Happy New Year!

1. Happy New Year! January 2013: Catering to your participants, Transitions and invites

2. Welcome to 2013! To start off the new year the training team would like to offer you some helpful tips on taking your assessments to the next level…

3. Topics for Today Oooo, that sounds so interesting! • Assessment burger • Transition statements • Invites • Case study activity • Review

4. Does this burger look tasty to you?

5. What about these burgers? Yuck! Yum!

6. What you have to start with…and you just can’t have a burger without these! Burger = Your great personality Top bun = ABCDE Guide Bottom bun = GTHM Tools Now work with your client to build their own personalized burger…

7. Catering to your client…. Let them build their own burger!

8. So what are these other parts? Here are a few examples: Their feelings Their concerns or what they would like to walk about What they already know about Their personal experiences

9. What’s missing? The Transition Statements • Think of your transition statements as the ketchup, mustard or mayo of your burger. • What does transition mean? • Can you think of when you use transition statements?

10. Transition Statements D B A + Transitions C GTHM Tools

11. Transition Statement Activity You have weighed and measured two year old Natalie and checked her hemoglobin. You used the time in the lab to collect most of the ABC information that you need. Now you are back in your office and have just entered in the anthropometric information into AIM. What transition statement can you use to shift into the D part of your assessment? • Thank you for helping me to collect your daughter’s height and weight and her hemoglobin. Now I’d like to talk with you about her nutrition and the way she eats. • Please have a seat. I have a new game that I’d like to play with you… • After entering in Natalie’s height and weight into the growth chart for girls her age I can tell you that she is right where she needs to be! That’s great, you must be doing a good job with feeding her and her nutrition. I’d like to talk to you a little more about her eating habits. • I noticed that you have a baby bottle filled with soda in your baby bag, is that for Natalie?

12. Transition Statement Examples The transition from doing ABC to moving to the GTHM tools can feel awkward, but with practice it will feel natural and easy. Here are a few examples of some transitions: • Well it looks like Jose is doing great health wise. Let’s talk more about how he has been eating. {Add the invite here…} • Here is where Ashlynn is charting on the growth charts which is great, she is right where she needs to be. That’s great! I’d like to hear more about the way she eats for you. {Add the invite here…} • Thank you for sharing all of that information for me, it helps paint a picture of how Michael is doing with his health. And it looks like everything is great. Now I’d like to discuss more about his diet and how he has been eating. {Add the invite here…} • I have entered in Sarah’s height and weight into the computer and it shows me that she is tracking well for her age. You had mentioned that you are a little concerned about the way she has been eating and I thought we could talk a little more about that.{Add the invite here…} After your transition statement, you can go right into your invite…

13. Invites I . Invites! • Invites are the phrases you use to introduce the GTHM tools and open up a conversation with the clients about their diet. • The way you invite the client to use the tools can help them to open up and share important information with you. • What invites do you use?

14. Remember these cards? Underneath the green area you will find a great invite you can use. Each tool has a similar card with some “Short, snappy and simple ways to introduce the tools.” * If you have lost or misplaced these cards, please contact your Nutrition Services Consultant. We have some extras that we would love to share with you.

15. Following the 3 simple steps to nutrition assessment success! • The Nutrition and Health Assessment: • Collect the information for the ABCE sections of the Guide • Collect the information for the D section of the guide using the GTHM tools (this is where you will use your transition statements!) • Offer the Message: or information to the client – this can include the goal setting, offering handouts or recipes, giving mom healthy nutritional information, discussing breastfeeding benefits, etc. • Tailor the Food Package to Meet Needs and Document: document the session using the TGIF notes

16. Step 1: The Nutrition and Health Assessment, Part A You are about to get a client from the front. Before you leave your office you check to make sure you are all ready for the appointment with this next client. You go into AIM and read the previous TGIF note, so you know now that mom’s previous goal was to breastfeed her baby and that the CNW used the Doors tool. Before you leave your office you take a quick look to make sure which of the following items are on your desk: • ABCDE Guide (which may actually be in your hand with the client’s WIC folder if you like taking it into the lab with you) • Your half eaten breakfast • Your cell phone • Your GTHM Tools

17. Step 1: The Nutrition and Health Assessment, Part A continued… You call your client by name and help her collect her baby bag and purse and she picks up the baby carrier (how very PCS of you!). You are already aware that this is an exclusively nursing 6 day old baby. You introduce yourself and inform mom that you will be heading to the lab to take some quick measurements of both baby and mom. Once in the lab you do which of the following: • Test mom’s hemoglobin • Ask mom what the doctor has said about the babies height and weight. • Follow the ABCDE Guide and ask mom the nutrition assessment questions for the ABC sections. • Ask mom how she feels about her current weight loss.

18. Step 1: The Nutrition and Health Assessment continued… Transition Alert! Moving into part B (using the GTHM tools to assess D) of this step… You were able to collect most of the ABC info in the lab while taking their measurements. Mom mentions that she is worried that she has not lost enough weight yet. You inform her that she has lost about 15 pounds from her weight at delivery. She tells you that she thinks she should have already lost the entire 30 pounds that she gained during the pregnancy. As you both have a seat in your office, you: • Thank her for sharing that info with you, and explain that you’d like to talk more about mom and baby’s diet. • Let mom know before you leave the lab and head to your office that you can tell that weight loss is important to her and you would love to share some healthy information on postpartum weigh loss with her. • Re-explain that she has already lost 15 pounds which is plenty for being only 6 days postpartum. • Tell her about the tools you will be using.

19. Step 1: The Nutrition and Health Assessment, Part B continued… Invites After entering into AIM the anthropometric data and assessing that everything looks good, you decided to use the faces tool. Which invite do you use? • Pick a face that says something about how you feel about breastfeeding is going. • I have a fun game to play with you…pick a face that tells me about how you are feeling about your breastfeeding experience. • Please take a quick look at these different faces and pick one that shows how you are feeling about your diet. • I have some pictures of some faces that I’d like you to take a look at. As you look through them pick one that says how you feel about your current weight loss.

20. Step 1: The Nutrition and Health Assessment, Part B continued… Mom says that breastfeeding is going wonderfully and she is feeling great, but she is more concerned about her weight. So you… • Tell her you want to talk more about her breastfeeding experience. • Let her continue to talk about her concerns over her weight loss. • Show her the faces cards again and ask her to choose one that says something about the way she feels about her current weight loss. • Ask her to tell you more about her weight loss concerns and what she has been trying already to help her to lose the baby weight.

21. Step 1: The Nutrition and Health Assessment, Part B continued… Tricky Transition (or bridge) Mom picks a face card and tells you that she is frustrated about her weight loss and that she thinks her boyfriend may be cheating on her because she doesn’t look as good as she did before she got pregnant. She starts talking more about their troubled relationship. So you… • Let her know that you can share with her some tips that other mothers have done to lose weight postpartum. • Ask her if you can talk to her about the healthy weight loss recipes you have on hand. • Let her know that you can tell she is really motivated to lose more weight and to get her boyfriend to not cheat any more. • Ask her to tell you more about what she is currently doing to help her lose the baby weight.

22. Step 2: Offering the Message You have successfully transitioned mom back to the topic of health and nutrition and you have been able to complete the assessment using your ABCDE Guide and the GTHM Tools. You are ready to offer some nutrition education to mom about her weight loss concerns. You… • Affirm mom for her efforts so far. • Ask her what she is currently doing to try to lose the baby weight. • Offer to share some healthy recipes with her. • Offer to share a map of safe local parks that she can walk with her baby.

23. Step 2: Offering the Message You continue on by offering mom some excellent nutrition and breastfeeding information about physical activity and postpartum weight loss. Mom tells you that she feels much better about her current weight loss and plans to continue breastfeeding for as long as she can to help with her weight loss.

24. Step 3: Tailor Food Package to Meet Need and Document Great job! Mom is happy with the great information you have shared with her and she starts nursing her baby as you focus back on AIM and the computer to tailor the food package. You let mom know it has been a pleasure meeting with her today and getting to meet her beautiful baby and you look forward to seeing her next time. After you walk mom to the waiting area, you head back to your office and complete the appointment by documenting the assessment in AIM using the TGIF format. • *For more information on Steps 2 and 3, please refer back to past PCS Champ calls which are saved to www.azwic.gov. • http://azdhs.gov/azwic/together/difference.htm

25. In Review: How to build a delicious WIC assessment burger Here are your parts: The ABCDE Guide, the GTHM Tools and your personality Let your clients choose the rest of the parts of the burger…

26. Review of the 3 Steps 1 2 Use the easy 3 steps to get through your appointment: • Nutrition and Health Assessment • Collect information for the ABCE sections of the Guide • Collect information for the D section using the GTHM Tools • Offer the Message • Tailor the Food Package to Meet Needs and Document 3

27. Meet the babies at ADHS! Lincoln Xavier Maelyn