Nutrition Education at the Free Clinic of Southwest Washington

Oregon Health and Science University, Graduate Program in Human Nutrition, Portland, Oregon
Denise Crowley, Tess Heyerman, Stephanie Michael, Cassidy Reeser, Liz Torres

Background Goals Implementation and Evaluation

We partnered with the Free Clinic of Southwest 1. Increase access to evidence-based nutrition education. One-hour nutrition education intervention for high-risk
Washington to create nutrition-related resources, as well 2. Evaluate the effectiveness of a one-time nutrition adults
as hold an Ask the Dietitian, In-Training class for education intervention in at-risk adults. Addressed the significance of nutrition, especially
patients seen at the clinic.
relating it with diabetes.
The Free Clinic of Southwest Washington provides Objectives Facilitated one hands-on nutrition activity to
services based on volunteers and donations, supporting Develop and host an Ask the Dietitian, In-Training practice developing a well-balance meal.
low-income patients with little access to affordable class for patients at the Free Clinic of Southwest
healthcare and nutrition education. Provided resources in Spanish to help reinforce
Washington by March 2017.
participants understanding of nutrition.
Significance Develop six nutrition education handouts on the topics
of hypertension, hyperlipidemia, prediabetes, diabetes, Pre-and Post-Surveys Figure 4. Team members explain the plate method.
Food insecurity is prevalent in lower socioeconomic physical activity and healthy eating, and eating out by Figure 5. Participants use food cut outs to make healthy plates.
status populations and is related to suboptimal dietary Assessed 11 participants before and after the
January 27, 2017 for patients at The Free Clinic of
intake, obesity and type 2 diabetes.1 Southwest Washington.
class for changes in perceived knowledge, beliefs, Future Class Recommendations
and self-efficacy in applying nutrition into their daily
Research shows that improved diet, physical activity, Conduct program assessments using participant Ensure a translator is available for future classes.
lives.
and weight-related behaviors can result from one-time knowledge and self-efficacy surveys at the beginning Develop SMART goals by the end of class to help
nutrition education interventions. and end of class. promote behavior change.
Hosting an Ask the Dietitian, In-Training class allowed What you eat effects your body. Portions Have participants write down questions at the beginning
this lower income population to have their nutrition- are important. You can eat bananas and of class, so questions can be grouped and class can
related questions answered, while gaining knowledge potatoes but in portions. Class participant proceed in a more logical and structured manner.
A clinic specialist estimated that 70% of the
and skills that will ultimately help with diabetes
management, as well as reduce the incidence of type 2
clinics clients are Spanish speaking, and use the Have the class be family focused to reinforce healthy
diabetes and other chronic conditions. clinic because they dont have anywhere else to eating in the household and provide support to family
How do you feel about your ability to make food
go for their healthcare. In 2014, the clinic had members with diabetes.
If no RD is present, a clinic health educator can utilize
over 7,600 patient visits and filled over 8,000
choices for your health?
the created handouts to assist in nutrition education. Pre-Class Survey Provide resources for economically feasible ways to
prescriptions from the dispensary. 5 eat/shop healthy on a budget.
4 Due to improved participant-reported self-efficacy, future
classes are warranted.

# of times chosen
Demographics
3

Class Participants 2

Lo que usted come hace una diferencia en su: 1

glucosa en la sangre, es la azcar principal que se encuentra en la sangre, y su fuente principal de energa.
La
Colesterol, un tipo de grasa que se encuentra en algunos alimentos y producido por el cuerpo.

Presin Arterial, La fuerza de la sangre ejercida en las paredes internas de los vasos sanguneos.
Thirteen participants ranging in age from 2-70 years.
Comer alimentos saludables no tiene que ser difcil. Crear su plato saludable es una forma sencilla y efectiva
de manejar su glucosa en sangre y su peso. Con este mtodo, a llenar su plato con ms verduras sin almidn y
Two teenagers participated. The majority of participants 0
0 1 2 3 4 5 6 7 8 9 10

were middle-aged.
porciones ms pequeas de alimentos ricos en almidn y protenas. No se necesitan herramientas especiales
ni contar!

Siete pasos para Crear Su Plato saludable:

1. Usando su placa de la cena, ponga una lnea abajo de la
Post-Class Survey
Of the middle-aged adults, there was a split attendance
mitad del plato. Luego, por un lado, divdelo de nuevo.
Usted tendr tres secciones en su plato.
2. Llene la seccin ms grande con verduras no
5
of four women and four men.
almidonadas.
3. En una de las secciones pequeas, pone los granos
integrales o un alimento almidonado.

4. En la otra seccin pequea, ponga su protena.
4
5. Agregue una porcin de fruta, una porcin de productos
lcteos, o los dos, tanto como su plan de comidas lo
permite.
All participants have accessed health care at the Free
Clinic of Southwest Washington.
# of times chosen

6. Elija grasas saludables en pequeas cantidades. Para

cocinar, use aceites. Para ensaladas, algunas adiciones saludables son nueces, semillas, aguacate y
vinagretas.
3 Figure 4. A team member provides nutrition handouts to participants.

7. Para completar su comida, agregue una bebida baja en caloras como agua o t sin azucarar.

Consejos Adicionales:
Trate de no omitir las comidas y comer alimentos bien balanceados y bocadillos a horas regulares cada da.
The majority of the class was native Spanish speakers, 2

with some English proficiency. Only the two teenagers

Elija "trigo integral o grano entero" al seleccionar los panes o los cereales.
Escoge fruta fresca y evite el jugo de fruta.


Limite sus dulces y come pequeas porciones de postres o dulces
Use pequeas cantidades de grasa al cocinar.
Acknowledgements
preferred to answer their pre/post class surveys in We would like to thank Lexie Jackson, MS, RDN, LD, CDE and Carol DeFrancesco, MALS,
Lmite la adicin de sal a su comida mientras cocina y en la mesa.
1

RDN, LD for their continued guidance throughout the project and The Free Clinic of
FREE CLINIC OF SOUTHWEST WASHINGTON

English. All other participants used the Spanish

4100 Plomondon Street Phone: (360) 313-1390
Vancouver, WA 98661 Fax: (360) 313-1391

0 Southwest Washington for sharing their knowledge, space and resources with us.
pre/post surveys. 0 1 2 3 4 5 6 7 8 9 10

References
Figure 1. Example of handouts created for the Free Clinic patients 1. Slawson DL, Fitzgerald N, Morgan KT. Position of the Academy of Nutrition and Dietetics: the
Figure 2, 3. Pre and post survey results for self efficacy survey. role of nutrition in health promotion and chronic disease prevention. J Acad Nutr Diet.
2013;113(7):972-979.