Introduction Childhood obesity disproportionately affects low-income women, children, racial/ethnic minorities, and rural populations. To effectively promote sustainable change, healthy eating and active living initiatives should apply individual plus policy, systems, and environmental (I + PSE) approaches. Methods Four public health maternal and child nutrition teams selected through an application process participated in 12 months of technical assistance (TA) to develop action plans incorporating I + PSE in nutrition programming. TA included: (1) online modules; (2) community of practice (CoP) meetings; and (3) individual coaching sessions. Teams completed midpoint and endpoint surveys to assess TA knowledge and process outcomes. Semi-structured, in-depth interviews conducted post TA were transcribed and content analysis used to characterize themes and sub-themes. Results Facilitators to implementing I + PSE approaches included TA delivery through online modules, participation in the CoP, and individual coaching to address barriers to implementation and leadership support. Barriers were time and funding limitations, working in isolation, and lack of infrastructure and self-efficacy. Co-learning helped TA teams overcome stagnancy and promote development of creative solutions. Teams recognized relationship-building as integral to systems development. Discussion Lessons learned occurred across three main areas: relationships, capacity-building, and barriers encountered. Relationship formation takes time and is often not recognized as an asset impacting public health programing. Relationship direction – upstream, downstream, and lateral - affects ability to build organizational and systems capacity. While this study includes a small number of public health nutrition teams, this practice-based research highlights the value of I + PSE TA to tackle complex problems, with reciprocal, multisectoral support to enhance public health nutrition program impact.
their counseling skills. In a mock hospital room with a 2-way mirror, a theatre student acts out a patient scenario and nutrition students conduct a nutrition assessment. After the simulation, the theatre student and nutrition instructor provide feedback regarding counseling skills. A week after the simulation, students complete a nutrition care plan and reflect on the experience. Evaluation Methods: An IRB-approved survey was sent by email to individuals who participated in Healthcare Theatre. Before distribution, the survey was pilot tested for face validity and content. The final version of the survey included 19 questions which asked respondents to evaluate their confidence in counseling skills, give feedback for improving the program as well as provide demographic information. Results: Of the 121 respondents, 110 (91%) were female, 102 (84%) were white/Caucasian and 92 (76%) were between 21-26 years of age. After participation, 99 (82%) reported feeling more confident in rapport building skills and 112 (93%) stated receiving immediate feedback was helpful or very helpful. Respondents stated the experience improved their nutrition interviewing skills and ability to ask open-ended questions. To improve the program, students requested more opportunities to participate in Healthcare Theatre. Conclusions: The Healthcare Theatre Program is an effective method for developing counseling skills in nutrition students. Funding: None.
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