Background to the Problem
As part of a community public health task force, Grace, a 70-year-old woman, was asked to share her ideas and opinions about increasing dietary fiber intake for better bowel health. Grace described that she currently resides alone in sheltered housing but still manages to get out when she can and enjoys socializing with her neighbors.
Grace has been finding it more difficult to do her weekly food shopping, as the supermarket is a bus ride away, and she finds it hard to carry much back. The woman has a son who visits her once a month and brings her deserts to eat and ready meals for her freezer. Grace does not know how to increase fiber as she cannot get fresh food as she did before, and the client is concerned that she is not getting the right amount of activity and water.
Explanation of Dietary Management
First, I would explain that it is not impossible and that she can take several small steps to increase her dietary fiber intake. To ease her realization of the importance of dietary fiber, I would explain that it is essential for her bowel health, can help her feel fuller for longer, and reduces her risk of developing conditions such as constipation and hemorrhoids. I would also provide some practical examples of how she can increase her fiber intake, such as adding wholegrains to meals, eating various fruits and vegetables, and including legumes and nuts.
I would then explain the concept of behavior change and how it can help Grace to make positive changes in her life. To motivate her, I would emphasize the benefits of enhancing her dietary fiber consumption, such as improved digestion, energy levels, and overall health (Barber et al., 2020). I would also explain how making small changes can lead to significant results and that starting with a tiny change at a time is important. Grace should be provided with resources to positively change her diet and lifestyle, such as recipes and tips for cooking fiber-rich foods. She should also speak to her son about bringing fiber-rich foods, exercising, and drinking more water.
Pattern of Eating
The first step in behavior change is to assess the situation and establish a change plan. In the case of Grace, the primary goal is to increase her dietary fiber intake (Barber et al., 2020). In order to do this, it is important to understand the factors influencing her current behavior. Grace has limited access to fresh food, which is likely a significant barrier to her ability to increase dietary fiber. Grace is also motivated by the pleasure she gets from eating sweet foods, which may prevent her from making the necessary dietary changes.
In order to support Grace in increasing her fiber intake, a range of behavior change approaches can be used. The most important approach is to focus on the positive aspects of increasing fiber intake, such as improved digestive health, increased energy levels, and overall well-being (Barber et al., 2020). It can also be helpful to provide practical tips on increasing dietary fiber, such as switching to high-fiber breakfast cereals, adding pulses and legumes to dishes, and eating more fruit and vegetables.
Psychological Theories
Both psychological and nutritional strategies will be employed to reach this objective. The social cognitive theory strongly emphasizes observing and imitating other people’s behavior (Marker & Norton, 2018). Grace may be more inclined to change their habit if they are informed about the advantages of consuming more fiber and witnessing others doing it. Additionally, self-determination theory posits that people are more likely to engage in behaviors that align with their values and goals (Marker & Norton, 2018). Educating Grace about the benefits of increasing fiber intake can help her understand how this behavior can support her health and wellness goals.
Aim of Treatment
The treatment aims to help Grace change her lifestyle and diet to improve her health. Psychological and nutritional management will be used to achieve this goal. Regarding social cognitive and self-determination theories, Cognitive Behavioral Therapy (CBT) and Motivational Interviewing (MI) will help Grace identify and modify her behaviors related to her diet, physical activity, and water intake (Marker & Norton, 2018).
Additionally, nutritional management will focus on providing evidence-based dietary advice and resources to help Grace increase her intake of whole grains, fruits and vegetables, and other high-fiber foods. The information and resources provided will also focus on the importance of a balanced diet, food safety, and labels, and practical advice on shopping for and preparing meals (Marker & Norton, 2018). Furthermore, practical strategies such as social support and goal setting will include self-monitoring, which will help Grace make and maintain the lifestyle changes necessary to improve her health.
Intervention Plan
To support Grace in increasing her fiber intake, one should identify the barriers and the primary motivators for her to change her behavior. The Health Belief Model (HBM) is applicable in this situation as it will allow us to understand why Grace is reluctant to change. The HBM is based on the concept that an individual’s behavior is determined by their beliefs about the severity of a particular health problem (Binji, 2020). It also includes the likelihood of being affected by it and the potential benefits or costs associated with taking action.
In Grace’s case, she may perceive that her current health is adequate, and the likelihood of her developing health issues is due to her low fiber intake, meaning that she is unlikely to take action. Therefore, it is important to help her understand the advantages of enriching her fiber intake, such as improved digestive health and reduced risk of diseases such as heart disease and diabetes.
The next step is to develop an intervention plan to help Grace increase her fiber intake. Using the transtheoretical model of behavior change (TTM) is important. This model explains how people progress through different stages of change, from pre-contemplation to action and maintenance (Binji, 2020). At the pre-contemplation stage, Grace must be aware of the benefits of increasing her fiber intake and the drawbacks of not doing so (Binji, 2020). The next step is to provide her with resources and tools to help her evaluate her current situation and the potential benefits of changing her behavior.
This can include providing her with information about healthy foods, recipes, and meal plans that include high-fiber foods. At the contemplation stage, Grace needs to be provided with an individualized plan to help her make small but achievable changes to her diet. This plan should focus on increasing her intake of high-fiber foods, such as wholegrain bread and cereals, fruits and vegetables, beans, and legumes. It should also involve reducing her intake of processed and convenience foods.
Once she is ready to take action, it is important to provide her with ongoing support, such as regular check-ins and advice on how to stay on track. It is also important to provide her with strategies to help her cope with any challenges she may face, such as difficulty with meal planning or food shopping.
Finally, at the maintenance stage, it is important to continue to provide her with support and encouragement to help her maintain her new behavior. This can include providing her with access to nutritional advice and support or incentives such as reward systems. Grace is likely to experience many challenges in increasing her fiber intake. It is, therefore, important to use the HBM and TTM to help her understand the benefits of changing her behavior and provide her with the necessary resources and support (Binji, 2020). With a tailored intervention plan, Grace can make small but achievable changes to her diet and lifestyle to improve her health and well-being.
Monitoring and Follow-Up
In order to monitor and identify if the intervention plan is working, I would use various methods. Firstly, I would use a pre- and post-assessment tool to measure Grace’s current fiber intake and bowel health. This would involve Grace completing questionnaires or a diary at the start of the intervention and at regular intervals throughout. This would allow Grace to reflect on her progress and any changes in her bowel health over time.
I would also use regular review meetings with Grace to discuss her progress and any challenges she may have faced in making the changes. During these meetings, I could ask Grace to provide updates on fiber intake and bowel health and review any goals we have set together. This would be done in a supportive, non-judgmental environment.
Finally, I would use various technology-based solutions to monitor Grace’s progress. This could include tracking apps to monitor her fiber intake or a reminder system to prompt her to drink adequate water. This could also include a system to remind her to be active and encourage her to go for walks or other activities. Overall, I can monitor Grace’s progress using assessment tools, review meetings, and technology-based solutions and identify whether the intervention plan is working. This would allow us to make any changes or adjustments if necessary.
Reference List
Barber, T. M. et al. (2020) ‘The health benefits of dietary fibre’, Nutrients,12(10). Web.
Binji, A. (2020) Transtheoretical model versus the health belief model. Web.
Marker, I., and Norton, P. J. (2018) ‘The efficacy of incorporating motivational interviewing to cognitive behavior therapy for anxiety disorders: A review and meta-analysis’, Clinical Psychology Review, 62, pp. 1-10. Web.