Guided goal setting the logical next step to vena
Download
1 / 50

Guided Goal Setting: The Logical Next Step to VENA - PowerPoint PPT Presentation


  • 434 Views
  • Uploaded on

Guided Goal Setting: The Logical Next Step to VENA. Presented by: Shirley H. Sword, MS, RD, LDN PA Department of Health – Division of WIC October 14, 2010. Objectives. To gain insight on the history of the development of Guided Goal Setting

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about 'Guided Goal Setting: The Logical Next Step to VENA' - latanya


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
Guided goal setting the logical next step to vena l.jpg

Guided Goal Setting: The Logical Next Step to VENA

Presented by:

Shirley H. Sword, MS, RD, LDN

PA Department of Health – Division of WIC

October 14, 2010


Objectives l.jpg
Objectives

  • To gain insight on the history of the development of Guided Goal Setting

  • To understand the research behind development of the Guided Goal Setting Module

  • To learn the local agency perspective on how Guided Goal Setting is working in the clinics


Facts and figures about pa l.jpg
Facts and Figures About PA

  • 9th Largest WIC Program

  • 44,817 square miles

  • 274 people per square mile

  • One-third of our 12.4 million residents live in rural areas, the largest non-urban population in the nation

  • 2nd highest percentage of residents >65 years old in the country


Facts and figures about pa wic l.jpg
Facts and Figures About PA WIC

  • 67 Counties

  • 24 Local Agencies

    • Community Action Programs

    • Medical Centers

    • County Health Departments

    • Private, Non-Profits

  • 265,000 Monthly Caseload


Service delivery system l.jpg
Service Delivery System

  • 329 Total WIC Clinics

    • 116 Primary Sites

    • 213 Satellite Sites

  • Users in total - 832

    • 383 CPAs

    • 449 Non-CPAs

  • 1767 WIC Authorized Stores

  • On-site, On-demand Check Printing



Special project grants l.jpg
Special Project Grants

  • Special funding from USDA for special State projects of regional or national significance to improve the services of the program

  • Address issues of critical and timely importance

  • Requires a rigorous evaluation component

  • Results are widely disseminated to other States


Slide9 l.jpg
Development and Evaluation of Guided Goal Setting (GGS) as a Behavior Change Approach and Monitoring Protocol in Pennsylvania WIC

Our Special Project Grant


Partners in this project l.jpg
Partners in This Project

  • PA WIC

    • Shirley Hsi Sword, Project Director

  • Indiana U of PA

    • Stephanie Taylor-Davis, Principal Investigator

    • Mia M. Barker, Co-Investigator

    • William F. Barker, Evaluator

    • Pao Ying Hsiao, Research Assistant


Slide11 l.jpg

Goals of this Project

  • To enhance the quality of WIC services provided to PA WIC participants

  • To further VENA initiatives via an evaluated and measurable, participant-centered nutrition education counseling approach that:

    • Maintains continuity from visit to visit

    • Empowers participants

    • Benefits the participant


Slide12 l.jpg

The Basis for Goal Setting

  • Straight-forward behavioral change approach that accommodates a variety of achievement levels

  • Emphasizes small, progressive steps that are concrete

  • Relevant to address emerging prevention-oriented public health concerns

  • Supported in scientific and behavioral literature with a variety of populations and topic areas


Slide13 l.jpg

Guided Goal Setting (GGS): Defined

An approach used by the nutritionist in conjunction with the participant that involves critical thinking based on assessment to develop strategies for goal setting to achieve desired participant outcomes


Slide14 l.jpg

Central Mission

  • Identification, development, implementation, and evaluation of GGS as a WIC counseling method to:

    • Increase participant-centered approach

    • Enhance staff competency and critical thinking skills

    • Assess participant commitment to food-based behavior change

    • Extend nutrition education by supplementing contact points with targeted reinforcements


Results by year 2005 2008 l.jpg
Results by Year2005-2008

GGS:

Special Project Grant


Slide16 l.jpg

Goals by Year

  • Year 1: “Profile Identification and WIC Evaluation”

    • Assess the state of being in PA WIC with respect to goal setting as a nutrition education counseling approach

  • Year 2: “Guided Goal Setting Practices & Assessment”

    • Formalize the GGS process through development and pilot testing of a training module and assessment tools

  • Year 3: “Improvement – Nutrition Education & Outcomes”

    • Project 1 = Provide standardized training to nutritionists to improve staff competency

    • Project 2 = Run an experimental protocol with GGS that uses reinforcement and is participant-centered and individualized


Slide17 l.jpg

Year 1 Projects

  • Interview and survey WIC staff to identify nutrition education best practices and barriers to best practices (n=147)

  • Survey WIC participants (not initially in proposal) (n=4665)


Year 1 data collection l.jpg
Year 1: Data Collection

  • Demographic Survey

  • Written Surveys

  • Semi-structured interviews

    • Face-to-face

    • Telephone

  • Nutrition Education Services Survey

  • Director Survey

  • Nutrition Education Coordinator Survey

  • WIC Participant Survey



Results year 1 staff insights l.jpg
Results:Year 1 – Staff Insights

  • Common themes for implementing:

    • Time

    • Environment

    • Distractions

    • Training

    • Resources

    • Attitudes about goal setting


Results year 1 staff insights21 l.jpg
Results:Year 1 – Staff Insights

  • Best practices:

    • Participant-centered

    • Committed and knowledgeable staff

    • Receptive participants

    • Good assessment with critical thinking

    • Personalizing process

    • Establish expectation for goal setting


Results year 1 staff insights22 l.jpg
Results:Year 1 – Staff Insights

  • Attributes:

    • Knowledge

    • Professional behaviors with participants

    • Professional behaviors within WIC

    • Program beliefs

    • Other

    • Professional values


Results year 1 participant insights l.jpg
Results:Year 1: Participant Insights

  • Participant attitude different than staff perceptions

  • Liked best

    • Helpful suggestions from nutritionist

    • Caring Staff

    • Handouts and brochures

    • Recipes


Results participant insights cont d l.jpg
Results: Participant Insights (cont’d)

Participant Response (n=4,665) Regarding What They Like About WIC Nutrition Information


Collective voice year 1 findings l.jpg
Collective Voice:Year 1 Findings

Resources

Sites

Information

Communication

  • TIME

  • Staff issues

  • Perceptions

  • Participant issues

  • Training issues


Slide26 l.jpg

Year 2 Projects

  • Develop & test a standardized, yet flexible, theory-based, user-friendly training module and associated instrumentation that will strengthen staff skills and competencies to facilitate the GGS Process


Slide27 l.jpg

General Concept of GGS Module Development

Literature

Nutrition Ed

Coordinator

Agency Staff

Nutritionists

Participants

LA Directors

GGS Module Units & Objectives

GGS Practices Assessment Instruments



Additional year 1 project findings incorporated l.jpg
Additional Year 1 Project Findings Incorporated

  • “Key principles, assumptions and expected components of a GGS contact” document

  • Recommendations regarding time and delivery system to support nutritionist and paraprofessional training

  • Best practices and success story reports from semi-structured interviews


Slide30 l.jpg

The GGS Module

  • Ten, 15 to 20-minute hands-on units

  • Activity rich

  • Case study oriented

  • Learner workbook

  • Evaluations: pre, one minute, post, workshop evaluation, and 6 week follow-up with “skill set use”

  • Pilot tested using facilitated group training


Ggs module units 1 5 l.jpg
GGS Module: Units 1-5

  • Definition and Relevance

  • Counseling Strategy for Behavior Change

  • Assessment and the Contribution of the WIC Staff

  • Personalizing the Process

  • Linking Risk Codes to Participant Goals


Ggs module units 6 10 l.jpg
GGS Module: Units 6-10

  • The Team Approach and Goal Priority

  • Structure of Measurable Goals

  • Documentation

  • Follow-Up and Goal Achievement

  • Action Plan


Slide33 l.jpg

Year 3 Projects

  • Staff Training using GGS module

  • Experimental protocol to test effectiveness of GGS with participants


Year 3 results staff training l.jpg
Year 3 Results: Staff Training

  • Alpha testing (February 2008)

    • n=10

  • Beta testing (July 2008)

    • n=12

Pre- and post-training surveys

One minute evaluations for each unit

Overall workshop evaluation

Six week follow-up “skill set use” survey



Slide36 l.jpg

GGS Evaluation:“Most Important Things Learned”


Ggs evaluation least important things learned l.jpg
GGS Evaluation: “Least Important Things Learned”


Ggs evaluation how use information l.jpg
GGS Evaluation:“How Use Information”


Suggestions after pilot testing l.jpg
Suggestions after Pilot Testing

Based on α Site

Based on β Site

Spend more time on the last five units and less time on the overview

Split into two sessions

More examples of goals and documentation

Fewer evaluations or group them

Good information but could go at faster pace

  • Modified the units to make them more consistent in presentation style

  • Added a small amount of time to each unit

  • Most substantial revision was to Unit 6 – TEAM approach

  • Modified the way the documentation template was introduced in Unit 8

  • Added the ‘Modified’ response option to Skill Set Survey Instrument


Conclusions after pilot testing l.jpg
Conclusions after Pilot Testing

  • By establishing a baseline and a consistent structure for participant goal setting within PA WIC, there are now parameters upon which to evaluate the nutritionist-participant interaction and assess the efficacy of this counseling method to support participant behavior change.

  • The GGS Training Module and Assessment Instruments provide a mechanism to address staff (both CPA/Nutritionist and Other Staff) competency to facilitate the goal setting process with WIC participants.





Staff reaction l.jpg
Staff Reaction

  • Better working relationship with the clients

  • More open communication between staff and clients

  • More aware of the client’s perception of their family’s nutritional needs


Client reaction l.jpg
Client Reaction

  • “Your nutritionist was very well informed and offers great ideas and information.”

  • “Staff was very friendly and explained everything in detail and offered excellent help.”

  • “Staff made us feel comfortable with her advice and help.”

  • “The Staff spoke to me, not at me.”


Hurdles to cross l.jpg
Hurdles to Cross

  • Don’t jump to conclusions!

  • Set small, achievable goals

  • Time

  • Documentation


Effect on clinic operations l.jpg
Effect on Clinic Operations

  • No change in staff duties

  • No operational changes within the clinic

  • Continuing education for professional and paraprofessional staff



Acknowledgements l.jpg
Acknowledgements

  • USDA, Food and Nutrition Service

  • FNS Project Officers

    • CherisaToomer (May 2007 – December 2008)

    • Carol Stiller, MS, RD (September 2005 – April 2007)

    • Home Nursing Agency staff and participants

    • Adagio Health, Inc.

  • PA Department of Health, Bureau of Information Technology and Ciber, Inc.


Contact information l.jpg
Contact Information

Shirley H. Sword, MS, RD, LDN

ssword@state.pa.us

Stephanie Taylor-Davis, PhD, RD, LDN

stdavis@iup.edu

Mia Barker, PhD

mabarker@iup.edu

Tracy Kelley

tkelley@homenursingagency.com