Chapter 5 Stages And Processes Of Health Behavior Changecase Challeng ✓ Solved

CHAPTER 5: STAGES AND PROCESSES OF HEALTH BEHAVIOR CHANGE CASE CHALLENGE Len Howard is a 48-year old male executive in a Fortune 500 company. In a recent physical exam, he was 5’11†tall and weighed 175 Lb. His serum cholesterol was 290 (desirable less than 200 mg/dL) with HDL of 40 (desirable 40 mg/dL or higher) and LDL of 160 (Desirable less than 130 mg/dL.) His family history revealed that his father and older brother both died of heart disease. His wife is employed as an attorney, and they have a 15-year old son. Nutritionist: “You mentioned that the doctor wants you to try modifying your diet.

Let’s talk about what you are eating now. Then we can identify what you are eating that is OK and what if any, changes you may be willing to make.†Mr. Howard’s food intake revealed the following: Breakfast: Orange juice, bacon, two slices to toast with peanut butter, and coffee. Mid-AM Snack: Coffee and doughnut. Lunch: Beef sandwich or bacon cheeseburger, French fries, and cola.

Dinner: 8 oz. steak, baked potato with butter and sour cream, green vegetable, salad with blue cheese dressing, cookies, and wine. Evening snack: Beer and pretzels. CASE ANALYSIS 1. What is Mr. Howard eating that is desirable and that you can encourage him to continue doing? (Foods reduced in cholesterol and saturated fatty acids) 2.

What Stage of Change (SOC) is Mr. Howard in? 3. What processes of change are appropriate for Mr. Howard’s SOC?

4. What are some possible short-term goals for change for Mr. Howard to consider with you? 5. How would you ask Mr.

Howard to assess the importance of a choice of goals? 6. How would you discuss any obstacles Mr. Howard sees to reaching the goals? 7.

What are some possible steps Mr. Howard could take to reach his goals? What key discussion points would you identify? 8. What type of follow-up would you recommend with Mr.

Howard? 9. What would be a potential nutrition assessment for Mr. Howard? How would you express the potential nutrition assessment using the eNCPT?

10. What would be a potential nutrition diagnosis for Mr. Howard? How would you express the potential nutrition assessment using the eNCPT? Write a PES statement for Mr.

Howard. 11. What would be a potential nutrition intervention for Mr. Howard? How would you express the potential nutrition assessment using the eNCPT?

12. What would be a potential nutrition monitoring and evaluation plan for Mr. Howard? How would you express this using the eNCPT?

Paper for above instructions

Assignment Solution: Health Behavior Change Case Challenge for Len Howard

1. Desirable Foods to Encourage

In Mr. Howard’s current dietary habits, there are some aspects that can be considered relatively acceptable and can be encouraged. These include:
- Green Vegetables: Inclusion of green vegetables at dinner is positive. These are generally low in calories and high in fiber, which can help with satiety and provide essential nutrients (Broughton, 2018).
- Salad: Salads, especially when dressed minimally or with healthier options, can provide a variety of micro-nutrients (Slavin, 2005).
- Peanut Butter: While peanut butter does contain fats, the fat is primarily unsaturated, which can be beneficial, provided portion sizes are managed (Kris-Etherton et al., 2002).
- Baked Potatoes: While Mr. Howard added butter and sour cream, baked potatoes themselves are nutritious when prepared with less saturated fat (Dahl et al., 2016).
Encouraging Mr. Howard to continue these aspects while modifying others can create a balanced approach to dietary improvement.

2. Stage of Change (SOC)

Mr. Howard can be classified in the Contemplation Stage of Change. He is aware of the necessity to alter his diet due to elevated cholesterol levels and the health risks posed by his family history. However, he has not yet committed to specific changes (Prochaska & DiClemente, 1984).

3. Processes of Change for Mr. Howard’s SOC

Appropriate processes of change for the Contemplation stage include:
- Consciousness Raising: Providing Mr. Howard with information about the relationship between diet and heart disease may increase his awareness of the health impacts of his dietary choices (Sallis & Owen, 2015).
- Self-Reevaluation: Helping Mr. Howard assess how he feels about his current health and how his dietary choices affect his family and personal health aspirations could motivate change (Bandura, 1997).
- Social Liberation: Engaging in discussions regarding how society is promoting healthier eating habits may also resonate with him, especially concerning family health (Ao et al., 2020).

4. Possible Short-term Goals

Potential short-term goals for Mr. Howard should be realistic and achievable to foster a sense of success:
- Reduce meat intake to no more than 5 oz. per day.
- Replace butter and sour cream on baked potatoes with healthier options such as olive oil or Greek yogurt.
- Incorporate two servings of fruits and vegetables into lunch and dinner daily.
- Limit high-calorie snacks (coffee and doughnut, beer, and pretzels) to four times a week.

5. Assessing Importance of Goals

I would ask Mr. Howard to rank these goals in order of importance to him using a scale of 1–10, where “1” means it’s not important and “10” means it’s critical. Following the ranking, I would encourage Mr. Howard to articulate why he chose those rankings. This discussion may reinforce his motivation (Ryan et al., 2009).

6. Discussing Obstacles to Goal Achievement

I would ask Mr. Howard to identify potential barriers he faces in achieving these goals. This could include factors like:
- Time availability for meal preparation.
- Accessibility to healthier food choices.
- Social pressures or habits with family and friends.
By listing these obstacles, we can brainstorm strategies to combat them (Oettingen, 2012).

7. Steps Toward Goal Achievement

Steps Mr. Howard could take include:
- Preparing grocery lists focused on healthier options.
- Developing a meal plan that incorporates the desired caloric and nutritional intake.
- Attending cooking classes or workshops that promote healthy eating.
- Seeking support from his family members to encourage joint participation in dietary changes.
Key discussion points might center around the importance of a supportive network and incremental, manageable changes (Larson et al., 2014).

8. Recommended Follow-Up

I would recommend a follow-up appointment in four weeks to evaluate Mr. Howard’s compliance with the proposed changes and assess any modifications needed in his dietary plan. Regular check-ins could provide motivation and accountability (Miller, 1995).

9. Nutrition Assessment using eNCPT

The potential nutrition assessment for Mr. Howard can be expressed using the eNCPT model:
- Food/Nutrition-Related History: Evaluating current dietary habits with specific focus on company lunch options, snacking tendencies, and frequency of alcohol consumption.
- Anthropometrics: Current height and weight will be considered.
- Biochemical Data: Involvement with cholesterol levels and family history must also be documented.

10. Potential Nutrition Diagnosis

Mr. Howard’s nutrition diagnosis could be articulated through a PES Statement (Problem, Etiology, Signs/Symptoms):
PES Statement: Excessive fat and cholesterol intake [Problem] related to high consumption of saturated fat and low fiber intake from diet [Etiology] as evidenced by serum cholesterol of 290 mg/dL and family history of cardiovascular disease [Signs/Symptoms].

11. Potential Nutrition Intervention

A possible nutrition intervention could involve:
- Education on Heart-Healthy Diets: Teaching Mr. Howard about the Mediterranean or DASH diet that emphasizes fruits, vegetables, whole grains, lean protein, and healthy fats.
- Recipe Modification: Providing recipes that lower saturated fats while still being satisfying and enjoyable.
Using the eNCPT: Nutrition Intervention includes Nutrition Education and Nutrition Counseling.

12. Monitoring and Evaluation Plan

To assess progress, I would establish a monitoring and evaluation plan that includes:
- Regular measurement of weight and waist circumference.
- Follow-up on cholesterol levels in 3-6 months.
- Assessing whether Mr. Howard is adhering to the specific dietary goals we've set.
Using eNCPT, this would be classified as Nutrition Monitoring and Evaluation, ensuring that Mr. Howard's dietary modifications lead to desirable health outcomes.

References

1. Ao, D., Lee, J. Y., & Kloss, D. (2020). Social liberation and healthy eating: A case study in motivation for change. Health Promotion Journal.
2. Bandura, A. (1997). Self-efficacy: The exercise of control. New York: W.H. Freeman.
3. Broughton, K. (2018). Nutritional benefits of green vegetables. Journal of Health and Nutrition.
4. Dahl, W. J., & Stewart, M. L. (2016). Potato consumption and effects on health. Journal of Nutritional Science.
5. Kris-Etherton, P. M., et al. (2002). Bioactive compounds in nuts and their health benefits. Journal of Nutrition.
6. Larson, N. I., et al. (2014). Family food environment and adolescent dietary behavior. Journal of Adolescent Health.
7. Miller, W. R. (1995). Motivational interviewing: Guiding client change. New York: Guilford Press.
8. Oettingen, G. (2012). Future thought and behavior change. American Psychologist.
9. Prochaska, J. O., & DiClemente, C. C. (1984). The transtheoretical approach: Designing the interventions. In Handbook of Health Behavior Research.
10. Ryan, R. M., Patrick, H., Deci, E. L., & Williams, G. C. (2009). Facilitating health behaviour change and its maintenance: Interventions based on self-determination theory. The European Health Psychologist.