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Communicating the Dietary Guidelines: Tools for Professionals

Published:January 30, 2018DOI:https://doi.org/10.1016/j.jand.2017.11.013
      The 2015-2020 Dietary Guidelines for Americans is a critical tool to help Americans make healthy food and beverage choices that support disease prevention and health promotion. However, it is written for health professionals and policymakers, leaving an important role for registered dietitian nutritionists (RDNs) to translate the science-based recommendations from the Dietary Guidelines into relatable and valued nutrition education materials and messages for the audiences they serve.
      We know the RDN’s time is valuable, and that food and nutrition practitioners need practical and effortless ways to develop resources based on the latest science. With the RDN’s needs in mind, the US Departments of Agriculture (USDA) and Health and Human Services (HHS) developed tools and resources that help take the guesswork out of translating the Dietary Guidelines. These resources include the Communicator’s Guide, available at ChooseMyPlate.gov, and the Dietary Guidelines Toolkit for Professionals, available at health.gov/dietaryguidelines. The Communicator’s Guide can help with customizing nutrition education materials for the audiences that RDNs serve, while the Dietary Guidelines Toolkit for Health Professionals provides turnkey resources that can easily be integrated into work and practice.

      Communicator’s Guide

      The Communicator’s Guide was developed to be a one-stop shop to help nutrition and health communicators apply the Dietary Guidelines to their nutrition education materials. It is designed to start where you are. For example, if the user wants to learn more about the DGA, the site provides background on key points from the most recent edition. For more inspiration on how to translate the Dietary Guidelines into nutrition education materials, the site provides overarching communication points, along with MyPlate’s consumer-tested messages and quick links that provide helpful information that may be relevant to an RDN’s audience. If the reader is new to nutrition communication, the site provides best practices for creating nutrition education materials. The Communicator’s Guide also includes links to a variety of existing nutrition and physical activity materials from USDA and HHS (Figure 1).
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      Figure 1The Communicator’s Guide overarching communication points.

      The Heart of the Communicator’s Guide

      The Dietary Guidelines is intended to inform nutrition policy and programs and is not intended to drive individual behavior change on its own. Creativity is encouraged when translating the recommendations from the Dietary Guidelines into messages and materials. For this reason, the section on “Translating the Dietary Guidelines into Consumer Messages” may be the most useful for RDNs who are looking for more guidance on how to develop messages that are consumer-friendly and based on the science underpinning the Dietary Guidelines.
      Eleven tables address topics ranging from the five food groups to healthy eating patterns, added sugars, sodium, saturated fats, oils, and beverages. This is where the one-to-one translations occur between the Dietary Guidelines key recommendations and the MyPlate consumer messages. Each table also links to supportive consumer resources on ChooseMyPlate.gov that provide “how-to” tips and advice and topical information that seamlessly links back to the Dietary Guidelines so the RDN can tailor their materials based on their audience (Figure 2).
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      Figure 2Example topic table on Healthy Eating Patterns from the Communicator’s Guide.

      Best Practices for Creating Nutrition Education Material

      The section of the Communicator’s Guide on creating nutrition education materials may be particularly useful to RDNs who frequently work with contractors, interns, or professionals who are new to nutrition communications. It walks the reader through the following five steps: 1) know your audience; 2) tailor messages and materials to your audience; 3) use plain language; 4) be aware of health literacy; and 5) maximize impact through partnerships. A Communicator Spotlight is included in this section to demonstrate how the best practices can be utilized.
      One example of the principles from the Communicator's Guide in action is the Dietary Guidelines Toolkit for Health Professionals produced by the Office of Disease Prevention and Health Promotion (ODPHP) within HHS. ODPHP co-leads the development of the Dietary Guidelines with the Center for Nutrition Policy and Promotion (CNPP), Food and Nutrition Service, on behalf of the Departments.
      ODPHP’s key audience is health professionals who work in a variety of different settings. Some, like doctors, nurses, and dietitians, work directly with patients, and others work on developing health programs and policies. With its audience in mind, ODPHP developed a suite of resources for health professionals based on the latest edition of the Dietary Guidelines. The Toolkit for Health Professionals is a free resource available in English and Spanish at health.gov/dietaryguidelines/. The toolkit uses each of the five principles outlined in the Communicator's Guide:

      Know Your Audience

      To inform the toolkit, ODPHP conducted formative research to better understand the needs of health professionals when communicating nutrition information to patients. This research showed that, although health professionals are trusted sources of information about nutrition, those who are not specialists in nutrition do not have high levels of confidence in talking with their patients and clients about nutrition and have varying degrees of knowledge about nutrition. This research included a literature review, a survey (n=120), and in-depth interviews (n=18) that were used to inform audience personas that helped guide the development of the toolkit.

      Tailor Messages and Materials to Your Audience

      ODPHP learned that health professionals wanted resources to help them quickly understand and incorporate key concepts from the Dietary Guidelines into practice. They also wanted resources to share with patients that communicate dietary behavior change in small steps; explain the relationships between diet and health outcomes; translate the Dietary Guidelines into simple, actionable messages; and address general nutrition concepts as well as specific topics, such as added sugars. They identified dietary behavior change and the relationship between diet and chronic disease as the most important nutrition topics to discuss with patients; fruits and vegetables and sugars as the topics most frequently discussed with patients; and healthy eating patterns as the nutrition behavior most discussed with patients. To address the needs and preferences identified from the research, the toolkit includes an executive summary and an “at-a-glance” document that allows health professionals to quickly and easily understand the new guidelines. It also includes conversation starters for health professionals and a series of patient handouts that can be used as takeaways in their interactions with patients and clients on topics such as healthy eating patterns, healthy “shifts” (ie, substitutions), added sugars, saturated fats, and sodium.

      Use Plain Language

      It was clear from the research that the use of plain language would be critical to the ability of health professionals to communicate with their patients and clients about nutrition. For example, health professionals noted that their biggest challenge with communicating recommendations from the Dietary Guidelines was knowing where to start. Since the Dietary Guidelines includes so many messages that are written for a professional audience, health professionals noted they didn’t have time to translate these recommendations into messages that resonated with patients. They also noted that simple messages and visual user-friendly resources have helped them to better communicate with patients. After developing key messages to address health professionals’ needs, ODPHP tested these messages with participants (n=13) to ensure they were hitting the mark and made adjustments based on participant feedback.

      Health Literacy and Other Considerations

      Health literacy is an important part of the mission of ODPHP, who hosts “Health Literacy Online,” a guide for creating health literate websites and digital tools on health.gov. When developing the patient handouts, ODPHP made sure to follow health literacy principles by including simple, actionable messages for patients with visual examples of healthy substitutions; defining terms that might be unfamiliar to patients, such as healthy eating pattern; and providing food-based examples when describing nutritional components that should be limited, such as saturated fats, trans fats, added sugars, and sodium.

      Maximize Impact through Partnerships

      ODPHP helps guide the nation toward better health through disease prevention policies and programs, but it doesn’t do this work alone. To help harmonize efforts and ensure that the federal government “speaks with one voice” about nutrition, the Toolkit for Health Professionals was developed in partnership with CNPP so that it would complement MyPlate’s consumer messaging. ODPHP and CNPP have also worked together to promote the Communicator’s Guide and Toolkit for Health Professionals through webinars and conferences. So far, these efforts are paying off. The Toolkit page on health.gov has had over 106,000 page views since it was released in March 2016, and the resources have been downloaded nearly 74,000 times, a conversion rate of 70%. The Communicator’s Guide on ChooseMyPlate.gov has had more than 160,000 page views since it was released in January 2016, a 90% increase in page views from the previous year.

      Come and Explore These Resources

      Whether you’re looking to develop your own materials or need ready-made handouts that can be used when advising patients and clients, these resources were developed with you in mind, to take the guesswork out of translating the Dietary Guidelines. We invite you to come and explore all these resources have to offer with the assurance of knowing they are all communicating the same messages and principles about healthy eating patterns that are promoted in the Dietary Guidelines. Working together, we can help move Americans toward eating patterns that support disease prevention and health promotion.

      Acknowledgements

      The authors would like to acknowledge Amber Mosher, MPH, RD, who contributed to the audience research summarized in this article during her work as an ORISE Fellow at ODPHP.