40 research outputs found
A qualitative study of adherence to nutritional treatment: perspectives of patients and dietitians
No full textRonit Endevelt, Anat Gesser-Edelsburg School of Public Health, University of Haifa, Mount Carmel, Haifa, Israel Background: Effective interaction between care providers and patients is crucial for the success of most medical treatments; in nutritional medical treatment, it is of paramount importance. The aim of the present study was to ascertain the role of the dietitian–patient relationship and the counseling approach in influencing individual patient decisions to adhere to counseling by persisting with nutritional treatment. Methods: We conducted focus groups with two types of patients, namely, those who had consulted dietitians only once and those who had attended at least three appointments. We divided these two groups into 12 focus groups. In addition, in-depth interviews were held with 17 clinical dietitians. Our qualitative research was based on the perceptions of patients and dietitians. Results: When the encounter between the dietitian and the patient followed the standard educational and informative approach, both the short-term nature of the interaction and the absence of an individualized therapeutic program discouraged patients from persisting with treatment. In contrast, the counseling and therapeutic nutritional approach promoted nutritional guidance through broader behavioral and lifestyle therapies. This approach appears more appropriate for chronically ill patients. The dietitians and some of the patients understand that the profession is changing from the informative and educational approach to a therapeutic counseling approach, but it is difficult for them to adapt to the new model. Conclusion: Most patients appear to want individualized, not standardized, treatment. In order to change patients' eating patterns, dietitians must adopt a more therapeutic approach and relate to patients’ cultural needs and desires to achieve sustainable results. Keywords: therapeutic counseling approach, nutrition educational approach, treatment, nutritiona
School Lunch Programs in Israel, Past and Present
No full textThe first lunch programs in Palestine were the “soup kitchens,” which were established in Jerusalem before the First World War to feed the poor. Then, in 1923, Henrietta Szold launched a lunch initiative in schools in order to supply basic nutrition to students. As the children at most of the schools prepared the meals themselves with local products, they also learned good, low-cost eating habits and the appropriate use of domestic goods and had educational goals as well. These educational goals were in line with Zionist ideology. School lunch programs lasted through the early years of the nation of Israel, albeit without official governmental support, but they came to an end amid the rising prosperity of the early 1970s. In 2004, in response to the alarming results of a food security survey conducted by the Ministry of Health, the Knesset passed a law establishing a new school lunch program on a trial basis. This article reviews the history of lunch programs in Israel, highlighting both their achievements and their limitations, in order to establish a framework for judging the success of the current school lunch policy
Outcomes Monitoring and Implementing Evidence-Based Nutrition Practice Guidelines for Type 2 Diabetes Mellitus in 2 Middle Eastern Countries
No full textWOS: 000209552800005Use of the Academy of Nutrition and Dietetics (Academy) evidence-based nutrition practice guidelines has not been tested internationally. The International Diabetes Outcomes Study explored implementation of the Academy evidence-based nutrition practice guidelines in Turkey and Israel by registered dietitians. The mean hemoglobin A(1c) levels decreased from 7.6% to 9.1% at baseline to 6.2% to 7.4% for participants in Turkey and Israel, respectively. Patients at goal increased from baseline to 12 months for low-density lipoprotein cholesterol and triglyceride. Most subjective ratings for lifestyle behavior changes improved and were positively correlated with hemoglobin A(1c) change. Outcomes suggest that Academy evidence-based nutrition practice guidelines could be adopted internationally with resources for training, translation, and adaptations.Academy of Nutrition and Dietetics Foundation; Abbott Laboratories; Academy of Nutrition and DieteticsEsther Myers received grant funding from the Academy of Nutrition and Dietetics Foundation (formerly named the American Dietetic Association Foundation) with support from Abbott Laboratories, and the Academy of Nutrition and Dietetics provided in-kind support for additional salary beyond grant funding. Abbott Laboratories provided glucometers and glucose strips for the research project. Naomi Trostler, Ronit Endevelt, Hillary Voet, and Emel Alphan were supported by the grant funding from the Academy of Nutrition and Dietetics
Do more specific plans help you lose weight? Examining the relationship between plan specificity, weight loss goals, and plan content in the context of a weight management programme
No full textObjectives: The conditions under which planning for behaviour change is most effective are not fully understood. In the context of a weight management intervention, we examined the interrelationship between plan specificity, type of behaviour planned (diet vs. exercise) and weight loss goals. Design: Prospective design and content analysis of plans formed by participants of a 10-week weight management programme. Methods: Participants (n=239) formulated two plans, for dietary and exercise behaviours respectively. Plans were rated for specificity by examining the number of plan components. Weight loss goals were assessed by asking how much weight participants intend to lose. Weight was measured objectively each of the 10 weeks. Changes in BMI over time and the interactions between plan specificity, and weight loss goals, for all plans and separately for diet and exercise, were estimated using linear mixed models. Results: Plan specificity was unrelated to weight loss, but interacted with weight loss goals in predicting linear change in BMI (t= -2.48): More specific plans were associated with higher decreases in weight in participants with high weight loss goals. Separate interaction tests for plans formulated for diet and exercise change showed that more specific dietary plans, but not exercise ones, were associated with higher decreases in weight in participants with high weight loss goals (t= -2.21). Conclusions: Within a population that is highly motivated to lose weight, the combination of high weight loss goals and formulating detailed plans for changing dietary behaviours may be most effective in supporting weight loss
An entertainment–education study of stereotypes and prejudice against fat women
No full text Objective: To evaluate the impact of Fat Pig on the attitudes of high school students towards fat women and investigate the perspective of dietitians as health professionals on the messages in Fat Pig. Design: Performance analysis, pre–post analysis of students’ responses to self-administrated pre-constructed questionnaires, students’ focus groups and personal interviews with dietitians. Setting: Tenth grade (15–16 year-old) high school students in Israel who saw Fat Pig as part of their high school’s educational–cultural curriculum, and dietitians from four different healthcare organizations in Israel that came to see the play as a group. Method: Performance analysis, quantitative analysis of students’ responses using SPSS, and qualitative analysis of students’ focus groups and personal interviews with dietitians. Results: Students’ responses indicate that the play’s impact is completely opposite to the playwright and the educator’s original intention to challenge stereotypes and prejudice towards fat women in society. Moreover, the play reinforces the student’s social and cultural norms that glorify the ‘thinness ideal’. In addition, according to the dietitians, the play cannot serve them as an additional treatment tool. Conclusion: Creating or using drama in education not according to theoretical approaches, such as the entertainment–education (EE) approach, may lead to paradoxical outcomes, completely contradict educational intentions, and even reinforce undesired attitudes and behaviours. </jats:p
Optimal Nutrition Care for all, from Policy to Action – A National Nutrition Program in Israel
No full textAbstract \ Background \ Malnutrition is a significant public health problem which includes both ends of the nutrition spectrum, with obesity and overweight at one end and under nutrition at the other. Israel is one of 14 countries in Europe which has joined the European Nutrition for Health Alliance (ENHA) whose common goals are ‘Optimal Nutrition Care for All'(ONCA). Israel is unique in that the four health maintenance organizations, which provide coverage for all, are fully computerized, with big accessible data. \ Objective \ Creating national awareness for better nutrition for all the population. \ Methods \ Four subcommittees were formed to develop policy: interventions in hospitals; within the community; communication and patient opinion; continuity of care with the aid of computerized and big data tools. \ Results \ All stakeholders signed a charter which included: Implementation of weighing in all health-care settings; screening for malnutrition; creating health quality indicators; improving the nutritional quality of food served to patients in hospital settings; continuity of treatment-care sequence; promoting a healthy lifestyle for the entire population and establishing a national malnutrition registry. \ Conclusion \ Multidisciplinary teams must work together at a national level towards reaching the goal of ‘Optimal Nutrition Care for All' against malnutrition.
Development and standardization of the “Let's Shop” questionnaire: an assessment of shopping habits and executive functions in people with obesity
No full text
The high cost of celiac disease in an Israeli Health Maintenance Organization
No full textBackground: The aim of this study was to identify costs in patients diagnosed with Celiac disease. Methods: This retrospective case control study covered the period 2003-2006 and was conducted in a large Israeli Health Maintenance Organization insuring over two million members. Our cohort comprised 1,754 patients with Celiac disease with a control group of 15,040. Costs were aggregated according to main cost-branches and computed individually for each member. A linear step wise regression was performed with costs being the dependent variable and the independent variables; age, gender and the presence of celiac disease. Costs were compared with patients suffering from other chronic diseases. Results: The total costs of the patients with celiac disease were significantly higher than that of the control group for hospital admission, medications, laboratory and imaging. Hospital admission rate was 7.98% as opposed to 7.1% for the control group (p = 0.06). When compared with other chronic illnesses, the costs of patients with celiac disease were similar to those of patients with diabetes and hypertension. Conclusions: Patients with Celiac disease utilize medical services more than the general population. This research suggests that the use of medical resources by patients with Celiac disease may be higher than previously thought
