Page 98 - Nutrition Counseling and Education Skills: A Guide for Professionals

5C H A P T E R

Stages and Processes of Health Behavior Change

Objectives

• Explain the six stages of change.
• Identify one or more processes appropriate for each stage of change.
• Discuss the decisional balance and how should it be used.
• Describe the impact of self-efficacy on behavior change.
• Explain the steps in goal-setting process and practice them with a client.
• Describe Nutrition Monitoring and Evaluation in the Nutrition Care Process (NCP).
• Explain the requirements of the Health Insurance Portability and Accountability Act (HIPAA).

CASE CHALLENGE 1

Len Howard is a 48-year-old male executive in a Fortune 500 company. In a recent physical
exam, he was 5’11” tall and weighed 175 lb. His serum cholesterol was 290 (desirable less than 200 mg/dL)
with HDL of 40 (desirable, 40 mg/dL or higher) and LDL of 160 (desirable less than 130 mg/dL.) His
family history revealed that his father and older brother both died of heart disease. His wife is employed as
an attorney, and they have a 15-year-old son.
Nutritionist: “You mentioned that the doctor wants you to try modifying your diet. Let’s talk about what

you are eating now. Then we can identify what you are eating that is OK and what, if any, changes you
may be willing to make.”
Mr. Howard’s food intake revealed the following:

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