In August, I spoke at the Association of Nutrition Service Agencies annual conference in San Diego. My presentation, Developing Nutrition Education Programs That Target Behavior Change, focused on how to create programs that really work for the intended audience. I started the presentation with a quick overview of the key messages in Dairy Council of California programs: eat nutrient-rich foods, include 30-60 minutes of physical activity most days of the week, all foods can fit in a healthy diet, and convenience, taste and family/cultural traditions must all be considered when planning daily food choices.

Armed with this understanding of the our nutrition philosophy, attendees learned about our behavior change model. 

1. The model begins with identifying choices that increase risks and the benefits of better choices which can improve outcome expectancies.
2. The next phase is to engage the user in the content to help them identify potential changes through reflection.
3. To facilitate behavior change clients must increase self-efficacy, improve decisional balance, set goals and increase intrinsic motivators (external motivators and rewards have not been demonstrated as effective).
4. The final phases are the adoption and maintenance of behavior change. Critical is encouraging social support, relapse prevention and addressing setbacks that do occur.

The principles of the behavior change model were illustrated using our new Shaping Up My Choices third grade program and our newly revised Activity & Eating program. These examples allowed the attendees to visualize how the steps were incorporated in the program development process.

The third and final portion of the presentation stressed the importance of including health literacy techniques. Most health education materials are written at or above a tenth grade reading level when they should be written at the sixth grade level. To achieve behavior change, users must understand the information and how to use it. Attendees broke into small groups and identified how to improve a program to achieve the principles of the behavior change model.

ANSA conference attendees come from across the country and from various agencies- and serve a wide range of populations- so the feedback received was from multiple viewpoints. The group found this interactive presentation beneficial, particularly the focus on readability and use of plain language during program development. It was reassuring that the feedback so closely match the changes made to Activity & Eating. One attendee mentioned he was very fond of the previous edition of Activity & Eating and could not imagine liking the new one better. After seeing the updates, he was even more thrilled about having this new resource available. As attendees asked for copies of the booklet to share with their health educators, I knew we had created a very usable booklet that can improve food and activity choices.

Trina Robertson, MS, RD

Project Manager