Community Nutrition Portfolio

Lauren Timmerman
March 21, 2017
B. [Tracking Document]
--1. Review and familiarize yourself with the form: sign, and return to my
desk by February 10th (16th) (I will sign and return to your folders in Ellens office.
Youll retrieve and keep with you entire course.
2. When youve completed the course, youll review the form again, checking
off the competencies you feel youve met. Youll SIGN and hand in with your
final portfolio. The tracking doc stays with you until graduation.
C. Reflections
UCONN College of Agriculture and Natural Resources
Department of Allied Health Sciences/Coordinated Program in Dietetics
Diet 3235/Spring 17/Reflection Template

Instructions: Choose the two (2) richest days from your weeks of supervised
practice experiences. Please copy and paste the template headers to a
new document, responding to all sections/questions in complete
sentences and in the context of the day you selected. Thanks!

1. Name: Lauren Timmerman

2. Date of placement: March 21, 2017

3. Placement site/description (urban, suburban, demographics, i.e. gender,

age, race/ethnicity, etc): Suburban area with a higher demographic of African
American children.

4. Site mentor: Carolyn Pancarowicz

5. Language barriers Y/N. If yes, please explain how you dealt with the
challenge: No

6. Describe the supervised practice placement/activity here. Please weave into your
response the following:
A. ConnectionstotheNutritionCareProcess
Assessmentfoodforthought:

I believe the model that may most closely correlate to the preschoolers
and the Veggie Sensory Lesson would be the Health Belief model. Most
of these children are having their first experience with the vegetable
(in this case, green beans). The two out of the three core assumptions
of the health belief model that relate to the preschool activity are: the
positive expectation of recommended action, and the belief that she/he
can successfully take a recommended health action. Even though
preschool children do not fully understand the benefits of vegetables,
the aim is to introduce a positive outlook of eating vegetables.

Diagnosis

Food and nutrition knowledge deficit related to students age of 4-5

years old as evidence by not having full familiarity with a common
vegetable.

Plan
Make sure to have a book that the children will like, understand, and
related to trying new things.
A vegetable that is easy for the kids to handle and that is a pleasant
and mild flavor.
 Make sure to have stickers to reinforce good behavior and trying the
vegetable.
Make sure to ask the kids about other vegetables, if they like the green
beans, if they will eat them at home.
Make sure to keep a positive and happy attitude.

Implementation

First arrived to the preschool and organized and washed the green beans. At
the first classroom we organized the green beans onto napkins, making sure
there was one for each child. We all gathered around in a circle on the carpet
and read the book Green Eggs and Ham. After the reading was done (about
10 minutes). We then talked to the preschoolers about different vegetables
theyve eaten or if they are familiar with green vegetables. We then all went
to the tables and passed out the green beans, one per child. Then we had the
kids feel the green beans, sniff the green beans, snap the green beans and
then taste the green beans (we all did this together). At each stage, we had
the children raise their hand and shout out what the green bean smelt like,
felt like, and tasted like. Each child was given a sticker and thanked for trying
the new vegetable and then asked if they would try it at home. The answers
were mixed with yes and no, but most children seemed to like the green
beans and wanted to try them again.

Evaluation/Modification

Since we were at a preschool we were not able to have a full written

evaluation for the children. Instead, we asked the children a series of
questions and had them raise their hands if they agreed or shout out the
answers. For example, we would ask what the green beans felt like, what
they smelled like, tasted like, and if they would try the green beans at home.
We would get answers like smelled sweet and felt smooth and even one
little boy who eagerly replied the green bean feels like my Uncle Jims cats
tail.

I believe we did meet our learning objectives of introducing the children to a

new vegetable, or reintroduce the vegetable to them in a positive light. Also,
we met the objective of having the children repeat a feeling or observation
back to us about the vegetable. Overall, it appeared that about 95% of all of
the children were engaged in the lesson and reported (by raising their hands)
if they liked the green beans or would try them at home.

Lessons learned

I believe that the lesson went well. The children loved Green Eggs and
Ham, especially because they were familiar with it. Surprisingly they were
more engaged and loved pointing out to the different pictures on the page.
Since they recognized the book, they seemed even more excited about trying
something new. Most of the children seemed very eager to learn and
participate, some even asked for second green beans! Next time, I would
have little plastic baggies for the green beans for the ease of handing them
 out and having the children touch the green bean. Otherwise, the children
seemed excited to try the green bean and especially earn a sticker at the
end.

BCompetencies you addressed/met. : 1.2, 1.6, 2.1, 2.3, 2.7, 2.9, 2.10, 2.11, 2.12,
3.8, 3.5, 3.3

Core Competencies for the RDN, 2017 CP

CRDN = Competence for the Registered Dietitian

Domain 1: Scientific and Evidence Base of Practice: integration of scientific informatio

research into practice
CRDN 1.1 Select indicators of program quality and/or customer service and measure achievement
objectives. (Note: Outcomes may include clinical, programmatic, quality, productivity, economic o
outcomes in wellness, management, sports, clinical settings, etc.)
CRDN 1.2 Apply evidence-based guidelines, systematic reviews and scientific literature
Applying Health Belief Model to the preschool lesson
CRDN 1.3 Justify programs, products, services and care using appropriate evidence or data
CRDN 1.4 Evaluate emerging research for application in dietetics practice
CRDN 1.5 Conduct projects using appropriate research methods, ethical procedures and data anal
CRDN. 1.6 Incorporate critical-thinking skills in overall practice
When tabling at supermarket , answering participant questions.
CRD 2.1 Practice in compliance with current federal regulations and state statutes and
as applicable and in accordance with accreditation standards and the Scope of Dietetic
and Code of Ethics for the Profession of Dietetics
When tabling, handing out food at Food Share Mobile, and conducting preschool
CRD 2.2 Demonstrate professional writing skills in preparing professional communications
(Note: Examples include research manuscripts, project proposals, education materials,
policies and procedures)
CRDN 2.3 Demonstrate active participation, teamwork and contributions in group settin
Tabling at all sites, tabling at supermarket, and putting together preschool lesson
CRDN 2.4 Function as a member of interprofessional teams
CRDN 2.5 Assign duties to NDTRs and/or support personnel as appropriate
CRDN 2.6 Refer clients and patients to other professionals and services when needs are
beyond individual scope of practice
CRDN 2.7 Apply leadership skills to achieve desired outcomes
While leading and designing preschool lesson.
CRDN 2.8 Demonstrate negotiation skills
CRDN 2.9 Participate in professional and community organizations
While visiting all community sites
CRDN 2.10 Demonstrate professional attributes in all areas of practice
While visiting all sites
CRDN 2.11 Show cultural competence/sensitivity in interactions with clients, colleagues
While tabling and visiting community sites such as WIC, and food share
CRDN 2.12 Perform self-assessment and develop goals for self-improvement throughou
While conducting this reflection
CRDN 2.13 Prepare a plan for professional development according to Commission on Dietetic
Registration guidelines
CRDN 2.14 Demonstrate advocacy on local, state or national legislative and regulatory issues or
policies impacting the nutrition and dietetics profession
CRDN 2.15 Practice and/or role-play mentoring and precepting others

3: Clinical and Customer Services: development and delivery of information, products, and
services to individuals, groups and populations
CRDN 3.1 Perform the Nutrition Care Process and use standardized nutrition language for
individuals, groups and populations of differing ages and health status, in a variety of settings.
CRDN 3.2 Conduct nutrition focused physical exams
CRDN 3.3 Demonstrate efective communications skills for clinical and customer servi
variety of formats
While visiting and tabling at WIC
CRDN 3.4 Design, implement and evaluate presentations to a target audience.
CRDN 3.5 Develop nutrition education materials that are culturally and age appropria
designed for the literacy level of the audience
While designing preschool program
CRDN 3.6 Use effective education and counseling skills to facilitate behavior change
CRDN 3.7 Develop and deliver products, programs or services that promote consumer health,
wellness and lifestyle management
CRDN 3.8 Deliver respectful, science-based answers to client questions concerning em
While tabling at all community sites.
CRDN 3.9 Coordinate procurement, production, distribution and service of goods and services,
demonstrating and promoting responsible use of resources

CRDN 3.10 Develop and evaluate recipes, formulas and menus for acceptability and
affordability that accommodate the cultural diversity and health needs of various populations,
groups and individuals

4 Practice Management and Use of Resources: strategic application of principles of ma

a and systems in the provision of services to individuals and organizations
CRDN 4.1 Participate in management of human resources
CRDN 4.2 Perform management functions related to safety, security and sanitation that affect
employees, customers, patients, facilities and food
CRDN 4.3 Conduct clinical and customer service quality management activities
CRDN 4.4 Apply current nutrition informatics to develop, store, retrieve and disseminate
information and data
CRDN 4.5 Analyze quality, financial or productivity data for use in planning
CRDN 4.6 Propose and use procedures as appropriate to the practice setting to promote
sustainability, reduce waste and protect the environment
CRDN 4.7 Conduct feasibility studies for products, programs or services with consideration of
costs and benefits
 CRDN 4.8 Develop a plan to provide or develop a product, program or service that includes a bu
staffing needs, equipment and supplies
CDRN 4.9 Explain the process for coding and billing for nutrition and dietetics services to
obtain reimbursement from public or private payers, fee-for-service and value-based payment s
CRDN 4.10 Analyze risk in nutrition and dietetics practice

4:

GRADING: Completing the 40 supervised practice hours will assist you in successfully completing t
following components of the course grade. The following are general grade guidelines: A
(93), A- (90), B+ (87), B (84), B- (80), C+(77), C (74), C-(70); D+ (67), D (64), D-(

METHODS OF STUDENT EVALUATION:

C. Connectionstoclasslecturenotes
a. The community nutrition practicum directly relates to the
lecture notes. Especially when assessing the community. In
the lecture, we talked about the goals of a community
assessment. For example, in the powerpoint, the goals were
listed: to improve health of people in a defined area, raise
official awareness of food and nutrition issues, determine how
to allocate limited resources, evaluate the efficacy of
programs and services, and identify current and potential food
and nutrition problems. In this case, this particular preschool
was chosen because of the data showing a higher count of
SNAP recipients. Conducting this lesson to the preschool
students was an opportunity to directly increase awareness
and the importance of vegetables for the children of this
community. There was also a handout given to the parents
about green beans and their child trying new things. The
handout is also an opportunity to increase the awareness of
the importance of vegetables to the parents.

D. Lastbriefnotes:
a. Acceptanceofyourpresenceatthesite
I felt very accepted at this site. All of the school staff was
very nice, receptive, flexible, and helpful with the lessons.
All of the teachers were happy to invite us into their
 classrooms and also made sure that all of the children were
attentive and polite while we conducted the lesson.
b. Yourperceivedvalueandworthoftheactivities/lesson
I believe that this lesson was very helpful. The children
seemed to enjoy it and eager to learn. They also seemed
very engaged and most had shown that they were happy
to try a new vegetable.
c. Sitementorperceivedvalueandworthofthelesson/shareanyoftheircomments
The site mentor, Carolyn, seemed very happy to have us
there to conduct the 4 lessons. She was very helpful in
suggesting materials and providing different props and
materials for us to use.
d. Yourcomfortlevelatsite
I was very comfortable at this site. The faculty and staff
were very inviting and the children were very polite,
receptive, and eager to learn.

7. KEY POINT TO END: What did you gain from the experience that speaks to your
growth and development as a community nutritionist? In what ways are you
feeling increasingly competent? (woo hoo!)

This activity helped me gain more confidence in planning

and teaching a lesson. After this community experience
Im feeling increasingly competent in being flexible with
what the teacher may want or expect us to teach their
students. After talking with Carolyn, I realized how many
different creative projects she takes on as a community
nutritionist. I like how this allows for a different day
everyday. As I grow as a community nutritionist I think it
will be fun to take on multiple small projects that allow for
interaction and creativity. This community rotation has
certainly helped me gain the confidence to exercise my
creativity in a flexible manner.

UCONN DAHS Coordinated Program in Dietetics

Diet 3235 Winter/Spring 2015
WIC reflection template

Lauren Timmerman WIC: TVCCA WIC Norwich office

Approx. clients serves at this site on this day: ~20

A. I was able to sit in on 4 counseling sessions with the WIC nutritionist.

The nutrition topics focused on the feeding of mostly babies 6-12
 months old. The nutritionist used motivational interviewing skills to
discuss topics with the families and help educate them on what the
babies can and cannot eat. The main messages addressed were if the
baby was seeing the pediatrician regularly and if he/she was
consuming enough formula. The main topic of conversation was
focused on the babys health. A small amount of conversation was on
the mother/fathers eating habits. There were no language barriers
while I was sitting in on the sessions.. Lauren do you know if the 4
sessions were Moms who were new or recerts? Im going to guess
recerts by the babys ages.

Your point on the topics could be expanded a bit: So what DID the
nutritionist say about what babies can and cannot eat? Did the
nutritionist show what is too much or too little formula or tell the
Moms/parents ounce amounts at all?

Lauren: really helpful for the future if you keep the template intros on the
response, esp bc were not wasting e paper.
B. There were both Spanish and English materials available to clients.
There was some information about breast feeding and fruits and
vegetables posted on the walls of WIC. Most of the information
provided was given in multiple pamphlets to the clients. The clients
were first asked if they would like to receive the information, and all of
them said yes. The nutritionist distributed the handouts and
highlighted appropriate information. She would then follow up by
explaining the important aspects of the handout that the client should
focus on for his/her child. There were no food models used while I was
sitting in on a session. Oh too bad. For visual learners, it could be a
god-send.
C. One of the sessions I sat in on, the mom seemed to be at the stage of
preparation to change. So the Theory Stages of Change. She was
introducing her baby to new foods but was not completely sure about
which foods to introduce. The nutritionist then helped her by explaining
through pamphlets and examples about what the baby can and cannot
eat at 6 months. Lauren this would be a great place to discuss what
happened next. Did the Mom quietly take that in and act like she could
care? Did the Mom take in the info and then offer a response that led
you to believe shed move to action stage?

D. We were able to converse with a few moms while at WIC. They were
both pregnant (one with her first child, and the other with her third).
We talked about good foods to keep in mind while pregnant. Both of
the moms were super excited for their new baby and wanted to do the
best by them! We also talked about different portion sizes as well as
watching sugar intake. Oh yay all terrific topics! I felt very comfortable
talking about nutrition topics with the clients. Most were friendly and
 curious about what we had to say about certain nutrition topics. As the
afternoon went on, it was easier to settle in and converse with clients.
Im so glad; itll get easier and easier! Wondering if you had food
models in your bin to back up those topics? IF you didnt all Id ask is to
have you think back to sharing info with those moms about portion
sizes kid vs adult and how wonderful it would have been to have two
plates with adult size foods and kids sized foods there to imprint that
in her/their minds.
E. Due to the way the WIC office is set up, there could be more indirect
nutrition education in the waiting room. The waiting room mostly
consists of childrens toys and a poster about healthy eating. I think it
would be helpful to have recipe cards set out each week with different
new, healthy, and easy to make recipes for the clients to take home.
Oh! Maybe even a recipe holder on the wall with seasonal recipes!
Im thinking at one point around 2011 or so, state WIC put out a
printed recipe booklet that was well done. Simple language, simple
ingredients etc. So they try. The satellite offices cant do their own
thing unfortunately; all edicts and mandates come from state office in
Htfd.

Thanks Lauren; I enjoyed reading this. I feel a bit like this was a little
rushed; perhaps it was bc I sent along the reminder. You included most
of what I asked for, so thats great. Thank you. I do think some of your
responses could have been a bit more in depth as to what you were
thinking along your way on that day and your discussion about
health model and face to face visits.

Thanks! Tina

+14/15

D.Time/Efort Forms & EARS Forms (Handed in)

E. SMART Goals and Objective Write Up

Initiation/ Ice Breaker: Introduce ourselves to the preschool

teachers and the kids. Then read the book Green Eggs and Ham .

Materials: Green Eggs and Ham, green beans, napkins, stickers,

and hand sanitizer.

Extension Activities: Have the children taste the green beans

and ask them if they will want to try them at home.
Closure: After we all try the green beans together, and thank the
children for trying them, make sure each child gets a sticker for
their participation and good behavior.

Goals Objectiv Situational Activitie Delivery Evaluatio

es Factors s Modes n
Planned
1. Make 90% of Preschool Read Read in a Have the
sure all preschoo children are Green circle and children
of the l children unpredictab Eggs then raise
prescho that are le, they and hand the their
ol presente may not Ham green hands to
children d to will want to and beans out if they
are become participate then individual liked the
familiar familiar in the have the ly at the green
with with the lesson or children tables. beans
green taste of want to taste and also
beans. green taste the the observe
beans by green bean. green if all of
tasting bean. the
the children
green tried the
bean by green
the end beans.
of the 25
minute
lesson.
2.100% Preschool With Hand out Have
of the children are everyon green children
preschoo again, e beans raise
l children unpredictab together individual their
will at le and may , snap ly and do hands
least not want to the each task and
touch, participate green together. shout
snap, bean, out what
and smell the
smell the green
the green bean
 green bean, feels
bean by and feel like,
the end the tastes
of the 25 green like, and
minute bean. smells
lesson. After like.
each Then
activity have
ask them
question raise
s about their
what it hands
feels again if
like, they
smells liked it or
like, etc. would try
it again.

F.Living the Challenge: Feeding yourself on the average

SNAP assistance for one day
Document #1: Original 24-hour recall
 Fa
Calories Carbs Protein Sodiu
Breakfast kcal g
t
g mg
g

Brownberry - Whole Wheat Toast, 0.65 slice 72 13 1 3 98

peanut butter - Trader Joes, 1 tbs 95 4 8 4 65
Special K - Red Berry, 0.33 cup 36 9 0 1 63
Organic's - Organic mixed berries, 1 cup (140g) 70 14 0 1 0
Soy Milk - Soy Milk, 0.67 cup 67 6 2 4 64
Add Food
340 46 11 13 290
Quick Tools

Lunch
Jam - Raspberry, 1 tablespoon 50 13 0 0 5
Peanut Butter: Skippy Chunky - Chunky Peanut Butter, 2 Tbsp (32g.) 190 7 16 7 125
Bread - Bread, Ezekiel 7 Grain, 2 slice 160 30 1 8 150
Apple-fuji Apple - Apple, 1 Medium (154g) 80 22 0 1 0
Panera Bread - Half Chinese Citrus Cashew Salad (No Chicken), 2 half
420 50 24 4 660
salad

Add Food
900 122 41 20 940
Quick Tools

Dinner
Glory - Kale Kale, 2 cups 45 9 0 3 35
Nasoya - Tofu, 3 oz. 80 3 4 9 25
Sweet Potato - Medium Baked Sweet Potato, 100 g (1 cup) 91 21 0 2 36
Three Bean Salad - Homemade, 0.5 cup 80 27 3 3 0
365 - Fig Balsamic Dressing, 2 Tbsp 30 7 0 0 230

Add Food
326 67 7 17 326
Quick Tools

Snacks
Clif Bar - Chocolate Chip, 1 bar (68g) 2.4 oz 240 44 5 10 150
Clif Kits Organic Fruit & Seed Bar Coconut Sesame Seeds - Protein Bar, 1
200 29 10 2 75
bar
Vega - Protein, 0.5 scoop 60 3 0 13 0
Brownie - Fiber One, 1 brownie 90 18 3 1 80

Add Food 590 94 18 26 305

Quick Tools

Totals 2,156 329 77 76 1,86

Your Daily Goal 2,240 280 75 112 2,30
Remaining 84 -49 -2 36 439

Calories Carbs Fat Protein Sodiu

kcal g g g mg

Document 2: Price of Original Meal

Food Price Per Serving

Breakfast Toast $0.29
Peanut Butter $0.17
Special K Cereal $0.20
Soy milk $0.33
Berries $1.00
Total $1.99
Lunch Jam $0.10
Peanut butter $0.17
Bread $0.60
Apple $1.00
Panera Salad $7.50
Total $9.37
Dinner Kale $0.70
Tofu $1.10
Sweet Potato $0.50
Bean Salad $0.20
Balsamic Dressing $0.18
Total $2.68
Snack Clif Bar $1.00
Fiber 1 Brownie $0.75
Kits Bar $1.50
Vega Protein $1.00
Grand Total $18.29
Document 3: Balanced SNAP Meal
Food Calori Price Item Price Reactio
es Per n
Servin
g
Breakfa 2 Large 180 $0.45 $2.69/doz Satisfie
st Eggs d,
2 Slices 200 $0.58 $3.50/loaf althoug
Bread h Im
8 oz. OJ 150 $0.16 $2.50/gal OJ not
usually
Total 530 $1.19 very
hungry
in the
mornin
g
Snack
1 35 $0.28 $1.49/ 16oz Starting
Serving to get a
Baby little
Carrots hungrie
r, the
carrots
and
hummu
s didnt
100%
hold me
over.
Hummus 75 $0.31 $2.49/packag
e

Total 110 $0.59

Lunch 1 tbsp 50 $0.16 $2.50/bottle The
jelly hunger
2 tbsp 200 $0.29 $3.69/jar is gone,
PB but Im
1 apple 100 $0.83 $2.49/ 3lb bag not
2 slices 200 $0.42 $2.50/loaf totally
bread satisfie
d.
Total 550 $1.70 Starting
to get a
little
tired.

Snack 1 cup 54 $0.24 $0.99/melon Barely

cantalou satisfyi
pe ng

Dinner 2 chicken 360 $0.25 family pack This

drumstick chix meal
s drumstick
drove
$0.69/lb
off
4 oz.green 35 $0.25 Green beans
beans $0.99/ 16 hunger.
oz.pk I was
1 baked 160 $0.70 $3.47/ 5lb not
potato quite
8 oz milk 120 $0.23 $3.60/ 1gal used to
eating
this
way. I
felt
restrict
ed that
I
couldnt
buy
another
snack
or stray
 from
the
meal
plan. I
realized
how
even
though
it can
be
done
you
have to
be very
strict
followin
g this
plan
and to
not go
over
your
allotted
amount
.

Total 675 $1.43

Grand 1919 $5.15
Total kcal

A. What was your estimated total food cost for your 24-
hour recall? How did it measure up against the typical
SNAP benefit of $5.50?

My estimated total food cost for the 24-hour recall was

$18.29. What made it so expensive was that I happened to
go to Panera that day. It was a lot more expensive than the
typical SNAP benefit. It would be borderline impossible to
meet the recommended SNAP budget while eating out.
 B. Discuss how easy or difficult it was to find the foods
you needed to fit into your budget

It was difficult to find foods that matched my budget. It took

planning and searching out sale items in order to safely meet
the $5.50 per day. It sometimes would have been beneficial
to buy items in bulk, such as rice and beans. However, I
would not have been able to buy anything in bulk that has a
strict expiration date because I only grocery shop for myself.

C. Discuss your ability to ofer yourself a balanced diet

with a variety of foods. Were there foods you needed
to select more often, less often?

I always had to select foods that were on sale. I had to keep

a close look on which frozen vegetables were a better deal,
and I mostly shopped at ALDIs. Finding a balanced diet is
possible, but it is more difficult and limiting because you
dont have the freedom of choosing any type of fruits and
vegetables in the supermarket.

D. Discuss your ability to ofer yourself the correct

portion sizes?
I had to be careful with portion sizes in order to make the
$5.50 mark. If I were too eat too much, then I would have
gone over my allotted budget. In order to keep the correct
portion sizes, I had to make sure that I checked each of the
packages in order to keep the prices in check.

When sticking to this meal budget, I felt full, but my appetite was not
completely satisfied. My usual intake includes more fruits and vegetables and
I did not feel that I had the complete freedom to indulge. This would be very
difficult to do for months or years. This individual would have to adhere to
eating what is always on sale at the supermarket. Significant nutrition related
outcomes could possibly include a deficit in fruit and vegetable intake, and
possible weight loss depending on age, gender, and activity level of SNAP
recipient. This participant could also possibly develop a deficit in essential
fatty acids because it is difficult to include foods that include those nutrients.