Judith C. Rodriguez

Legal, Ethical, and Professional Issues to Consider When Communicating via the Internet: A Suggested Response Model and Policy

Providing nutrition information via the Internet enables dietetics professionals to expand their practices, markets, and networks, but also presents new legal, ethical, and professional issues. Based on her experiences responding to unsolicited questions through a Spanish-language nutrition Web site, this author presents issues related to electronic communication, a process for formulating responses, and makes suggestions for a policy. The issues include the global nature of cyberspace; cultural variations in Spanish-language food terms and models, credentialing, licensure, and scope of practice; presentation of credentials; the inquirers knowledge and information sources; the nature of the cyberspace relationship; and protection of the client and the professional. These issues have created a need for an electronic communication policy and some components of such a policy are identified, including the nature of electronic nutrition, distinguishing between public and client-specific communication, question-and-answer formats, opening and closing caveats, and recording processes.

Dietary Self-Monitoring in Weight Management: Current Evidence on Efficacy and Adherence

O BESITY IS A PUBLIC HEALTH burden associated with a number of adverse health conditions and high health care costs. As an integral part of standard behavior-based therapy, selfmonitoring has been used in many lifestyle intervention programs to address the obesity epidemic. In weight management, self-monitoring usually consists of tracking dietary intake, physical activity, body weight, and/ or other health measurements. Previous research examined the efficacy of dietary self-monitoring on weight management. However, most of those studies addressed self-monitoring using traditional paper methods. The subsequent development and use of advanced technology-based self-monitoring approaches shows promising effects inweight loss.We evaluated the emerging evidence on the efficacy and adherence to different types of dietary self-monitoring, including traditional paper methods, web-based self-monitoring, and the use of mobile devices such as personal digital assistants, wearables, and tablets/mobile smartphones. Motivations and barriers to dietary selfmonitoring are described and strategies to improve adherence are identified. A discussion on future directions of dietary self-monitoring approaches in research and practice is also provided.

Serving the Public: Health Literacy and Food Deserts

wo issues that have recently increased in awareness by the general public have always been a oncern to ADA members: health litracy and food deserts. Both problems ave the potential to affect all segents of the population, but they disroportionately affect underserved ow-income people. Through our profesional training and our practice expeience, we are uniquely qualified to ake a difference on both issues.

Servant Leadership: Helping People Make Wise Choices

Judith C. Rodriguez T HE TERM “SERVANT LEADER” may sound archaic or odd, but understanding its meaning and objective actually infuses it with nobility, worth, and a strong applicability to ADA members and our profession. The term was coined in 1970 by Robert K. Greenleaf. In his classic essay, “The Servant as Leader,” Greenleaf wrote, “The difference manifests itself in the care taken by the servant—first to make sure that other people’s highest priority needs are being served. The best test, and difficult to administer, is: Do those served grow as persons? Do they, while being served, become healthier,wiser, freer,more autonomous, more likely themselves to become servants?” [emphasis added]. Isn’t dietetics a serving profession? Aren’t we committed to helping people become healthier through foods? But implicit in that commitment is an underlying goal: Helping people be wiser about their choices so they can grow to be more active in their own care. Through our work, we participate in health fairs; do community-based presentations; serve on health, food, and nutrition committees; collect food for food banks or soup kitchens; provide in-kind services to school’s parente teacher organizations; and many other activities. Many ADA members volunteer hours to plan local professional meetings, participate in scholarship selection committees, and organize farmer’s markets or food drives to assist soup kitchens and food pantries. These members are serving and leading at the same time. If you are wondering how you might get involved in servant leadership, think about the needs in your community. BUILDING A GOOD SOCIETY In another essay, “The Institution as Servant,” Greenleaf wrote, “Caring for persons, the more able and the less able serving each other, is the rock upon which a good society is built. Whereas, until recently, caring was largely person to person, now most of it is mediated through institutions.” We need to look no further than our own institution, ADA, to see an organization that is committed to helping all our members develop the skills necessary to be servant leaders—in our work with patients, clients, and the public and also in our work for our profession and Association. ADA facilitates opportunities for us to develop servant leadership skills through numerous initiatives like the Leadership Institute, leadership sessions at the Food & Nutrition Conference & Expo, and a new series of online learning programs on leadership that will be released during the 2010-2011 membership year on ADA’s Web site.

Culturally Competent Dietetics: Increasing Awareness, Improving Care

e are facing rapidly changing demographics, health disparities, and the related need to be culturally competent. In that our values include a customer focus and social responsibility, the American Dietetic Association (ADA) is committed to helping members develop the knowledge and skills necessary to be the trusted and chosen xperts when it comes to food and nutrition for all people. To that end, in the fall of 2007, the House of Delegates (HOD) f the ADA appointed an HOD Leadership Team and established a workgroup to develop resources for members to use n addressing and overcoming barriers related to health disparities. Culturally competent dietetics practice was dentified as a key strategy for eliminating disparities and improving care across all population groups. In an effort to rovide members with greater information about and exposure to the topic, the Journal of the American Dietetic ssociation published a series of articles on culturally competent care, examining the beginnings of and rationale ehind the cultural competency movement, models and standards for the implementation of culturally competent ractice in the health care setting, and practical advice from experts about how to interact with patients and clients of iverse cultures both sensitively and effectively. The Journal has also continued its long history of publishing nnovative research into the interaction between cultural values and food and nutrition behaviors and beliefs. The articles in this reprint supplement explore cultural issues from both the research and practice perspectives, nvestigating the impact of culture on food purchasing and intake behaviors, as well as exploring how best to apply the rinciples of cultural competency to dietetics practice. Far from a simple primer on the typical food habits of different thnic groups, these articles investigate the obstacles to quality care that arise from a multitude of different sources, ncluding socioeconomic inequality, disability, low literacy and English-language proficiency, and access to accurate utrition information. Other articles focus on past and present efforts to implement models of culturally competent care nd on the ongoing process of defining accreditation standards for its delivery.* The information presented in this supplement to the Journal provides you with a foundation of knowledge on which o build your cultural competence skills and improve the quality of care you provide to patients and clients of all ackgrounds. By doing so, we all take an important step toward realizing ADA’s goal of eliminating health disparities n dietetics care. Increasing cultural competency will not only enable us to better serve all clients, but enrich our ersonal lives as well.