Get healthy together: a program to improve counseling for childhood obesity in community-based WIC clinics.

Counseling parents of overweight children is a sensitive issue that has been reported to be difficult for many health professionals. The Get Healthy Together (GHT) project involved an 18-month intervention that provided skills training and new tools to Women, Infants, and Children (WIC) program staff and a staff wellness program to improve the physical self-concept and functioning of WIC employees. All WIC staff from the 48 WIC clinics in New Mexico participated in this study. The design used random assignment to intervention or control condition. Staff participating in the Get Healthy Together project reported improved confidence in their ability to counsel parents of overweight children and improved counseling skills related to health behaviors. Use of the innovative tools provided visual aids that helped parents understand the health implications of their child's weight without the parents becoming defensive. These tools are publicly available in English and Spanish on the WIC Works Sharing Gallery (website: http://www.nal.usda.gov/wicworks/Sharing_Center/gallery/healthytogether.html).

Innovative tools help counselors discuss childhood obesity with parents.

BACKGROUND: Childhood overweight and obesity pose potential health risks for many children under the age of 5 years. Women, Infants, and Children (WIC) nutritionists are in a unique position to help reduce this problem because of their frequent counseling contacts with clients during certification visits. Therefore, four new tools to facilitate nutritional counseling of parents of overweight children during certifications were developed and systematically evaluated. METHODS: The Nutrition and Activity Self-History (NASH) form, Report Card/Action Plan (ReCAP), Talking Tips, and Healthy Weight Poster were evaluated by WIC nutritionists via an online survey. Anchors on the Likert scale were 0 for Strongly Disagree to 6 for Strongly Agree. Four regional focus groups were also conducted. Data were analyzed descriptively. RESULTS: The response rate on the survey was 83% (n=63). Focus groups were comprised of staff that volunteered to participate (n=34). The NASH form, which replaces a food frequency questionnaire for identifying nutrition risk, had a mean rating of 5.20 as "Helpful when counseling about weight." The ReCAP, Talking Tips, and Healthy Weight Poster achieved mean ratings of 5.70, 4.75, and 5.30, respectively, in this category. Focus group responses were very positive about the usefulness of the ReCAP and Healthy Weight Poster to visually convey the concept of BMI percentile for age using a green, yellow, and red color-coded "traffic light" approach to showing healthy versus unhealthy BMI values. CONCLUSIONS: WIC programs and other pediatric health care settings may want to consider adopting these innovative tools to better serve their clients and address pediatric overweight in the populations they serve.

Professional baseball athletic trainers' perceptions of preparation for job-specific duties.

CONTEXT: The extent to which individuals are prepared completely for work in a particular athletic training setting (eg, professional sports, college, high school) is unknown. This issue is critical today, and findings in this area have implications for athletic training education policy and employers. OBJECTIVE: To determine the perceptions of preparation for work-specific tasks by professional baseball athletic trainers (PBATs). We also wanted to determine whether various preparation experiences interact with perceived skills. DESIGN: Cross-sectional study. SETTING: Online survey administered via Survey-Monkey. PATIENTS OR OTHER PARTICIPANTS: Two hundred seventy-five PBATs. INTERVENTION(S): The PBATs reported their levels of preparation before employment in their positions and their current skills in each of the 8 work task domains: evaluation of elbow injuries; evaluation of shoulder injuries; evaluation of general injuries; acute care; injury prevention; treatment, rehabilitation, and reconditioning; organization and administration; and non-athletic-training tasks. MAIN OUTCOME MEASURE(S): Nine repeated-measures analyses of covariance were performed with each perception of preparation (retrospective, current) as a within-subject factor. Preparation experiences were included as between-subjects factors, and number of years working in baseball was the covariate. RESULTS: Subscale reliabilities were calculated and found to be between 0.79 and 0.97. A total of 180 PBATs (65%) completed the survey. The backgrounds and routes by which PBATs gained employment in the professional baseball setting varied. Individuals who completed professional baseball internships, had previous work experience, and immediately entered the professional baseball setting after graduation had noted differences in their perceptions of preparation for work tasks. The PBATs indicated they were substantially underprepared for tasks in the organization and administration and non-athletic-training task domains. CONCLUSIONS: The organizational socialization process is complex, and no 1 experience appears to completely prepare an individual for work in the professional baseball setting.

Motivational interviewing skills are positively associated with nutritionist self-efficacy.

OBJECTIVE: To examine the relationships between physical and social self-concepts, motivational interviewing (MI), and nutrition assessment skills with dimensions of counseling self-efficacy. DESIGN: Cross-sectional survey. SETTING: Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) clinics. PARTICIPANTS: Sixty-five WIC nutritionists. MAIN OUTCOME MEASURES: Counseling self-efficacy on topics related to physical activity and nutritional behaviors and in the presence of language and cultural differences. ANALYSIS: Multiple linear regression. RESULTS: Nutritionists' perception of their own MI skills was positively associated with their self-efficacy for counseling clients of a culture different than their own, when counseling about physical activity, and when counseling about nutrition behavior. Hispanic ethnicity and social self-concept were positively associated with counseling self-efficacy when culture differences were present. Physical self-concept was positively associated with self-efficacy related to physical activity topics. Nutrition assessment skill was negatively associated with self-efficacy for working with non-English-speaking clients. CONCLUSIONS AND IMPLICATIONS: Development of MI skills and strategies to improve social and physical self-concept may increase WIC nutritionists' counseling self-efficacy, particularly when counseling clients from diverse backgrounds.