PEN eNews 10(6) June 2020

PEN® eNews is a monthly e-newsletter shared with the global PEN Community and created to help dietitians position themselves as leaders in evidence-based nutrition practice. In addition, users of the PEN System will find articles on the new evidence, resources and features available and how to maximize one's use of PEN.

Open Access to COVID-19 Content Continues

For the past two months, the PEN^® System has been Open Access to eliminate barriers to evidence-based nutrition as dietitians around the world abruptly shifted gears in response to COVID-19. More than 50,000 users accessed the PEN System during that time. That’s a 27% increase over the same time period last year! If you used the PEN System’s Open Access, please take 3 minutes to fill out a survey about your experience: https://www.surveymonkey.com/r/GLDSL7S

Although the Open Access to the entire PEN System is now closed, we will continue to make COVID-19 information, Trending Topics and PEN^® eNews available to all with no PEN subscription or access credits required:

If you are interested in continuing your access to the entire PEN System and you are not a current subscriber, please view the different subscription options available at: https://www.pennutrition.com/signup.aspx. Revenue from PEN subscriptions is reinvested in the system to keep the content up-to-date and constantly growing while positioning you on the leading edge in your practice. The PEN System does not accept industry revenue or advertising.

We hope you'll be an active member of our PEN community and stay connected with us:

Stay Safe,
The PEN Team

Telehealth and Healthy Eating Promotion

The Question

What are the characteristics of effective telehealth interventions (including telephone, Internet-delivered and smart phone technology) to promote healthy eating in adults (i.e. intensity, duration, type of clients, characteristics of providers)?

The Evidence

Data from clinical trials is not sufficient to determine the optimal characteristics of effective telehealth interventions. Based on expert consensus, the following appear to be associated with positive outcomes in telephone interventions used to promote healthy eating:

individually tailored advice and feedback based on participants’ stage of change
self-monitoring via text message with feedback tailored to the self-monitored measures
the use of goal setting as a behaviour change technique
the provision of weekly text reminders to reinforce the intended health outcomes
counselling/education delivered in an interactive format
a focus on high risk individuals or specific populations that have common interests and motivation
matching the intensity of the telephone intervention to the level of health risk
Interventions ranging from two months to six months or greater can significantly improve healthy eating.
Focus on changing one or two eating behaviours at a time to improve overall dietary quality and provide feedback on the most relevant clinical outcomes to reinforce dietary changes.
Allow 15 to 20 minutes per call, but this may vary based on the complexities of the individual.
Communicate feedback to clinical providers; this allows dietary care to be seamless and may be especially important if the individual's condition changes and medication adjustments are required.
Use telephone counsellors trained in the theoretical basis of dietary behaviour change (e.g. Social Cognitive Theory, themes from the Transtheoretical Model and motivational interviewing).
Follow individuals for an extended period of time (i.e. 12 months and beyond).

For Internet-delivered interventions, most studies report that a lack of consistency in the methods used, limited engagement and nonuse-attrition data make interpretation of the results difficult. Based on expert consensus, the following appear to be associated with positive outcomes in online interventions:

the use of tailored feedback
interventions of greater than six months
the use of a theoretical framework (e.g. Social Cognitive Theory, Transtheoretical Model and Theory of Planned Behaviour).
interactivity (e.g. online peer support or forums, involvement of children in parent-focused interventions)
the use of behaviour change techniques (e.g. goal setting, providing information on consequences of behaviour, self-monitoring, problem-solving)
In-person contact combined with the online intervention may improve outcomes, although evidence shows that interventions using motivational interviewing and online learning are just as successful as those that do not.
Include a measure of participant engagement in the intervention.

To see the full practice question, click here.

Want to know what else is new and updated? Bookmark these pages:
New Knowledge Pathway Content  (Knowledge Pathways, Practice Questions, Summary of Recommendations and Evidence, Practice Guidance Toolkits, Backgrounds)
Tools and Resources.

Ostomy - What is the Latest?

The Gastrointestinal - Ostomy Knowledge Pathway has just been updated. Click here to see the full knowledge pathway. Here are the topic areas:

dietary interventions that reduce the amount of gas and odour in individuals with an ostomy
post-discharge dietary interventions to reduce the risk of postoperative complications in individuals with a colostomy
post-discharge dietary interventions to reduce the risk of postoperative complications in individuals with an ileostomy.

In addition, the following were updated:
Gastrointestinal System - Ostomy Practice Guidance Toolkit
Gastrointestinal System - Ostomy Summary of Recommendations and Evidence.

Did you know that the PEN System has:

24 Gastrointestinal System knowledge pathways
more than 170 practice questions on gastrointestinal disease and related issues
and many consumer and professional tools and resources!

What’s New for PEN^® Client Handouts

PEN Handouts for Your Clients

There are hundreds of PEN-developed handouts in the PEN System; many of which have been culturally adapted and are available in a variety of languages.

New and Updated Handouts

Some of our latest new and updated handouts include:
Soy: Nutrition and Health French
Reducing Risk of Food Allergy in Your Baby English
Quick Nutrition Check for Vitamin B12 Korean Farsi
Healthy Eating Guidelines for Early Chronic Kidney Disease Spanish Korean Farsi Chinese Punjabi Vietnamese French
Eating Habits for a Healthy Immune System English French
Grocery Shopping and Food Purchasing During the Coronavirus Pandemic English French

Handout Collections

There are eight PEN Handout Collections:

Breastfeeding Friendly
Food Service
Food Sources and Nutrients (Canada)
Food Sources and Nutrients (U.K.)
Health Conditions
Healthy Living
Nutrition Over the Lifespan
Pediatrics

Read more about the Handout Collections in this PEN eNews article.

Dietitians of Canada is pleased to bestow the 2020 PEN Achiever Award Canada on Dr. Paula Brauer

Dietitians of Canada is pleased to bestow the 2020 PEN Achiever Award Canada on Dr. Paula Brauer. This award recognizes members who demonstrate leadership in evidence-based practice through significant or ongoing contributions to the PEN: Practice-based Evidence in Nutrition^® System.

Dr. Paula Brauer was chosen to participate in the development and review of numerous PEN^® knowledge pathways, practice questions and background documents as an internationally recognized expert and researcher in cardiometabolic disease, obesity and the dietitian’s role in primary care. Given her breadth of knowledge in these topics as well as in evidence syntheses and appraisal, she is an ideal candidate to interpret evidence and translate recommendations for practitioners. Notably, she has co-authored many scientific and review papers, served as a lead developing obesity guidelines with the Canadian Task Force on Preventive Health Care, and has been part of a dietitian advocacy group focused on primary health care.

Dr. Brauer is recognized with a PEN^® Achiever (Canada) Award for her important contributions to PEN content, including participation as a coauthor of a PEN international review panel developing recommendations for treatment of cardiovascular disease using GRADE process. Her robust and relevant feedback on a number of practice questions and her expertise in team-based obesity services in primary care settings has also led to enhanced rigour and relevance of PEN content on dietitians in primary care, and on weight cycling and weight stigma.

Dr. Brauer commented on her award: "I would like to thank my colleagues for launching PEN in 2005 and the many volunteers who have also contributed over the years. As our ability to access evidence has increased, PEN has grown and matured to become an international resource."

Congratulations to Paula on receiving this well deserved award! Click here to watch Dawna Royall (member of the PEN Team) congratulating Paula.

How do I… Customize and Send PEN^® Client Handouts?

The PEN Client Handouts are one of the most popular features of the PEN System, but did you know you can customize the handouts and email them directly to your clients from the PEN System? You can add your organization/company logo to the handout, add a personalize note to your client and/or remove the additional resources section. Read the steps below to become a PEN Client Handout aficionado!

How do I customize the “Distributed by” box in PEN Client Handouts?

*Skip to Step 4 if your logo is already uploaded or if you do not want your logo included.

Step 1: Click on ‘My Profile’.

Step 2: Under “My Handout Distribution Preferences”, click on “Upload New Photo” and find the logo you want to add. If desired, add a distribution message.

Step 3: Click “SAVE & UPDATE” at the bottom right-hand side of the page.

Step 4: Navigate to the PEN client handout you wish to customize.

Step 5: Click on “Customize and Share this Resource” phrase or the icon.

Step 6: On the Share this Resource pop-up page, make sure that the “Include” bubble corresponding with “Distributed By” is checked.

Step 7: Text in the “Distributed By” box can be added or edited. The “Distributed By” box will not accept images.

Step 8: Click "PDF PREVIEW" to view this content on the last page of the handout. Make sure the “Include” bubble is checked if you want your logo displayed.

Step 9: A hard copy of the handout including your “Distributed By” information can be printed from the PDF preview, or click SEND to e-mail a copy to your client or yourself.

How do I customize the editable "Notes" feature in PEN Client Handouts?

Step 1: Access a PEN handout from the Search, or the Related Tools and Resources section within a Knowledge Pathway, or from the PEN Client Handout Collection.

Step 2: Click on “Customize and Share this Resource” phrase or the icon.

Step 3: A Customize and Share this Resource pop-up window will appear that will allow you to enter a message in the “Notes” section (up to six lines of text). Make sure that the ‘Include’ bubble corresponding with the “Notes” section has been checked.

Step 4: Once you have entered the information, you can click ‘PDF Preview’ to check that information is correct, and then you can click "Send". If you want to provide a hard copy to your client, you can e-mail the handout to yourself, and then print.

How do I suppress the Additional Resources, Notes and/or Distributed By section from displaying in a Handout?

Step 1: Access a PEN Handout using the Search, or the Related Tools and Resources section within a Knowledge Pathway, or from the PEN Handout Collection.

Step 2: Click on the ‘Customize and Share this Resource’ phrase or the icon.

Step 3: A Customize and Share this Resource pop-up window will appear. To exclude any of the “Additional Resources”, “Notes” or “Distributed By” sections, make sure that the corresponding bubbles are cleared of check marks.

You can click the PDF PREVIEW button to view the handout and print a hard copy, or click the SEND button to e-mail a copy to your client or yourself.

How do I send a PEN^® Handout to a client via email?

Step 1: Click on “Customize and Share this Resource” phrase or the

icon

Step 2: Fill in your e-mail address, your client’s e-mail address, the message you wish to send to your client to accompany the handout and press Send.

PEN eNews

June 2020 Volume 10 (6)

A Publication of the PEN® System Global Partners,
a collaborative partnership between International Dietetic Associations.
Learn more about PEN.
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