparative Risk
Perceptions in a Breast Cancer Prevention
Program. Annals of behavioral medicine : a
publication of the Society of Behavioral
Medicine. 2011. Epub 2011/06/24. doi:
10.1007/s12160-011-9287-8. PubMed PMID:
21698518.
18. Fagerlin A, Zikmund-Fisher BJ, Ubel PA.
If Im better than average, then Im ok?:
Comparative information influences beliefs
about risk and benefits. Patient Education &
Counseling. 2007;69(1-3):140-4.
19. Klein WMP. Comparative risk estimates
relative to the average peer predict
behavioral intentions and concern about
absolute risk. Risk, Decision & Policy.
2002;7(2):193-202.
20. Weinstein ND, Lyon JE, Cuite CL,
Sandman PM. Experimental evidence for
stages of health behavior change: The
precaution adoption process model applied
to home radon testing. Health Psychology.
1998;17(5):445-53.
Costs and Benefits of Using Online

Social Networks to Promote Nutrition
and Physical Activity Behavior Change
David Cavallo, PhD, MPH, RDN
Online social networks (e.g., Facebook,
Twitter) hold significant potential as a tool
for improving dietary and physical activity
behavior. The use of online social network
websites has grown exponentially since
these websites were introduced, and
currently almost three-quarters of online
US adults now use online social network
websites.1 Once largely the domain of
younger users, these websites now reach a
broad demographic range. In fact, 45% of
online users over 65 years of age use
Facebook.1 These sites are also popular
among racial/ethnic minorities and
individuals with low socioeconomic status,
opening the possibility that social media
sites could be used in efforts to reach
individuals most at risk for poor dietary
and physical activity behavior.2 In addition,
disparities in access to these websites is
lessening as greater numbers of
individuals gain access to the internet
through mobile devices.3 Users are also
now turning to online social network
websites for health information by
following their online friends personal
health experiences (23%) and obtaining

general health information (15%).4
Online social network websites offer a
number of potential ways of influencing
dietary and physical activity behavior. One
approach is to use these websites as a media
communications tool to promote optimal
nutrition and physical activity. This can be
accomplished in several ways. Online social
networks provide opportunities for
marketing through the use of paid
advertisements, which can be targeted to
specific demographic groups and
geographic locations. Health promoting
organizations can also set up their own
online social network presence through the
use of tools within existing services. An
example is the Center for Disease Control
and Preventions Facebook page
(https://www.facebook.com/CDC), which
has approximately 400,000 followers, and
produces health related content on a daily
basis that is pushed out to and shared by
Facebook users. These types of efforts are
also present at the local level in many
geographic regions (e.g., Chicago
Department of Public Health Facebook page,
https://www.face
book.com/
Chicago
PublicHealth;
Arizona
Department of
Health Services
Twitter account,
https://twitter
.com/AZDHS).
In addition to
public sector
David Cavallo
social media
efforts around
health promotion, there are other groups
who promote optimal nutrition and physical
activity through their social media presence
including organizations such as the National
Dairy Council (https://www.face
book.com/nationaldairycouncil) or our own
Academy of Nutrition and Dietetics (https://
www.facebook.com/EatRightNutrition).
Another related approach to using online
social networks for promoting optimal
nutrition and physical activity is conducting
more structured nutrition and physical
activity behavior change programs
delivered through online social network

websites. There is an emerging body of
research examining the feasibility and
effectiveness of this approach. Several
studies have employed online social
network features such as groups, fan pages,
and Twitter accounts to influence important
determinants of dietary and physical
activity behavior including social support
for and behavioral modeling of positive
behaviors. In one study, a Facebook group
was developed for college undergraduates
interested in increasing their physical
activity where a moderator encouraged
them to share information and emotional
support by contributing prompts to the
group.5 In the area of weight loss, studies
have examined the delivery of weight loss
campaigns via Facebook to college
students and the use of Twitter to promote
social support for weight loss among
adults.6-8 To date, these studies have failed
to demonstrate that use of social media
sites has a significant impact on weight loss
or changes in physical activity behaviors,
and the sites have had difficulty
maintaining user interest over time.
However, there is some evidence of an
association between the use of social
network features in these studies and those
outcomes.9, 10
Attracting and engaging users requires

a commitment to frequently updating
content, and producing content that is
interactive and relevant to the target
audience. This content also needs to be
consistent between platforms, and
integrated well with other communications
efforts (e.g., website, print materials).
For example, a local health department
promoting weight maintenance during the
holidays should promote related content
between its online social network
platforms, website(s), and other
communications materials. This type of
campaign may require the hiring of an
outside company with expertise in the
design and execution of media campaigns.
Implementing more structured online social
network-based health behavior change
programs has similar needs, as participants
in these programs need to be recruited, and
provided with content that will keep them
engaged over the length of the program.
In addition, because the success of an
online social network program is predicated
on the development and sharing of content
by users, a risk exists that these
contributions may not be congruent with
the mission or message of the organization,
and will need to be monitored and
responded to.
Despite the potential of using social media

to improve dietary and physical activity
behavior, many challenges exist with this
approach. Although used in the majority of
commercial marketing efforts, paid
advertisements sold by online social
network websites may be prohibitively
expensive for smaller health-related
organizations, especially those funded by
the public sector. For many organizations,
establishing a social network presence
themselves (e.g., through the creation of a
Facebook fan page or a Twitter account for
the organization) may be the only option.
Although the process of creating a social
network site or account can be relatively
simple and inexpensive, producing one that
is successful in attracting and engaging
users is more difficult and requires time,
effort, and money. It is engagement that
drives both the growth of users as they
invite and encourage others to get
involved, and the dissemination of the
organizations message as users share
online social network content with each
other. Engagement is also critical for
structured online social network-based
health behavior change programs, where it
influences the dose of the program (e.g.,
how much social support is exchanged) as
well as other measures of effectiveness such
as how many participants complete the
program.
Using online social networks such as

Facebook and Twitter to promote nutrition
and physical activity is a potentially
powerful tool for many organizations.
As a media communications tool, a
structured behavior change program or
some combination of both online social
networks and websites provide extensive
reach to the general population and
traditionally underserved groups. There are,
however, many potential challenges,
including the need for resources both in
money and staff time, and the ongoing
battle to keep users engaged. Organizations
considering the use of online social
networks to promote optimal nutrition and
physical activity should consider the costs
and commit the necessary resources if they
decide to use this approach.
About the Author

David Cavallo is a PHCNPG member and an
Assistant Professor in the Department of
Nutrition at Case Western Reserve
University in Cleveland, Ohio. Dr. Cavallo
teaches in the Master of Science in Public
Health Nutrition Dietetic Internship
Program, and conducts research on the use
of emerging communications technologies
in health behavior change interventions.
Using online social

networks such as
Facebook and Twitter
to promote nutrition
and physical activity
is a potentially
powerful tool for
many organizations
References
1. Duggan M, Smith A. Social Media Update
2013. 2013, Pew Research Center.
2. Social Networking Fact Sheet. 2013, Pew
Research Center: Washington, DC.
3. Mobile Technology Fact Sheet. 2013, Pew
Research Center: Washington, DC.
4. Fox S. The Social Life of Health Information,
2011. 2011, Pew Research Center:
Washington DC.
5. Cavallo D, et al. A social media-based
physical activity intervention: a randomized
controlled trial. Am J Prev Med, 2012. In
press.
6. Napolitano M, et al. Using Facebook and
Text Messaging to Deliver a Weight Loss
Program to College Students. Obesity.
Silver Spring, 2012.
7. Turner-McGrievy G, Tate D. Tweets, Apps,
and Pods: Results of the 6-Month Mobile
Pounds Off Digitally (Mobile POD)
Randomized Weight-Loss Intervention
Among Adults. J Med Internet Res, 2011.
13(4): p. e120.
8. Merchant G, et al. Click like to change
your behavior: a mixed methods study of
college students exposure to and
engagement with Facebook content
designed for weight loss. J Med Internet Res,
2014. 16(6): p. e158.
9. Cavallo D, et al. Social support for physical
activityrole of Facebook with and without
structured intervention. Translational
Behavioral Medicine, 2014: p. 1-9.
10. Turner-McGrievy GM, Tate DF. Weight
loss social support in 140 characters or less:
use of an online social network in a
remotely delivered weight loss intervention.
Translational Behavioral Medicine, p. 1-8.
Telehealth: An Internet-Based Tool for

Nutritional Assessment, Consultation, and
Monitoring of Diet-Related Health Conditions
Amanda Bontempo, MS, RD, CND
How Does Telehealth Relate

to Nutrition?
In the age of the Internet and the 24-hour

news cycle, consumers can be almost overinformed. After reading one too many
health or fitness articles that pose
contradictory recommendations,
consumers may be left feeling completely
spun around without a clear idea of what
they can do to improve their health.
Additionally, busy work schedules, family
obligations, or everyday life can present
barriers to making health a priority.
Therefore, consumers most often look for
ease and clarity. They need to know whats
true, whats effective, whats worth it, and
what they can begin to change, starting
today. Telehealth can be that much-needed
bridge of clarity for clients.
Telehealth platforms like Maven are uniquely

suited to be telenutrition platforms,
providing nutrition interventions for disease
prevention and treatment via health
promotion, consultation, and nutrition
therapy. Chronic diseases are pervasive in our
society, and the US Centers for Disease
Control and Prevention estimates that as of
2012, approximately half of all adults117
million peoplein the US had one or more
chronic health conditions; one out of four
adults had two or more chronic health
conditions. Seven of the top ten causes of
death in 2010 were chronic disease.
Telehealth platforms can improve access to
nutrition therapy and remote monitoring to
manage chronic health conditions. In this
way, telenutrition fosters functional medicine
for caring for an individual with controllable
conditions. For example, people with
diabetes have been shown to improve
glycated hemoglobin results, and those with
heart disease have shown improved lipid
panels, resulting in reduced healthcare costs
related to medications, hospital admissions,
and emergency room visits.2-4 The potential
benefit of using telehealth for nutrition
interventions to control chronic disease is
enormous.5
What Is Telehealth?
Telehealth is defined as the use of
electronic information and
telecommunication technologies to
support long-distance clinical healthcare,
patient and professional health-related
education, public health, and health
administration, according to the
Department of Health Resources and
Services Administration.1 One company
that is preparing for launch of a telehealth
platform in winter 2015 is Maven. Through
this service, Maven will offer an online
health platform that provides fast and
convenient virtual care to women
including new motherswhose lives are
fraught with barriers to receiving quality
care, including time and traveling
distance.
How Is Telehealth Used in Practice?

Via telehealth, Maven has essentially
created a clearinghouse of health experts to
provide credible and evidence-based care,
allowing clients to remotely engage with
healthcare providers and thus further
removing barriers to quality care. What
does this mean? Through an app, clients
can book a video appointmentor a series
of several video appointmentswith a
nutritionist of their choice to develop a
custom-made plan for meeting their health
goals. This convenient and almost
immediate intervention encourages users
to engage and commit to their own care,
enhancing the client experience and, more
importantly, improving nutrition and health
outcomes.
What is the Take-Away Message

on Telehealth?
Simply searching the Internet for answers
will not make people healthy. Health
practitioners know that the Internet is
flooded with inaccurate information among
quality, cutting-edge data and trusted
resources. Through telehealth, the nutrition
practitioner can become an easily available
and trusted source to guide consumers
through the chaosone who also offers
personalized support and encouragement.
A Final Note from the Author

Telehealth, at its foundation, is a return to a
healing ethos of healthcare. I truly believe
that it is not only possible, but is our moral
obligation as providers to harness
technology to return to the provision of
quality healthcare, while simultaneously
improving community nutrition and public
health.
About the Author
Amanda Bontempo is a Registered
Dietitian at the New York University
Perlmutter
Cancer Center, a
National Cancer
Institutedesignated
cancer center, in
New York City,
where she
advises
hospitals,
universities,
private medical
practices, chefs,
Amanda Bontempo
and hotels as
the founder of Spill the Beans Nutrition
Consulting. Ms. Bontempo also consults
with Maven, the digital clinic for women,
connecting nutritionists and new clients
via video appointments. Follow Amanda
on Twitter @AmandaBontempo.
References
1. US Department of Health and Human
Services, Health Resources and Services
Administration. Telehealth.
http://www.hrsa.gov/ruralhealth/about/tele
health/. Accessed November 18, 2014.
2. Levin K, Madsen JR, Petersen I, Wanscher
CE, Hangaard J. Telemedicine diabetes
consultations are cost effective, and effects
on essential diabetes treatments
parameters are similar to conventional
treatment: 7-year results from the
Svendborg Telemedicine Diabetes Project.
J Diabetes Sci Technol. May 2013;7(3):
587-595.
3. Chilelli NC, Dalfr MG, Lapolla A.
The emerging role of telemedicine in
managing glycemic control and
psychobehavioral aspects of pregnancy
complicated by diabetes. International
Journal of Telemedicine and Applications.
September 2014.
4. Odnoletkova I, Goderis G, Nobels F,
Aertgeerts B, Annemann L, Ramaekers D.
Nurse-led telecoaching of people with type
2 diabetes in primary care: rational, design
and baseline data of a randomized
controlled trial. BMC Family Practice.
2014;15(24).
5. Ho YL,Yu JY,Lin YH,Chen YH,Huang
CC,Hsu TP,Chuang PY,Hung CS,Chen MF.
Assessment of the cost-effectiveness and
clinical outcomes of a fourth-generation
synchronous telehealth program for the
management of chronic cardiovascular
disease. J Med Internet Res.
June 2014;16(6):e145.
Application of the Transtheoretical Model

for Weight Management Interventions
through the Use of Web-based Technology
Janice M. Prochaska, PhD
How is the Weight Management

Intervention Delivered?
The transtheoretical model of behavior

change (TTM), an evidence-based approach
commonly used in weight management
counseling, involves assessing an
individuals readiness to engage in healthy
behaviors. By identifying the individuals
stage of change, a practitioner can better
tailor an intervention whether the
individual is in a stage of Precontemplation
(not ready), Contemplation (getting ready),
Preparation (ready), Action (doing the
healthy behavior), or Maintenance (doing
the healthy behavior for six or more
months).
After assessment, participants are staged in

a computerized tailored intervention (CTI)
session, and assessed on their pros and
cons, confidence, and processes of change.
They receive feedback through the
following four categories:
Pros and Cons: Lists the pros of adopting
or engaging in the new healthy
behavior (e.g., regular exercise and
eating healthy), and how the
participants scores compare to those of
others who have changed successfully,
including strategies for increasing the
pros, and decreasing the cons.
Confidence: Identifies situations in
which the participant is most tempted
to engage in the unhealthy behavior
(e.g., skip exercising or indulge in
overeating), and ideas for coping with
those situations.
Processes of change: Identifies how
frequently the participant is using
specific stage-matched processes of
change and how he or she compares
with others who were most successful in
progressing to the next stage of change.
Strategies: Determines small steps for
progressing to the next stage of change
(e.g., starting to walk for one-quarter
mile each day, or reducing calorie intake
by 100 calories a day).
With the evolution of technology,

web-based programs are being developed
that can individualize behavior change
guidance, offering a format that saves both
individuals and practitioners time and
money, while offering consistency in
results. Pro-Change Behaviors Systems, Inc.,
a company that offers engaging and
evidence-based behavior change solutions
through a variety of technologies, uses
the TTM as a basis for their Utilization
Review Accreditation Commission (URAC)
award-winning program in weight
management.
How is Readiness to Change

Assessed?
The weight management intervention
offered by Pro-Change focuses on
increasing exercise and improving eating
habits of participants. A software program
administers assessments, scores them, and
follows empirically-derived decision rules to
deliver individualized feedback and
guidance efficiently, cost-effectively, and
with fidelity.
First, participants are staged on their
readiness to:
Eat 500 fewer calories a day to reach and
maintain a healthy weight;
Eat a diet low in unhealthy saturated
and trans fat;
Exercise at least 150 minutes/week; and
Manage emotions using healthy
strategies like relaxation instead of
eating.
10
Participants are then able to access a

printed report, as well as an online Personal
Activity Center (PAC) where they can find
information and activities designed to
elaborate on and reinforce ideas presented
during the CTI session.
Specific activities are suggested based on the
participants stage of change, and include:
Listing the benefits of the new healthy
behavior;
Examining their self-image as it relates
to the healthy behavior;
Developing a plan for action;
Getting support;
Substituting unhealthy behaviors with
healthy behaviors;
Avoiding people, places, and things that
increase temptation to engage in the
unhealthy behaviors; and
Identifying intrinsic and extrinsic
rewards for healthy behaviors.
How are
Participants
Monitored
and
Evaluated?
Thirty days and
60 days after the
first CTI session,
participants may
be prompted by
up to eight text
and/or email
Janice Prochaska
messages to
return to the CTI program to complete a
follow-up session. During follow-up
sessions, the CTI reassesses the TTM
measures, tracks and gives feedback on
stage transitions and changes in stagematched principles and processes of
change, and provides access to an updated
printed report.
In addition to the CTI feedback reports and
the PAC, participants can receive tailored
text messages every one to three days,
depending on their current stage of
change. All text message feedback is
individually tailored to the participants
most recent stage of change, and scores on
measures to include pros and cons,
confidence, and processes of change. For
example:
Individuals in Precontemplation and
Maintenance receive a text message
every three days, with a maximum of 30
messages between CTI sessions. A
participant in the Precontemplation
stage for reducing calories might receive
the following message to facilitate
Consciousness Raising: Start learning
about all the pros of having a healthy
weight. It could inspire you to start
thinking about healthy eating.
Individuals in Contemplation receive a
message every two days, with a
maximum of 45 messages between CTI
sessions.
Individuals in Preparation and Action
receive a message every day, with a
maximum of 90 messages between CTI
sessions. A participant in Preparation
might receive the following message to
increase confidence: Read about
relaxation techniques you can use to
relax. It will make you more confident
not to overeat when you are stressed.
Login at [link to activity in the PAC].

A participant in the Action stage might
receive the following message to
facilitate Counter Conditioning: When
you feel the urge to stay on the couch
and not exercise, resist it by substituting
healthier thoughts on how good you
will feel if you exercise.
The Benefits of Using a Web-based

Approach to Deliver Interventions
Given their capacity to reach individuals at
all levels of readiness to change, digitallyassisted TTM programs are populationbased but provide a completely customized
experience for each end user with feedback
that is dynamically updated when users
return to the program. The customized
behavior change guidance is based on the
comparison of the users responses to
reliable and valid assessment questions to
pre-programmed, statistically-derived
decision rules.
In a randomized controlled trial of the
Pro-Change weight management program,
significant treatment effects were found for

healthy eating (47.5% versus 34.3%),
exercise (44.9% versus 38.1%), managing
emotional eating (49.7% versus 30.3%), and
untreated fruit and vegetable intake
(48.5% versus 39.0%) progressing to
Action/Maintenance at 24 months. The
groups differed on weight loss at 24 months
with 30% of the treatment group losing 5%
of their weight.1 The digital weight
management program also has a coach
facing option where coaches can give the
assessment questions and then be given
evidence-based bulleted tailored guidance
to deliver to their clients.
Pro-Changes weight management
program demonstrates the ability of
TTM-based tailored feedback to improve
healthy eating, exercising, managing
emotional eating and weight on a
population basis.
Demos of the Weight Management and
other programs, including a healthy eating
and exercise program for teens, are
available at http://www.prochange.
com/online-behavior-change-programs.
About the Author
Janice M. Prochaska is the President and
CEO of Pro-Change Behavior Systems, Inc.
She earned a Masters degree in Social Work
from Wayne State University, and a PhD in
Social Work Administration and Policy from
Boston College.
References
1. Johnson S, Pavi, A, Cummins C, Johnson J,
Dyment S, Wright J, Prochaska J, Prochaska
J, Sherman K. Transtheoretical model-based
multiple behavior interventions for weight
management: Effectiveness on a
population basis. Preventive Medicine, 2008.
46, 238-246.
Treatment on the other components of
the intervention had a significant effect on
increasing fruit and vegetable intake, even
though the intervention did not focus on
that behavior.
Technology in Practice: Testimonials from the Field

Using Social Media to Generate Awareness about Global Issues
Kristina DeMuth, RD
From the First Ladys Lets Move Twitter
account (with over 137,000 followers),
to the Center for Disease Control and
Preventions Social Media Toolkit, it is clear
that some of the biggest names in public
health are harnessing the power of the
Internet to promote their messages.1
Additionally, many public health nutrition
professionals are recognizing the value that
social media has for connecting with the
public, as well as networking with other
professionals and organizations.2-3 Social
media has been an important leverage for
my career in nutrition, and has provided a
space to elevate my platform as a dietitian
and public health student.
My first experience with using social media
for professional purposes was while
volunteering with a non-profit eating
disorder organization. We created YouTube
videos for campaign events, shared content
with our Facebook and Twitter followers,
and hosted online forums to provide
positive support for people with eating
disorders. These Institutional Review Board
(IRB)-approved social media sites also
provided a platform for recruitment for
participants in an online research study.

My early experiences with social media
showed me how quickly we could reach a
wide variety of diverse people in a relatively
short amount of time.
More recently, social media played a large
role in my work as a volunteer at an
orphanage in Haiti. Social media allowed
me to share experiences about projects at
the orphanages feeding center. My pages
were updated daily with pictures, recipes,
and various goals we were working on
(e.g., menu planning, increasing fruit and
vegetable intake, and buying more local
produce). These blogs and social media
pages were not only avenues for sharing
experiences, but also served as platforms
for bringing attention to the need of
nutrition education in Haiti. My blog posts
inspired other organizations to consider
making nutrition a priority within their
schools and childcare settings, and I was
contacted by humanitarian workers
throughout Haiti about nutritional advice
for their orphanages and organizations.
I connected with several different
organizations, educated them about the
native foods used at our feeding center, and
informed them about how to make
nutritious
changes to their
menus that
incorporated
foods from local
farmers in Haiti.
Further, my use
of social media
and my blogs
also provided me
the awesome
opportunity of
Kristina DeMuth
writing a
nutrition chapter
for the book entitled, In Pursuit of Orphan
Excellence.
Both current and future dietitians often
hesitate to use social media for fear of
scrutiny by their employers or potential
employers. Anyone using social media,
regardless of their career, should always be
mindful of the content they share. By
remaining professional and sharing
evidence-based content, dietitians can have
an advantage in the field of public health.
In fact, there are even graduate classes in
public health that now require social media
as the driving tool for class projects and
assignments. I have observed and
11
experienced numerous benefitsof knowing

how to use social media properly and
professionally. Here are just a few:
Networking with other professionals
and organizations.
Continuing personal education
Writing blog posts often requires
gathering resources and getting
educated about specific foods, public
health issues, and/or dietary patterns.
Providing public educationSharing
both experiential and educational blog
posts, recipes, and information about
nutrition and health can help the public
access tools to make healthy lifestyle
changes.
Research toolsPublic health
professionals may consider using social
media to better understand their target
population for a research study or a
public health program, and pending IRB
approval, researchers may use social
media for data collection.
Getting feedbackSocial media can
help keep professionals up-to-date with
current trends, fads, and public interests.
It allows professionals to be aware of
information their clients or target
demographic might be exposed to.
In addition, social media can provide a
place for professionals to respond to
nutritional misinformation or trending
fads.
Broadening personal viewsBased on
input, feedback, and professional
discussions with people outside of your
immediate network circle.
Widening reachSocial media provides
an opportunity to reach a much wider
network. With globalization and
technology, we have the capability to
reach people all over the world!
Key tips to remaining social

media savvy:
Remain a positive role model for your
profession.
Allow for healthy, respectful debates
Professionals will always have differing
opinions, but learning how to properly
handle this allows for continued growth
on both ends of the debate.
ExploreTry out different social media
sites, different blogging tools, and web
apps. There are a vast number of
resources to use. Find one or a few that
you enjoy, and run with it! Current
popular tools include Twitter, Facebook,
Instagram, various blogging sites, and
YouTube.
Take breaksIt is important to keep
your social media pages active, but also
allow yourself the freedom to take a
break from posting content every day.
Reference your sourcesIt is always
important to cite your sources so that
readers and other professional can see
where your information came from.
Be transparentIf you do sponsored
posts, work for a food company, or are
paid by food companies to try products,
disclose this on your social media sites.
Refer to the Academys article, Ethical
and Legal Issues Related to Blogging
and Social Media, for more information.4
Know the lawLearn about the legal
issues relating to the use of social media,
and keep these in mind as you engage
in dialogue with the public and other
organizations. Legal issues that pertain
to health professionals include: patient
privacy, defamation of organizations
and people, copyright, and issues
surrounding medical advice. Health
professionals should have a terms of

use disclosure made visible on social
media pages. Refer to the Academys
articles, Legal Risks of Social Media:
What Dietetics Practitioners Need to
Know and Copyright Clarity: What
Registered Dietitian Nutritionists Need
to Know about the Basics of Copyright
Law, for more information.5-6
About the Author
Kristina DeMuth is a Registered Dietitian
and is currently completing a graduate
degree in Public Health Nutrition at the
University of Minnesota. Visit Kristinas Haiti
blog: For I was Hungry.
References
1. Thackery R, Neiger CL, Smith AK, Van
Wagenen SB. Adoption and use of social
media among public health departments.
BMC Public Health. 2012;12:242.
2. Hoggle, LB. Nutrition advocacy via social
media. Accessed December 19, 2014:
http://www.eatright.org/media/blog.aspx?i
d=4294970825&blogid=6442451184
3. Post RC, Eder J, Maniscalco S, JohnsonBailey D, Bard S. MyPlate is now reaching
more consumers through social media.
J Acad Nutr Dietetics. 2013;113(6):754-755.
4. Helm J. Ethical and legal issues related to
blogging and social media. J Acad Nutr
Dietetics. 2013;113(5):688-690.
5. Fox M. Legal risks of social media,
what dietetics practitioners need to know.
J Acad Nutr Dietetics. 2012;112(11):17181723.
6. Peregrin T. Copyright clarity: what
registered dietitian nutritionists need to
know about the basics of copyright law.
J Acad Nutr Dietetics. 2014;114(11):1718-1722.
Top Innovators in Dietetics Practice and Education

Becky Dorner, RDN, LD
Chair, Council on Future Practice
The Council on Future Practice is excited
to announce the top two innovators from
the sixth annual FNCE Innovations in
Dietetic Practice and Education session.
The sessions purpose is to promote new
innovations in dietetic practice, and
education of future and current
practitioners. The top innovators were
selected by a panel of judges (4 for
innovations in practice and 4 for
innovations in education).
12
Based on the evaluations completed by

our panel of judges, we would like to
recognize the top innovation in practice
and the top innovation in education
presented during the session:
Top Innovation in Education: Using
Twitter to Enhance Engagement in
Undergraduate Nutrition Courses,
presented by Carrie Hamady, MS, RD, LD,
Sylvania, OH.
Top Innovation in Practice: A Six Month
Worksite Weight and Pre-Diabetes
Healthy Lifestyle Program with Bundled

Billing through Employee Insurance,
presented by Cynthia Moore, MS, RD,
CDE, FAND, Charlottesville, VA.
Please join us in congratulating the
members who presented the top two
innovations in dietetics practice and
education. To learn more about the
innovations displayed at the session in
Atlanta, click here: http://www.eat
right.org/futurepractice/
Technology in Practice: Testimonials from the Field

How the Use of Mobile Applications Can Enhance Efficiency
and Productivity in Practice
Jody Pannozzo, RD
After seventeen years of reviewing paper
food logs, it occurred to me that the saying
a picture is worth a thousand words very
much applied to food journaling. For many
years, precious time during counseling
sessions was consumed by attempts to
decode illegible handwriting, and formulate
conceptual ideas of a clients daily food
intake. As smartphones became more
widespread, I required my most challenging
clients to substitute traditional, written food
records with pictures of what they ate. This
worked well for me, but the clients phones
quickly grew to storage capacity and we
still used too much of the session reviewing
food.
Over the years, as the tiny cameras on cell
phones became better and better, I had the
majority of my patients text me photos of
the foods they ate. This was a quick and
effective way for us to communicate about
food. However, while I was thrilled to have a
much clearer idea of what my clients were
eating in real time, I was not thrilled with
the abundance of incoming text messages,
nor did I like the idea of opening the door
to two-way communication twenty-fourseven.
It was about time that I learned about
mobile applications (apps), such as popular
tools like MyFitnessPal or RD-specific tools
like MobileRD, which allow users to record
their diet throughout the day, automatically
build a daily profile of their diet, and
transfer the information to the users
dietitian for evaluation and feedback. Using
a state-of-the-art mobile app platform gave
my clients the ability to track their daily
food intake via a photo journal, while
allowing me to conveniently send feedback
via smartphone or computer. Through the
use of this app in my practice, I not only
learned far more about my clients eating
habits, I also realized that I could now enter
a session armed with the information
I needed to help my clients succeed.
In my own practice, I have found that the
compliance rate is better than traditional
food journaling, and my clients are no
longer racing to write down everything
they ate five minutes before our session.
I cannot emphasize enough how
dramatically this product has improved my
capabilities as a dietitian.
By using an app, I learn far more about my

clients than I previously did through written
journals. In addition to a very thorough
understanding of eating patterns, the app
allows me to relate my clients hunger
levels, mood, sleep patterns and stress to
the foods they eat, and I am able to identify
harmful eating behaviors with the
precipitating factors that may lead to those
behaviors. My clients and I are then able to
work more efficiently on developing
strategies to avoid those harmful behaviors.
For instance, if a client appears to overeat
on the days he or shereports high stress
levels, we can work on ways to decrease
stress and come up with other tools for
dealing with stress. Efficiency is my favorite
part of the app. Rather than waiting for our
next visit to begin working toward goals,
I am able to provide education and
behavior modification tools during the
week as the behaviors occur.
The bottom line is that technology is
becoming an ever growing part of
healthcare and wellness. If dietitians do not
expandthe way we practice to include this
latest technology, we risk becoming
obsolete. The FDA reports that500 million
smartphone users worldwide will be using a
healthcare application by 2015, and by
2018, 50% of the more than 3.4 billion
smartphone and tablet users will have
downloaded mobile health applications.1
As dietitians, we need to play a role in
promoting and using apps that give the
consumer access
to our extensive
expertise on
nutrition and
wellness.
Through using an
app in my own
practice, I am
able to provide
my clients with
more efficient
care while
accommodating
Jody Pannozzo
their individual
needs as their exclusive provider of
nutrition information.
About the Author
Jody Pannozzo is a private practice dietitian
in Phoenix, Arizona. She is a graduate of
The Ohio State University, and served as the
Sports Nutritionist for the Ohio State
Athletic Department while working as a
clinical dietitian for the Universitys hospital.
Jody also previously worked for Remuda
Ranch Treatment Centers, an eating
disorders treatment center, in Wickenburg,
Arizona.
Reference
1. Food and Drug Administration. Mobile
medical applications. Accessed December
10, 2014: http://www.fda.gov/Medical
Devices/ProductsandMedicalProcedures/Co
nnectedHealth/MobileMedicalApplications/
ucm255978.htm.
Get Connected with PHCNPG!

The PHCNPG Website & Technology
Committee is excited to get PHCNPG
members connected!
NEW!Google Group EML: PHCNPG has
anew EML! This member benefit allows
members to communicate with one
another and stimulate discussion on
important topics.Tojoin theEML, send an
email to phcnpg.communications@
gmail.com with the subject lineGet
Connected with PHCNPG and indicate the
email address where you would like to
receiveEMLmessages. You will receive a
Welcome Message with instructions on
how to communicate with the group, email
options, and opt-out options.
Join us on Facebook and Twitter: Be sure

to like thePHCNPG Facebook page and
follow us on Twitter@PHCNPG. These are
great ways to connect with other PHCNPG
members! We host photo contests and
frequently post current information of
relevance for public healthand community
nutrition professionals as well as important
announcements.
Catherine Metzgar, RD and

Serena Fuller, PhD, RDN
PHCNPG Website & Technology Committee
Chairs, 2014-2015
Phcnpg.communications@gmail.com
13
PHCNPG @
The2014 Food & Nutrition Conference & Expo (FNCE), the annual
meeting of the Academy of Nutrition and Dietetics, was held
October 18-21, 2014, in Atlanta, GA. Here are highlights from
PHCNPG atFNCE!
House of Delegates Meeting

Shannon Looney (Delegate), Brittney Stuard (Secretary), Katrina Holt
(Nominating Committee Chair), Lauren Melnick (Chair-Elect), and
Mayra Crespo (Student Committee Chair) attended the House of
Delegates Meeting.The Mega Issue, Business and Management
Skills, in addition to a current practice issue, preceptor shortages,
were discussed. Visit the PHCNPGHOD pagefor more information
on the issue.
DPG Town Hall Meeting

Kay Sisk and Catherine Metzgar presented a session on Best
Practices entitled Increasing Student Involvement in the DPG
through Student Leadership Opportunities. During the 2013-2014
membership year, the PHCNPG established aStudent Committee
and a Student Committee chair position, creating a mutually
beneficial service opportunity for both student members and
leaders of the PHCNPG. Through their presentation, Kay and
Catherine discussed the vision for the Student Committee, and the
steps taken to bring this vision to fruitionfrom a discussion at an
Executive Committeee meeting to the selection and appointment of
the first Student Committee Chair, Mayra Crespo. Kay, Catherine, and
Mayra have been invited to host a discussion on the Academys
Student Committee web portal. The discussion is tentatively
scheduled for March 9-13, 2015.
Educational Session Highlights

PHCNPG collaborated with the Renal Dietitians DPG to sponsor the
session entitledThe Power of Prevention: Reducing the Burden of
Type 2 Diabetes and CKD through Public Health Interventions and the
Affordable CareAct. Click here to download the presentation slides,
or click here to view the session and earn CPE credit!
Pictured:Mary Ann Hodorowicz, MBA, CDE

(Speaker), Susan Weiner, MS, RDN, CDE, CDN
(Moderator), Bonnie Bradley (PHCNPG Chair), and
Desmond Williams, MD, PhD (Speaker).
Margaret Tate, MS, RD and Helene Kent, MPH, RD, PHCNPG members
and members of the Academys Committee on Public Health and
Community Nutrition, presented two educational sessions.Through
a session entitled,Changing Environments, Emerging Opportunities
in Public Health and CommunityNutrition, attendees learned about
14
the multitude of rapidly changing environmental and societal

factors impacting public health and community nutrition practice
leading to opportunities in this dietetic practice area.Click here to
download the presentation slides or click here to view the session
and earn CPE credit! During the session entitled,Open Discussion:
Your Role in Public HealthNutrition, participants provided input into
what the Academy can do in the area of public health nutrition,
identified strategies to move forward in the public health nutrition
arena, and examined the future of public health nutrition.
DPG/MIG Showcase
Thanks to all of our current members who stopped by to say Hi, and
those who came by looking for opportunities to get more involved.
One way that PHCNPG members can get involved is by volunteering
oncommittees. PHCNPG garnered interest from many potential
members.
Pictured: Jason Pelzel (Membership Chair), Kay Sisk

(Newsletter Editor), Catherine Metzgar (Website
Chair), Phyllis Crowley (Treasurer), and Bonnie
Bradley (Chair).
PHCNPG Networking Meeting

Approximately 70 members attended the PHCNPG networking
meeting. PHCNPG members who were recipients of DPG and
Academy awards were recognized. Read about each award winner
beginning on page 16.
Pictured: Student members at the PHCNPG

Networking Meeting, Lailiz Ortiz, Marlene Ramirez,
Marielle Counts, Mayra Crespo, and Randa Meade
PHCNPG Student Stipend Winners

Through a donation to the 2014 FNCEStudent Stipend program,
PHCNPG supported five students to attend the conference.
PHCNPG @
Volunteers Provide Support for
Breastfeeding Mothers at FNCE 2014
Nicole Larson, PhD, MPH, RDN
Past Chair, Public Health/Community Nutrition Practice Group
At the Food and Nutrition Conference & Expo (FNCE) 2014, the
Mothers Room provided a quiet and relaxing space for 41
breastfeeding mothers to nurse their infants or pump breast milk.
The Mothers Room has been available to breastfeeding mothers at
the conference since it was started in 1991 to accommodate the
needs of members, Academy staff, presenters, speakers, and women
who work at the Expo. As the number of mothers served by the
Mothers Room has grown each year at FNCE, so have the space and
services provided. This year, the specially prepared space in the
Georgia World Congress Center had 12 private rooms for mothers to
nurse or pump milk, along with a breast pump holding area,
refreshments for mothers, and a freezer and refrigerator to store
expressed milk. The Mothers Room was available to mothers
throughout the day on Saturday and each day until the end of the
conference on Tuesday. More than 160 visits by mothers utilizing the
Mothers Room were serviced over the four days.
DPG Volunteers
Student Host Program

Volunteers
Lisa Akers
Judy Bodner
Ginger Carney
Mayra Crespo
Phyllis Crowley
Serena Fuller
Catherine Holly
Judy Klavens-Giunta
Benita Long
Shannon Looney
Dominica Nichols
Kathleen Pellechia
Megan Puryear
Christine Rivera
Kay Sisk
Brittney Stuard
Tammy Baranowski
Shennie Barroso
Stefanie Brocker
Lindsey Brumlow
Stefanie Dove
Susanna Dysart
Sarah Galicki
Letal Garber
Yasmine Junqueira
Jana Wolff
Partnerships
The organization of the Mothers Room each year is a collaborative
effort of the Academy of Nutrition and Dietetics, the Public
Health/Community Nutrition Practice Group, the Womens Health
Practice Group, the Pediatric Nutrition Practice Group, and the
Academy affiliate in the FNCE host city. The services provided for
mothers could not have been provided without the generous
support of numerous volunteers, and the financial sponsorship of
Medela Inc and General Mills Inc. I had the honor this year to serve as
the 2014 Mothers Room coordinator, and would like to extend a
large thank you to these partners, volunteers, and sponsors on
behalf of the many appreciative mothers who benefited from their
efforts. Additionally, a special thank you is due to Bonnie Bradley, the
Chair of the Public Health/Community Nutrition Practice Group, for
her efforts to organize the space and volunteers onsite in Atlanta.
Womens Health Practice Group

Pediatric Nutrition Practice Group
Student Host ProgramAcademy of Nutrition and Dietetics
Meeting Services TeamAcademy of Nutrition and Dietetics
Georgia Academy of Nutrition and Dietetics
Sponsors
Medela Inc.
General Mills Inc.
If you would like to learn more about the Mothers Room, please
click here to watch a YouTube clip of Phyllis Crowley, the Public
Health/Community Nutrition Practice Group Treasurer, showcasing
the space at FNCE 2013.
DIDNT MAKE IT TO FNCE?

No Worries FNCE Sessions are Virtual!
Receive 24/7/365 access to FNCE Sessions while earning CPEUs from the comfort of your own home!
The conference library enables you to access FNCE Sessions on demand, allowing you to earn your
CPEUs whenever its most convenient for you.
Learn more at www.starlibraries.com/fnce/sessions/conference/1461.

15
Public Health/Community Nutrition Practice Group
Member SpotlightACADEMY AWARDS

50 Year Membership
Frances H. Cook, MA, RDN, LD
The Public Health/Community Nutrition
Practice Group (PHCNPG) is pleased to
recognize Frances Cook for 50 years of
membership in the Academy of Nutrition
and Dietetics!
During her career as a registered dietitian
nutritionist, Frances served for 4 years in
clinical nutrition, and 34 years in public
health. As Director of the Office of
Frances Cook
Nutrition at the Georgia Department of
Public Health, Frances developed and
implemented a statewide public health system that provided
nutrition information and services to citizens within Georgias 19
public health districts, including participants in the Special
Supplemental Nutrition Program for Women, Infants and Children
(WIC). The system involved policymaking, statewide planning and
evaluation, management, supervision, and fiscal control. Program
planning included a population-based approach to address the
complexity of obesity and chronic disease prevention in children, as
well as some adolescents and adult populations. As part of the
approach, Frances built partnerships and collaborations between
public health, the community, schools, worksites, and the private
sector. One of the highlights of Frances career occurred in 1991
when the Commission on Accreditation for Dietetic Education or
CADE (now called the Accreditation Council for Education in
Nutrition and Dietetics or ACEND) granted approval for an accredited
community-based dietetic internship in the Office of Nutrition at the
Georgia Department of Health, making Georgia the second state
(following Virginia) to have an accredited internship in a state public
health agency. Frances retired in 2007, and was proud of the fact that
150 employees (public health nutritionists) had completed the
dietetic internship with an overall passing rate of 80% for first-time
takers of the National Registration Examination.
Frances grew up on a family-owned, 500-acre farm in Fort Gaines,
Georgia, located in the southwest rural section of the state. Peanuts,
cotton, corn, wheat, fruits and vegetables were the primary crops
that were sowed and harvested. Frances attributes her interest in
foods and nutrition to her experiences in growing up on a farm. She
earned a Bachelor of Science degree in Food and Nutrition from
Tuskegee University, and a Master of Arts degree in Food and
Nutrition from New York University. Frances completed a dietetic
internship at Beth Israel Hospital in Boston, Massachusetts.
Frances has been an active member of the Academy and the Public
Health/Community Nutrition Practice Group (PHCNPG), and she has
served in several leadership roles within the Academy along with
other public health nutrition organizations. Frances served as Chair
for the 63rd Food & Nutrition Conference & Expo (FNCE) of the
Academy of Nutrition and Dietetics when the meeting was held in
Atlanta, Georgia, for the first time. She served as a program reviewer
in conducting site visits for the CADE (now ACEND), and served on
the Academys Item Review Committee where she reviewed test
16
2014
Academy
of Nutrition
and Dietetics
Award
Recipients
items for the National Registration

Examination for Dietitians. Additionally, Frances served as President
of the Association of State Public Health Nutritionists (1996-1997),
and was appointed by Georgias governor to serve on the Georgia
Board of Examiners of Licensed Dietitians (2007-2012).
Since retiring in 2007, Frances has continued to be involved in many
aspects of her community. In her own words, Frances says,
Retirement can cause you to either resign from everything that is
worthwhile in life, or it can open new doors. When I retired, I chose
the latter. My living is renewed as I continue involvement in bible
study, traveling, and consultant work in community health and
nutrition initiatives.
In her free time, Frances enjoys planting and caring for her yard
flowers and vegetable garden. She enjoys the fruits of her labor as
some of her favorite foods include tomatoes, collard greens, mustard
greens, kale, okra, and green peppers. Frances and her husband,
Edmond, have been married for 34 years and live in Fayetteville,
Georgia, not far from Atlanta.
PHCNPG is proud of Frances work and appreciates her 50 years of
contributions to the Academy, public health nutrition, and our
profession!
Medallion Award Recipient

Katrina Holt, MPH, MS, RD, FAND
Katrina Holt has over 25 years of
experience in public health and
community nutrition. She is currently
a project director at Georgetown
Universitys Health Policy Institute in
Washington, DC. Throughout her career,
she has worked on numerous nutrition,
oral health, and physical activity initiatives
focusing on health promotion and disease
prevention for pregnant women, infants,
Katrina Holt
children, adolescents, and their families.
In this capacity, she works closely with
staff from federal agencies and national organizations, as well as
experts in the field, to convene national conferences and advisory
committee meetings, and to develop educational resources for
health professionals, program administrators, policymakers, and
families.
Katrina enjoys the diverse range of projects she works on at the
Health Policy Institute. For example, through the national Bright
Futures initiative, she coordinated the development of several
publications, including Bright Futures in Practice: Nutrition, and
Bright Futures in Practice: Physical Activity; and she contributed to
Bright Futures: Guidelines for Health Supervision of Infants, Children,
and Adolescents. She also participated in conducting a content
validation of the Healthy Start, Grow Smart series of educational
booklets designed for pregnant women and parents of children
enrolled in Medicaid, and she served on the planning committee
that convened the Surgeon Generals Conference on Children and
Oral Health. Additionally, Katrina coordinated and convened an

expert committee to develop criteria for overweight and obesity to
be integrated into preventive screening of adolescents ages 1121 in
clinical and public health settings.
Before joining the faculty at Georgetown University, Katrina provided
nutrition care to patients and clients in a variety of settings,
including prenatal clinics, refugee clinics, school-based health
centers, city and county health departments, and programs such as
Head Start and the Special Supplemental Nutrition Program for
Women, Infants and Children (WIC). Katrina also served as a Head
Start consultant, conducting site visits and providing education and
training to nutrition staff at local Head Start programs in Maryland,
Pennsylvania, Virginia, Washington, DC, and West Virginia. For
Katrina, the most rewarding part of providing community-based
services was seeing how much support these programs offered
families.
Katrina developed an interest in public health, and specifically in the
area of maternal and child health, while working on her Master of
Science degree at the University of Nebraska-Lincoln. While
conducting a literature review for her thesis, Katrina learned about
the important role of health professionals in preventing and
reducing the incidence of cardiovascular disease through
preventive measures in childhood. From this experience she gained
a profound appreciation for public health, and it became her chosen
field.
Katrina earned a Bachelors degree in nutritional sciences and food
from the University of Washington. She completed a dietetic
internship and earned a Masters degree in human nutrition and
foodservice management from the University of Nebraska-Lincoln.
Katrina also earned a Master of Public Health degree with an
emphasis in maternal and child health from the University of
Minnesota. She also completed a fellowship in adolescent nutrition
at the Adolescent Health Training Program at the University of
Minnesota. Later, she completed a dual fellowship in adolescent
health and nutrition at the National Center for Education in Maternal
and Child Health at Georgetown University.
Katrina has been a member of the Public Health/Community
Nutrition Practice Group (PHCNPG) since 1990. Following the advice
of her academic advisor, Mary Story, who was currently serving as
chair of PHCNPG, Katrina joined the practice group and became
extremely involved. Katrina is the current Nominating Committee
Chair, and previously served as Advisor (2010-2012), Membership
Committee Chair (20072010), Past Chair and Mothers Room
Coordinator (20062007), Chair (20052006), Chair-Elect (2004
2005), Treasurer (1999-2001), and Secretary (1999-2000).
In 20012003, Katrina served as a community nutrition professional
issues delegate in the House of Delegates, and represented PHCNPG
and the Hunger and Environmental Nutrition Practice Group.
Katrina has also been deeply involved with the Academy and has
received several awards and recognitions for her contributions. In
2014, she was honored with one of the Academys highest
recognitions, the Medallion Award. The award was presented at the
Academys annual Food & Nutrition Conference & Expo (FNCE).
Katrina has also received the Presidents Circle Nutrition Education
Award from the Academy of Nutrition and Dietetics Foundation, and
the Award for Excellence in the Practice of Community Nutrition
from the Academy. She also received the Outstanding Member of
the Year Award from PHCNPG, and the Outstanding Dietitian of the
Year Award from the District of Columbia Metropolitan Area Dietetic
Association. Additionally she received the Excellence in Dietary
Guidance Award from the American Public Health Association, Food

and Nutrition Section.
In her free time, Katrina enjoys skiing, biking, hiking, and kayaking
with family and friends. She has taught alpine and adaptive skiing for
over 30 years in three different statesWashington (Stevens Pass),
Minnesota (Buck Hill), and currently Pennsylvania (Liberty Mountain).
Additionally, Katrina serves as a volunteer clinician for the Maryland
Special Olympics, training coaches in teaching athletes how to
improve their skiing and racing skills in preparation for the winter
games.
Since she grew up in the dairy-farming community of Snohomish,
Washington, on a small family farm with many fruit trees, Katrinas
favorite food is locally made ice cream with fresh fruit.
PHCNPG is proud of Katrinas work and appreciates her contributions
to the Academy, our practice group, and public health and
community nutrition!
Medallion Award Recipient

Gloria Stables, PhD, MS, RD, LD
Gloria Stables is a partner at Catalyst
Research & Communication, a firm
offering strategic planning for health
promotion and communications, located
in Washington, DC. Previously, she worked
for more than 25 years at the National
Institutes of Health, specializing in public
health and disease prevention. Gloria was
awarded the 2014 Medallion Award in
recognition of her dedicated service to
Gloria Stables
the profession and the Academy, her
exceptional leadership in public health and community nutrition,
and her insightful collaboration with allied health organizations.
As the National Program Director of the 5-A-Day for Better Health
campaign, Gloria integrated expertise in research, community
nutrition practice, and behavioral therapy to develop a program that
improved public health, promoted dietetics practice, and built an
impressive nationwide public-private partnership. Testimony from
representatives of professional societies, schools of public health,
state health departments, industry, and advocacy groups
demonstrated such enthusiastic support that the program continues
through the Centers for Disease Control and Prevention, and the
Produce for Better Health Foundation, where it is now called Fruits
and VeggiesMore Matters. Gloria has helped increase recognition
of the registered dietitian nutritionist through her insightful
collaboration with allied health organizations, including the Society
for Nutrition Education and Behavior, the US Public Health Service,
the Surgeon Generals Dietitian/Nutritionist Professional Advisory
Committee, the National Institutes of Health Nutrition Coordinating
Committee, and the Centers for Disease Control and Prevention
School Health Guidelines.
Gloria has been an active member of the Academy of Nutrition and
Dietetics since 1977. Her dedication to serving the profession and
the Academy is evidenced by numerous roles in the Academy and
affiliates, including contributions with the Commission on Dietetic
Registration, the Academys Work Group on US Family Structure, the
Public Health/Community Nutrition Practice Group, the Clinical
Management Practice Group, and the District of Columbia
17
Metropolitan Area Dietetic Association. She has received several

awards and recognitions for her contributions. In 2014, Gloria was
honored with one of the Academys highest recognitions, the
Medallion Award. The award was presented at the Academys Annual
Food & Nutrition Conference & Expo (FNCE). Gloria was deeply
honored that her undergraduate advisor, Susan Crockett, PhD, RD,
traveled to the conference specifically for the award ceremony to
celebrate Glorias accomplishments. Additionally, Gloria has received
other awards from the Academy Foundation including the
Presidents Circle Nutrition Education Award, and the Award for
Excellence in the Practice of Community Nutrition. She has also
received several awards from the National Institutes of Health, and
the US Public Health Services.
Gloria joined the Public Health/Community Nutrition Practice Group
(PHCNPG) early in her career as it was the group of nutrition
professionals that she most identified with. She has been greatly
involved, having previously served as Membership Committee Chair
(2010-2013), Chair (2008-2009), Chair-Elect (2007-2008), and Past
Chair (2009-2010).
Gloria grew up in Minot, North Dakota. During her undergraduate
studies at North Dakota State University, Gloria majored in Food and
Nutrition, and then completed the Coordinated Undergraduate

Program in Dietetics. She earned a masters degree and doctorate
from Virginia Polytechnic Institute & State University.
In her free time, Gloria enjoys golfing, biking, horseback riding, and
trying to keep up with her husband and three children. Once a
month, Gloria cooks for a homeless shelter in the DC area, and has
grown to appreciate cooking in large quantities for 32 men.
PHCNPG is proud of Glorias work and appreciates her contributions
to the Academy, our practice group, and public health and
community nutrition!
Visit the
Public Health/Community
Nutrition Practice Group
(PHCNPG) online:
www.phcnpg.org
Member SpotlightPHCNPG AWARDS
2014
PHCNPG
Award
Recipients
Award for Excellence in Public Health/Community Nutrition

Marsha Spence, PhD, MPH, RDN, LDN
Marsha Spence is the Director of Public
Health Nutrition, and an Assistant
Professor of Practice in the Department of
Nutrition at University of Tennessee in
Knoxville, Tennessee. In addition, Marsha is
the Director of the Maternal and Child
Health Bureau funded Public Health
Nutrition Leadership Education and
Training Program at the University of
Tennessee. Her research focuses on school
Marsha Spence
and community-based interventions to
prevent childhood overweight/obesity,
and to promote healthy environments, youth leadership, and
advocacy development to improve school and community health
environments. Her research on collaborative community nutritionrelated needs assessments and assessing urban transportation routes
to grocery stores was highlighted in a 2013 webinar hosted by the
Public Health/Community Nutrition Practice Group (PHCNPG). Click
here to learn more and view the webinar!
Marsha currently serves as President-elect of the Association of
Graduate Programs in Public Health Nutrition, Inc. (AGPPHN).
Through funding by AGPPHN, she led an expert panel on the
revision Strategies for Success: Curriculum Guide 3rd Edition, the
basis for graduate public health nutrition curricula which consists
of knowledge and skill competency statements and experience
18
guidelines, including goals and objectives for supervised practice

experiences. She also currently serves as a member of the Expert
Review Committee for the revision of the Guidelines for
Community Nutrition Supervised Experiences, representing the
American Public Health Association, Food and Nutrition Section.
Marsha earned a Bachelor of Science in Human Ecology (Nutrition),
a Master of Science in Nutrition, and a Master of Public Health
degree, as well as a doctorate in Human Ecology (Nutrition) from
the University of Tennessee.
An active member of the Academy of Nutrition and Dietetics,
American Public Health Association, and PHCNPG, Marsha has
received several awards and recognitions for her contributions to
education and to the field of public health nutrition. In 2008,
Marsha received the Outstanding Dietetics Educator Award from
the Knoxville Academy of Nutrition and Dietetics, and was
recognized in 2009 as Innovative Faculty by the University of
Tennessees Innovative Technology Center. Click here to learn about
how she incorporates blogging into a course curriculum! Most
recently, Marsha was awarded the PHCNPG Award for Excellence in
Public Health/Community Nutrition Practice. The award was
presented at the Academys annual Food & Nutrition Conference &
Expo (FNCE).
PHCNPG is proud of Marshas work and appreciates her passion for
public health nutrition!
Member SpotlightPHCNPG AWARDS

Outstanding Member of the Year
Kay Sisk, MS, RD, LD
Kay Sisk is a registered dietitian in Saint
Louis, Missouri. She currently serves as
Newsletter Editor for the Public
Health/Community Nutrition Practice
Group (PHCNPG), as well as Liaison to the
Association of State Public Health
Nutritionists (ASPHN), and project co-chair
for the revision of the Guidelines for
Community Nutrition Supervised
Experiences. Kay previously worked as an
Instructor in the MS in Public Health
Kay Sisk
Nutrition Dietetic Internship Program in
the Department of Nutrition at Case Western Reserve University,
where she also served as the campus dietitian. As faculty, Kay
enjoyed the variety that her job offered through teaching, program
management, research, and direct patient care. She was motivated
by her students enthusiasm for learning and her dedication to
helping patients make healthy changes. As a member of the
PHCNPG, Kay values the opportunities for leadership, professional
growth, and connecting with dietitians in the field of public health
and community nutrition.
Kay was recognized as the 2014 PHCNPG Outstanding Member of the
Year for her dedication to improving member involvement and
member benefits, her leadership in developing student leadership
and award opportunities, her contributions to the newsletter, her
service with the Website & Technology Committee, and her
involvement in the PHCNPGs partnership with ASPHN. The award was
presented during the PHCNPG Networking & Business Meeting at the
Academys annual Food & Nutrition Conference & Expo (FNCE). Kay
has been a member of the PHCNPG since 2011, and previously served
as Technology Chair (2012-2013), and Website Chair (2013-2014).
Kay grew up in Springfield, Missouri. Her interest in nutrition began
to develop early in her undergraduate studies at the University of
Missouri-Columbia, where she earned a Bachelor of Science in
Nutritional Sciences. She was drawn to the field of nutrition because
it incorporated her interests, science and health. According to Kay,
One of the most exciting aspects of a career in nutrition and
dietetics is that it requires me to use many different skill sets. In
public health nutrition, I have the greatest opportunity to use these
skill sets to make a larger impact on the well-being of others.
She completed her dietetic internship and earned a Master of
Science in Public Health Nutrition as well as a Certificate of
Gerontology from Case Western Reserve University.
In her free time, Kay enjoys spending time with her family, playing
music, hiking, and traveling. She also enjoys spending time with her
toddler in the kitchen, teaching him how to cook and exposing him
to a variety of foods. With the perspective that your pantry is your
kids grocery store, Kay stocks her shelves with a wide variety of
foods (both healthy and fun!).
PHCNPG is proud of Kays work and appreciates her passion for
2014
PHCNPG
Award
Recipients
Outstanding Young
Member of the Year
Shannon Looney is a Postdoctoral Fellow
in Child Behavior and Nutrition at
Cincinnati Childrens Hospital Medical
Center in the Division of Behavioral
Medicine and Clinical Psychology.
Much of her time is spent delivering
intervention for a clinic and home-based
preschool obesity treatment clinical trial.
Her independent research is in the area of
behavior-based pediatric nutrition
interventions, with a specific focus in
Shannon Looney
pediatric obesity. In addition, Shannon
engages in a standard training plan that includes didactic training
for professional and scientific advancement. The interdisciplinary
aspect of her work is most fascinating to Shannon, as it allows her to
combine her training in nutrition and behavior sciences.
Shannon grew up in Connecticut. Her interest in nutrition originated
during high school when she observed unhealthy eating habits
among her peers and saw the nutrition misinformation that was
conveyed by media sources. For these reasons, Shannon was
determined to gain the knowledge she needed to enter the field of
nutrition. She completed her undergraduate work at the University
of Delaware, followed by completion of a dietetic internship, Master
of Public Health degree, and a doctorate degree at the University of
Tennessee, Knoxville.
Shannon joined the Public Health/Community Nutrition Practice
Group (PHCNPG) in 2008 as a student member. For Shannon, the
practice group was not only an opportunity to learn more about the
field of community nutrition, but is was also an opportunity to get
involved within the nutrition profession. As a student, involvement
both within the PHCNPG and the Academy allowed her to learn from
experts in the field, and it created an easy transition to remain
involved as a professional member. Shannon is currently the
PHCNPGs Delegate to the Academys House of Delegates. Previously,
she served as the practice groups Assistant Newsletter Editor (20122014). In 2011, Shannon received the Amy Joye Memorial Research
Award to support her doctoral research investigating efficacy and
program cost-effectiveness of Prevention Plus for childhood obesity
from the Foundation. She was also awarded a doctoral scholarship
from the Commission on Dietetic Registration in 2012. Most recently,
Shannon was awarded the PHCNPGs Outstanding Young Member of
the Year for 2014. The award was presented during the PHCNPG
Networking & Business Meeting at the Academys annual Food &
Nutrition Conference & Expo (FNCE).
In her free time, Shannon enjoys spending time outdoors with her
husband and dog, running, hiking, and camping. She also enjoys
traveling and learning about new places.
PHCNPG is proud of Shannons work and appreciates her passion for
19
2014-2015
Executive Committee
Chair
Bonnie Bradley, MPH, RD, LD
bonnie.bradley@arkansas.gov
Chair-Elect
Lauren Melnick, MS, RD, LD
melnicl@ccf.org
Past Chair
Nicole Larson, PhD, MPH, RDN
phcnpg.larson@gmail.com
Treasurer
Phyllis Stell Crowley, MS, RD, IBCLC
pcrowley@utah.gov
2014-2015 Executive Committee: First Row, from Left to Right: Serena Fuller (Technology
Chair), Phyllis Crowley (Treasurer), Bonnie Bradley (Chair), Lauren Melnick (Chair-Elect), Doris
Fredericks (Advisor), Judy Klavens-Giunta (Policy and Advocacy Leader). Second Row, from
Left to Right: Jason Pelzel (Membership Committee Chair), Margaret Tate (Awards Committee
Chair), Catherine Metzgar (Website Chair), Kay Sisk (Newsletter Editor), Shannon Looney
(Delegate), Brittney Stuard (Secretary), and Mayra Crespo (Student Committee Chair).
Not pictured: Nicole Larson (Past Chair), Katrina Holt (Nominating Committee Chair), and
Kathleen Cullinen (Assistant Newsletter Editor).
Secretary
Brittney Stuard, MPH, RDN
brittney.stuard@colostate.edu
PHCNPG Delegate
looney.shannon@gmail.com
Advisor
Doris C. Fredericks, MEd, RD, FADA
doris@choices4children.org
Awards Committee Chair
Margaret Tate, MS, RDN
mjtate@cox.org
Thank you to the following PHCNPG members who
serve on the Newsletter Committee as Editorial
Staff and Review Board Members for The Digest.
Rebecca Bennett, RD, LD
Nichole Brandenburg, RD
Justine Britten, RDN
Mary Chesney, PhD, MSN, MPH, RN
Marielle Counts, BS
Bethany Daugherty, MS, RDN, CD
Margaret Diaz, RD
Ahlam Badreldin ElShikieri, PhD, MBA
Alyssa Fritz, RD, LD
Mary Jo Gillespie, MPA, RD, LMNT
Jennifer Huang
Micheline Hynes, BS
Leslie Kaye, MS, RD, CLE

Judy Klavens-Giunta, RDN
Tara Larson, MS, RD
Courtney Luecking, MPH, MS, RDN, LDN
Janet Ziesemer Malusi, RD
Patricia Nicholas, MS, RD, CSG, CDN
Laura Perdue, MPH, RD
Isabel Reckson, RD
Julie Shimko, MA, CPT
Andrea Spadoni, BS
Elise Truman, MS, RD, LDN
If you are interested in joining the Newsletter Committee for the 2014-2015
membership year, contact Kay Sisk (Newsletter Editor) and Kathleen Cullinen
(Assistant Newsletter Editor) at phcnpg.communications@gmail.com,
and include Newsletter in the subject line.
Membership Committee Chair

Jason Pelzel, MPH, RD
jason.pelzel@gmail.com
Nominating Committee Chair
Katrina Holt, MPH, MS, RD
kholt@georgetown.edu
Policy and Advocacy Leader
Judy Klavens-Giunta, RDN
giunta@aesop.rutgers.edu
Student Committee Chair
Mayra Crespo, BS
mayra.crespo1@upr.edu
PHCNPG Communications Team
phcnpg.communications@gmail.com
Technology Chair
Serena M. Fuller, PhD, RDN
serenaphcnpg@gmail.com
Website Chair
Catherine Metzgar, RD
cjmetzgar14@gmail.com
Newsletter Editor
Kay Sisk, MS, RD, LD
kaysisk@gmail.com
Assistant Newsletter Editor
Kathleen Cullinen, PhD, RD
The views and statements appearing in The Digest do not necessarily reflect policies
and/or official positions of the Academy of Nutrition and Dietetics (Academy) or Public
Health/Community Nutrition Practice Group (PHCNPG). Product names mentioned in this publication do not
constitute endorsement by the Academy or PHCNPG.
2014 Public Health/Community Nutrition Practice Group, a dietetic practice group of the Academy. The PHCNPG welcomes corporate relationships that support our strategic plans and activities; however, these relationships do not necessarily indicate endorsement by our membership.
The Digest
20
KCullinen@michiganfitness.org
Newsletter Design and Layout
Joyce Simpson
joyce@slaytonsolutions.biz
DPG Relations Manager
Mya Wilson, MPH, MBA
mwilson@eatright.org

The Digest Winter 2014 Issue

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The

Message from the Chair

Academy of Nutrition and Dietetics stands

Moving forward, the Public

Wishing for you a joyous and happy holiday

INSIDE THIS ISSUE:

10 Application of the Transtheoretical

How the Use of Mobile Applications

5 Digital Health: Examples of EvidenceBased Health Technology

14 Summary of PHCNPG Events at FNCE

7 Costs and Benefits of Using Online Social

15 Volunteers Provide Support for

9 Telehealth: An Internet-Based Tool for

CPE Opportunity from FNCE!

2014 Academy Award Recipients

20 2014-2015 Executive Committee

than air travel, in

Message from the Student Committee Chair

dietitians in public health and community

Free CPE Opportunities

The DigestWinter 2014

Dietetics Students Perceive Themselves as Leaders and Report

Message from the Delegate: Delegate Update

HOD Motion #2: The HOD requests that

The Speaker of the HOD, Elise Smith, issued

Message from the Academys PHCN Committee

mega-issue on public health and

need to strengthen its public health focus is

strategies for working together on the

intersection of public health nutrition

Explore a possible certificate of training

2014-2015 Public Health and Community Nutrition Committee

Earn Continuing Professional Education Units from Your Computer

The DigestWinter 2014

Digital Health: Examples of EvidenceBased Health Technology

adopting healthy behaviors (see Figure 1).

million unique visitors, and has often been

Analyses show that Your Disease Risk

Wide reach has been a long-term goal for

The strong dual focus of Your Disease Risk on

One limiting factor of the Your Disease Risk

Figure 1. Your Disease Risk

In its current version, Your Disease Risk

amount of time. Results for each disease are

The DigestWinter 2014

patients in clinic waiting areas, who then

Director of the Institute for Public Health at

Columbia: A health disparities information

2014/10/17. doi: 10.2105/AJPH.

RK, Alford SH, McClure JB, Fagerlin A. The

Costs and Benefits of Using Online

health experiences (23%) and obtaining

delivered through online social network

Attracting and engaging users requires

Despite the potential of using social media

Using online social networks such as

The DigestWinter 2014

About the Author

Using online social

Telehealth: An Internet-Based Tool for

How Does Telehealth Relate

In the age of the Internet and the 24-hour