Rationale: In this scoping review we aimed to identify and map available evidence concerning counseling strategies that contribute to effective dietary counseling. Dietary counseling, as component of dietary treatment, is important to empowerclients in achieving dietary treatment goals.Methods: Following the PRISMA SCR-Scoping Reviews Statement and Checklist, a systematic search in electronic databases (CINAHL, PsychInfo, Pubmed/Medline, Web of Science, SOC Index, Embase, and Psychology & Behavioral Sciences) was performed in March 2020. No date restriction for year of publication was applied to allow for inclusivity. Studies were included if they were peer-reviewed,quantitative and qualitative, had a primary analysis of empirical work,written in English or Dutch, and focused on dietary counseling in 1-on-1 consultations between dietitians and adult clients (≥18 years). Only studies which gave a description of the effective strategies of dietary counseling were included.Results: Analysis of recurring themes in the 28 included studies revealed seven core counseling strategies that effectively contribute to dietary counseling: 1) connecting to motivation, 2) tailoring the modality of dietary counseling, 3)providing recurring feedback, 4) using integrated dietetic support tools, 5) showing empathy, 6) including clients’ preferences, wishes, and expectations during decision-making, and 7) dietitians having high self-efficacy.Conclusion: Multiple counseling strategies contributing to effective dietary counseling have been identified and mapped. Insights from this scoping review provide a foundation for dietitians to effectively carry out dietary counseling. To work towards effective dietary counseling, further development of an integrated approach that includes combinations of strategies that form a unified whole is required.
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ObjectiveThe aim of this scoping review was to identify and map available evidence concerning counseling strategies that contribute to effective DC.MethodsFollowing the PRISMA SCR-Scoping Reviews Statement and Checklist, a systematic search in electronic databases was performed in March 2020.ResultsSynthesis of recurring themes in the 28 included studies revealed seven core counseling strategies that effectively contribute to DC: 1) connecting to motivation, 2) tailoring the modality of DC, 3) providing recurring feedback, 4) using integrated dietetic support tools, 5) showing empathy, 6) including clients’ preferences, wishes, and expectations during decision-making, and 7) dietitians having high self-efficacy.ConclusionsMultiple counseling strategies contributing to effective DC have been identified and mapped. The counseling strategies identified seem to interrelate, and their conceived interrelatedness reveals that strategies can both compliment or contrast each other. Therefore, advancing effective DC requires further development towards an integrated approach to DC that includes combinations of strategies that form a unified whole.Practical implicationsInsights from this scoping review provide a foundation for dietitians to effectively carry out DC and serve as a starting point to further work towards effective DC.
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Rationale: In this study, we aimed to explore how dietitians’ history-taking questions function during dietary counseling of clients with malnutrition (risk). Fruitful functioning of history-taking questions during the problem identification phase is crucial for dietitians to develop a client-centered dietary treatment plan.Methods: Using discursive psychology, we analyzed the problem identification phase of recorded dietitian-client conversations of 7 dietitians and 17 clients. Discursive psychology is a qualitative, inductive methodology that is used to analyze real-life conversations. Discursive psychology focuses on how descriptions in talk (including wording, intonation, pauses, non-verbal behavior) accomplish actions such as presenting oneself in a particular way.Results: Our analysis shows how, in response to dietitians’ history-taking questions, clients repeatedly demonstrate that they have already made some effort to self-help. Typically, these history-taking questions presume some biopsychosocial factor as the cause of the dietary problems discussed. In response, clients show they already started to eat extra, closely monitored their body weight, and tried to eat despite having no appetite. In addition, clients account for the absence of efforts by claiming various kinds of inability, such as facing difficulties in preparing food for oneself or by questioning whether their underlying medical condition caused the diet-related problem in the first place.Conclusion: This study shows that history-taking questions not only elicit answers with factual information but also evoke clients’ self-presentations. Responses from dietitians show little attention to the relevance of these self-presentations,while clients treat self-help as a normative requirement to demonstrate they have done everything they can before they sought professional help. To optimize the problem identification phase, we suggest that in addition to conversationaltechniques dietitians could increase their attention to clients’ actions performed.
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Purpose: This study aimed to evaluate the implementation of a physical activity counseling program in rehabilitation and to study heterogeneity in received counseling and investigate its association with changes in patients' physical activity outcomes. Methods: This prospective cohort study was conducted in 18 rehabilitation institutions. Data were collected using surveys completed by professionals (n= ±70) and patients (n = 1719). Implementation was evaluated using different process outcomes: reach, dosage, satisfaction, maintenance. Patients' physical activity outcomes included changes in total minutes/week of physical activity. Latent class analyses were conducted to identify profiles of received counseling characteristics and multilevel models were used to investigate associations with physical activity outcomes. Results: 5873 Patients were provided with motivational interviewing-based counseling after rehabilitation. Professionals and patients were positive about the program. Sixteen institutions (89%) formally agreed to continue the program. The four identified profiles of counseling characteristics illustrate a large variation in received counseling among patients. No substantial differences in physical activity outcomes were found between profiles. Conclusion: After a three-year program period, the physical activity counseling centers were sustainably implemented in Dutch rehabilitation care. This study illustrated an innovative approach to assess heterogeneity in implementation outcomes (e.g., counseling profiles) in relation to program outcomes (e.g., physical activity). Implications for rehabilitation Physical activity counseling after rehabilitation is important to support people with disabilities in making the step from rehabilitation-based physical activities to community-based physical activities. Establishing "Physical Activity Counseling Centers" is a promising "disability-overarching" strategy to promote physical activity after rehabilitation. Although the actual received counseling (dosage) varied among patients, this did not coincide with large differences in physical activity outcomes. The training in Motivational Interviewing, the financial incentives, and the advisory support were considered as important or essential ingredients for a successful implementation of the counseling program in rehabilitation practice.
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In response to a rapidly changing, increasingly insecure and complex labor market, career counselors and researchers are developing methods that can meet the needs of individuals who would navigate this new terrain. In the last two or three decades, narrative career counseling practices (Cochran, 1997; McMahon & Watson, 2012; Reid & West, 2011; Savickas, 2012) have been developed to promote career adaptability (Savickas, 2011) and career resilience (Lyons, Schweitzer & Ng, 2015). Narrative counseling (i.e. career construction) is founded on the idea that in order to survive and thrive on the labor market of the 21st century, individuals must reflexively construct their identities in a process of meaning making, where identity is co-constructed in the form of a narrative: a story about who one is that provides both meaning and direction (Wijers & Meijers, 1996). LinkedIn: https://www.linkedin.com/in/reinekke-lengelle-phd-767a4322/
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Purpose: For prevention of sarcopenia and functional decline in community dwelling older adults, a higher daily protein intake is needed in addition to increased exercise. A new e-health strategy for dietary counseling was usedwith the aim to increase total daily protein intake to optimal levels (minimal 1.2 g/kg/day, optimal 1.5 g/kg/day) through use of regular food products.Methods: The VITAMIN (VITal AMsterdam older adults IN the city) RCT included 245 community dwelling older adults (age ≥ 55y): control, exercise, and exercise plus dietary counseling (protein) group. The dietary counselingintervention was based on behavior change and personalization was offered by a dietitian coach, by use of face-to-face contacts and videoconferencing during a 6-month intervention. Dietary intake was measured by a 3d dietaryrecord at baseline, after 6-month intervention and 12-month follow-up. The primary outcome was average daily protein intake (g/kg/day). Sub-group analysis and secondary outcomes included daily protein distribution, sources,product groups. A Linear Mixed Models (LMM) of repeated measures was performed with STATA v13.Results: Mean age of the 224 subjects was 72.0(6.5) years, a BMI of 26.0(4.2) and 71% were female. The LMM showed a significant effect of time and time*group (p<0.001). The dietary counseling group showed higher protein intakethan either control (1.41 vs 1.13 g/kg/day; β +0.32; p<0.001) or exercise group (1.41 vs 1.11 g/kg/day; β +0.33; p<0.001) after 6-month intervention and 12-month follow-up (1.24 vs 1.05; β +0.23; p<0.001 | 1.24 vs 1.07 β +0.19;p<0.001). Additional analysis revealed the higher protein intake was fully accounted for by animal protein intake.Conclusions: This study shows digitally supported dietary counseling improves protein intake sufficiently incommunity dwelling older adults with use of regular food products. Protein intake increase by personalizedcounseling with e-health is a promising strategy for dietitians with the upcoming rising ageing population.Keywords: Ageing, Behavior change, Nutrition, Physical Functioning, Sarcopenia
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Rationale In order to prevent sarcopenia in community dwelling older adults a higher daily protein intake is needed. A new m-health strategy for dietary counseling was used with the aim to increase total daily protein intake to optimal levels (minimal 1.2 g/kg/d, optimal 1.5 g/kg/d) through use of regular food products.Methods The VITAMIN (VITal AMsterdam older adults IN the city) RCT included 245 community dwelling older adults (age ≥ 55y): control, exercise, and exercise plus dietary counseling (protein) group. Dietary intake was measured by a 3d dietary record at baseline and after 6 months intervention. In total 173 subjects were eligible for analysis. A two-way mixed ANOVA with time, group, and time*group interaction was performed. Post-hoc Bonferroni was performed with significance level at p<0.05.Results Mean age of the subjects was 72.1±6.3, with a BMI of 25.7±4.2 of which 68% were females. ANOVA revealed significant effect of time, group and time*group (p<0.001). Table 1 shows higher protein intake over time in the dietary counseling group than either control (p=0.038) or exercise (p=0.008) group. Additional analyses revealed no change in vegetable protein intake. The higher protein intake was fully accounted for by animal protein intake. In the dietary counseling group 72% of subjects increased protein intake above the minimum intake level.Conclusions This study shows digitally supported dietary counseling improves protein intake sufficiently in community dwelling older adults. Protein intake increase by counseling with m-health is a promising strategy for dieticians with the upcoming rising ageing population.Keywords: Aging, Sarcopenia, Functioning, Nutrition, Technology
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BACKGROUND. In order to prevent sarcopenia in community dwelling older adults a higher daily protein intake is needed. A new e-health strategy for dietary counseling was used with the aim to increase total daily protein intake to optimal levels (minimal 1.2 g/kg/d, optimal 1.5 g/kg/d) through use of regular food products.METHODS. The VITAMIN (VITal AMsterdam older adults IN the city) RCT included 245 community dwelling older adults (age ≥ 55y): control, exercise, and exercise plus dietary counseling (protein) group. Dietary intake was measured by a 3d dietary record at baseline and after 6 months intervention. In total 173 subjects were eligible for analysis. A two-way mixed ANOVA with time, group, and time*group interaction was performed. Post-hoc Bonferroni was performed with significance level at p<0.05.RESULTS. Mean age of the subjects was 72.1±6.3y, with a BMI of 25.7±4.2 of which 68% were females. ANOVA revealed significant effect of time, group and time*group (p<0.001). Table 1 shows higher protein intake over time in the dietary counseling group than either control (p=0.038) or exercise (p=0.008) group. Additional analyses revealed no change in vegetable protein intake. The higher protein intake was fully accounted for by animal protein intake. In the dietary counseling group 72% of subjects increased protein intake above the minimum intake level. DISCUSSION. This study shows digitally supported dietary counseling improves protein intake sufficiently in community dwelling older adults. Protein intake increase by counseling with e-health is a promising strategy for dieticians with the upcoming rising ageing population.
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OBJECTIVE: The purpose of this study is to determine objective vocal quality, vocal characteristics, and vocal habits in future speech language pathology (SLP) students and to evaluate the possible impact of a provided vocal counseling procedure. A comparison of vocal data was done in SLP students who had and who had not undergone vocal counseling procedure. It is hypothesized that counseling results in good vocal quality, adequate vocal performance, and appropriate vocal hygiene. STUDY DESIGN: Randomized controlled study design. METHODS: To determine the vocal quality, questionnaires (Voice Handicap Index [VHI]), subjective (videostroboscopic and perceptual evaluations), and instrumental assessment techniques (aerodynamic, vocal range, acoustic measurements, Dysphonia Severity Index [DSI]) were used. Identical voice assessments were made in 71 students who followed and have not (n=83) followed the vocal counseling procedure. RESULTS: The VHI showed the absence of a psychosocial impact of the vocal quality. Thirty percentage of the subjects mentioned hoarseness as the most common vocal complain. Videostroboscopic evaluations revealed normal vocal anatomy and physiology. A significant difference regarding the DSI value was found between the students with (+3.3, 83%) and without (+1.8, 68%) a followed voice counseling procedure. CONCLUSION: This vocal counseling procedure is added as a standard procedure when future students gain information about the SLP master program. To what extent the presence and content of the vocal education strategy can influence the choice of the profession as an SLP is subject for further research.
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BACKGROUND. In order to prevent sarcopenia in community dwelling older adults a higher daily protein intake is needed. A new m-health strategy for dietary counseling was used with the aim to increase total daily protein intake to optimal levels (minimal 1.2 g/kg/d, optimal 1.5 g/kg/d) through use of regular food products. METHODS. The VITAMIN (VITal AMsterdam older adults IN the city) RCT included 245 community dwelling older adults (age ≥ 55y): control, exercise, and exercise plus dietary counseling (protein) group. Dietary intake was measured by a 3d dietary record at baseline and after 6 months intervention. In total 173 subjects were eligible for analysis. A two-way mixed ANOVA with time, group, and time*group interaction was performed. Post-hoc Bonferroni was performed with significance level at p<0.05. RESULTS. Mean age of the subjects was 72.1±6.3y, with a BMI of 25.7±4.2 of which 68% were females. ANOVA revealed significant effect of time, group and time*group (p<0.001). Table 1 shows higher protein intake over time in the dietary counseling group than either control (p=0.038) or exercise (p=0.008) group. Additional analyses revealed no change in vegetable protein intake. The higher protein intake was fully accounted for by animal protein intake. In the dietary counseling group 72% of subjects increased protein intake above the minimum intake level.
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