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6/22/20

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Welcome!

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Event Page: https://militaryfamilieslearningnetwork.org/event/64660

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Building Cultural Competence in Nutrition and Dietetics

Event MaterialsVisit the event page to download a copy of the presentation slides and any additional resources.

This webinar has been approved to offer continuing education credit. Please stay tuned for more information!

Continuing Education

Gerard Altman/ CC0 via Pixabay

Event Page: https://militaryfamilieslearningnetwork.org/event/64660/

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https://militaryfamilieslearningnetwork.org/event/64660/

6/22/20

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Connecting military family service providers and Cooperative Extension professionals to

research and to each other through engaging online learning opportunities

https://militaryfamilieslearningnetwork.org

This material is based upon work supported by the National Institute of Food and Agriculture, U.S. Department of Agriculture, and the Office of Military Family Readiness Policy, U.S. Department of

Defense under Award Numbers 2015-48770-24368 and 2019-48770-30366.

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Henna Muzaffar, PhD, RD, FAND

Today’s Presenters

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Assistant Professor and EDOC FacilitatorCollege of Health and Human SciencesNorthern Illinois University

Specialty: Obesity prevention and healthy lifestyle nutrition education interventions with children and their families in the schools and the community

Karina Diaz Rios, PhD, RDCooperative Extension SpecialistDivision of Agriculture & Natural ResourcesUniversity of California, Merced

Specialty: Development and evaluation of culturally relevant nutrition education for communities vulnerable to malnutrition

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Objectives

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1 Explain the need for attaining cultural competence in nutrition and dietetics

2 Describe the steps to develop cultural competence in research and counseling

3 Identify strategies to achieve cultural sensitivity in nutrition research and dietetics practice

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Poll

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Which of the following best describes you?

a. Student

b. Dietitian

c. Researcher

d. Educator

e. Other

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Culture and Diversity

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Culture: The integrated pattern of human knowledge, belief, and behavior that depends upon man’s capacity for learning and transmitting knowledge to succeeding generationsDiversity: Means dissimilarity and variance between things or people. Cultural diversity is the recognition that people come from a variety of ethnic, geographic, economic, and religious backgrounds. Multicultural: It is a term often used to describe an organization which promotes an environment free of discrimination and promotes policies, processes, and procedures that recognize and value cultural diversity.

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Melting Pot or Salad Bowl

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• Currently, 25% of the US population consists of ethnic subpopulations.

• By 2050, 47.5% of the US population will consist of ethnic subpopulations.

• By 2065, Non-Hispanic whites will most likely be a minority.

• Melting pot effect• Multicultural marketing

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Cultural Competency

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• Cultural Competency: It is the acceptance and tolerance of different backgrounds and their associated traits, beliefs, etc., and absence of prejudice against unfamiliar cultures.

• Cultural Sensitivity: Cultural sensitivity means recognizing subtle but important facets of another person’s culture, and accepting their expression of their culture.

• Salad bowl effect

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Culture Matters

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• When culture is ignored, families are at risk of not getting the support they need.

• Cultures gives context and meaning:• It is a filter through which people process their

experiences • It influences people’s values, actions, and

expectations of themselves• It impacts people’s perceptions and

expectations of others

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Steps Involved in Developing Cultural Competency

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• The steps include:• Recognize your own personal cultural biases and

preconceived ideas/opinions.• Desire to learn about and become involved with

people from diverse cultures.• Seek out and increase your knowledge about

other cultures.• Learn and develop multicultural communication

and counseling skills.

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Cultural Competency Continuum

Cultural Destructiveness

Cultural Incapacity

Cultural Blindness

Cultural Pre-competence

Cultural Competency

Cultural Proficiency

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1. Cultural Destructiveness• Attitudes, policies and practices

which are destructive to cultures and individuals within them• Purposeful destruction of a

culture• Assumes one race superior

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2. Cultural Incapacity• Intent not to be intentionally

culturally destructive• Lack of capacity to work with

minorities• Extreme bias and belief in racial

superiority of dominant group

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3. Cultural Blindness:• Midpoint on the continuum• Systems/agencies provide services

with philosophy of being unbiased• Belief that color or culture make no

difference• Belief that dominant culture

approaches are universally applicable

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4. Cultural Pre-competence• Implies movement• Weaknesses recognized in working

with minorities• Attempts to improve practices and

increase knowledge• Danger of tokenism

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5. Cultural Competency• Acceptance and respect for

difference• Continuing self-assessment

regarding culture• Careful attention to

dynamics of difference• Continuous expansion of

cultural knowledge and resources

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6. Cultural Proficiency• Culture held in high esteem• Knowledge base of cultural competence sought by• Conducting culture-based research• Developing new approaches based on culture• Publishing and disseminating results of culturally

sensitive/competent research

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How Do We Acquire Cultural Competence

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• Recognize the broad dimension of culture• Respect families as the primary source for

defining needs and priorities• Increase sensitivity to alienating behaviors

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How Do We Acquire Cultural Competence

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• Change decision making processes to include families and the community

• Commit to structural and policy changes that support cultural diversity

• Make policies and practices fluid to accommodate necessary adjustments

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Cultural Differences

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• Six Cultural Phenomenon• Communication• Personal space• Social organization• Time• Environmental control• Biological variations

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Cultural Differences

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• General assessment and teaching strategies• Establish rapport• Assessment

• Readiness to learn, considering cultural background

• Determine health beliefs, values, and practices

• Use client’s primary language

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Acquiring Cultural Competence

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• Individually:• Do you have close personal

relationships with people who are culturally and socioeconomically different?

• Do you have the desire, knowledge, and skill to integrate culturally relevant considerations into your work?

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Acquiring Cultural Competence

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• Organizationally:• Value diversity• Conduct cultural self-assessment• Identify cross-cultural dynamics• Institutionalize cultural knowledge• Adapt service delivery to diversity within

and between cultures

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Movement Towards Cultural Competence

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• Attitudes must change• Policies must change• Practices must become more congruent

with cultures

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Culturally Competent Research

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• Commitment to provide culturally competent research• Must include• Awareness of cultural differences• Awareness of own cultural values• Understanding of dynamics of difference• Basic knowledge of research participants’

environment(s)• Ability to adapt research methods, evaluation, data

collection and analysis to participants’ cultural context

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Research with Latinos

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• Focus group study with Latino mothers (n=41)• Attitudes• Behaviors

• Cultural viewpoints around feeding and cooking and feeding strategies was explored.

• Plan interventions taking Latinos attitudes and behaviors in consideration.

Martinez et al. J Acad Nutr Diet. 2014;114(2):230-237.

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Culturally Competent Health Care

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• Health care providers should understand:• Beliefs, values, traditions and practices of a

person’s culture• Family structure and the roles within the family in

making decisions• Health related needs of individuals, families, and

communities• Cultural beliefs about health and the etiology of

diseases• Cultural beliefs about healing and disease

treatments• Attitudes about seeking help from health care

providers

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Values of Anglo-American Culture

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• High value on individualism, privacy, and personal responsibility and control.

• Emphasis is placed on the nuclear family.• Extended family does not play a role in major

decision making.• Value direct, open and honest communication.• Informality is considered synonymous with

friendliness.• Anglo-Americans are future oriented and place value

on promptness.

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Values of Traditional Cultures

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• Believe that fate, God or other supernatural factors determine a person’s destiny.

• Personal relationships determine self-worth and take priority over time schedules.

• Family almost always includes extended family.• Family hierarchy in many traditional cultures.• Informality is often associated with rudeness in certain

cultures.• Traditional cultures are polychronistic as opposed to

Anglo-Americans, who are monochronistic.• Traditional cultures prefer cooperation, traditions, and

idealism.

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Case Study

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Mary, the outpatient dietitian at a large teaching hospital, was extremely annoyed when Juan Martinez, a 44-year-old man recently diagnosed with hypertension and type 2 diabetes arrived 20 minutes late for his appointment. She became more agitated when he arrived with three other adults and two children. In order to keep to her schedule, Mary asked the family members to sit in the outer office and omitted taking a diet history. She got “right to the point” and immediately began explaining how to count carbohydrates, frequently asking “Juan, do you understand?” Mary was satisfied when Juan responded yes. Mary was able to finish Juan’s diet instruction in a record 30 minutes. Rather than seeing Juan to the door and shaking his hand, Mary explained that she had another meeting and gestured for Juan and his relatives to exit. Two weeks later Mary was surprised when Juan did not return for his follow-up appointment. Why did Juan most likely not return for his follow-up appointment? Simply, Mary failed to “connect” to Juan and his family through cultural blindness.

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Questions???

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“Cultural and linguistic

competence is a life’s journey not a

destination”!

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Poll Question

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Do you work with/for clients whose cultural background is different than yours?

a. Yes, often

b. Yes, occasionally

c. No, but I have or will do

d. No, I am just curious

e. I don’t know

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cultural competence

diaz rios | 34Bruening M, et al. J Acad Nutr Diet. 2015;115:1699-1709

ability to productively engage clients from different cultural

backgrounds

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culturelearned beliefs, traditions, and values that guide behavior

diaz rios | 35

Brislin RW, 2001.Gannon M. J Organiz Behav. 1995;16:497Weaver GR, 1986

acquired through interpersonal interactions

widely shared among group members

framework for interacting with the world

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appearance

tools & utensilslanguage

behavior

practicespreferences

norms

valuesbeliefs

attitudes

expectationsstressors

coping style

Weaver GR, 1986

Chapman-Novakofski K & Diaz Rios LK. In: Krause and Mahan’s Food & The Nutrition Care Process. 15th ed. Elsevier; 2021. Ch 13, pg 229-30 diaz rios | 36

deepcultureout of awareness

surfaceculturein awareness

surfaceculturein awareness

deepcultureout of awareness

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diaz rios | 37

we are what we eat

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principles

38Chapman-Novakofski K & Diaz Rios LK. In: Krause and Mahan’s Food & The Nutrition Care Process. 15th ed. Elsevier; 2021. Ch 13, pg 229-30

of cultural competence in dietetics practice

actively practice cultural awareness, centeringclient’s cultural perspectives, needs, and wants

integrate deep structure attributes of eating choices & evidence-based recommendations into advice

survey client’s deep structure attributes affecting their eating choices & perceived nutritional status

explore internalized assumptions, beliefs, & attitudes informing your perception of client’s practices

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cultural competence

Chapman-Novakofski K & Diaz Rios LK. In: Krause and Mahan’s Food & The Nutrition Care Process. 15th ed. Elsevier; 2021. Ch 13, pg 229-30 39

cultural competence



39

cultural competence

Nutrition care process and model. J Am Diet Assoc. 2008;108:1113-17Chapman-Novakofski K & Diaz Rios LK. In: Krause and Mahan’s Food & The Nutrition Care Process. 15th ed. Elsevier; 2021. Ch 13, pg 229-30

in the nutrition care process

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personal relationship inventorydifferent cultural background?

closeness to you & your family?

can you write their biography?


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cultural competencein the nutrition care process

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National Center for Health Statistics,Maternal mortality in the United States, 2018

maternal mortalitydeaths per 100,000 live births

37.1

14.7

11.8

Black

White

Hispanic

weight biasperceived bias & healthcare engagement: themes

Rubino F, et al. Nat Med. 2020;26:485-97

opioid prescription

treat opioid dependence, such as methadone and buprenor-phine, were not included in counts of opioid prescriptions.Patient zip code of residence was mapped onto ZCTAs!" byusing a previously described crosswalk.!#

Counts of patients receiving prescriptions were com-bined with population counts from the American Commu-nity Survey!! to create estimates of prevalence. We also usedAmerican Community Survey data to obtain sociodemo-graphic information for each ZCTA, including the percentageof individuals identifying as non-Hispanic white and the meanper-person income. Shapefiles were obtained from the US Cen-sus Bureau!$,!% and used for mapping. We obtained zip code–level data describing the rate of age-standardized opioid over-dose mortality per "&& &&& persons for #&"" through #&"% byusing publicly available files from the California Departmentof Public Health.!'

We evaluated trends in racial/ethnic and income patternsat the state level by classifying all ZCTAs in quintiles of the per-centage of residents identifying as non-Hispanic white and ofper-person income and by calculating the prevalence of eachquintile as well as all #% race/ethnicity–income quintile com-binations. We decided to use a dichotomous index of racial/ethnic composition after observing that the main racial/ethnic differences in prescription prevalence were capturedusing a white/nonwhite scale (eFigure " in the Supplement).Geographic trends were explored with maps at the ZCTA levelfor the southern portion of Los Angeles County. We chose thisarea as the site for a more detailed case study analysis be-cause it represents a large, heavily populated city with sub-stantial socioeconomic and racial/ethnic diversities.

We conducted all data preparation and analyses betweenJanuary and May #&"( using R, version !.$." (The R Project forStatistical Computing).!) More information regarding data

preparation and completeness is provided in the eTable andeAppendix in the Supplement.

ResultsThe CURES database contains unique records for #*.) millionindividuals who received a prescription for a Drug Enforce-ment Administration–scheduled substance from #&"" to #&"%.Among these individuals, the mean (SD) age was $'.% (#&.')years, and %).&% were female.

Opioid Overdose Mortality and PrescriptionsFrom #&"" through #&"%, there were *%!$ reported opioid over-dose deaths in California. These deaths included overdosesattributed to any opioid, including prescription medication,heroin, and synthetic opioids, such as fentanyl. Overdosedeaths were highly concentrated in lower-income and mostlywhite areas. We observed an approximate "&-fold differencein overdose rates across the race/ethnicity–income gradient inCalifornia (Figure !A). Per "&& &&& people in age-standard-ized rates, there were *.' opioid overdose deaths each yearin the highest proportion–white/lowest-income quintile ofZCTAs compared with ".! in the lowest proportion–white/highest-income quintile. This racial/ethnic and income gradi-ent is consistent with prior research describing the uniqueconcentration of the opioid epidemic in low-income and ma-jority-white areas.#,!

In California, #!.'% of all individuals "% years or olderreceived a prescription for an opioid medication each year dur-ing the study period. Opioid prescriptions were concentratedamong ZCTAs with a higher proportion–white/lower-incomepopulation, with a mean annual prevalence of $$.#% among

Figure 1. Opioid Overdose Deaths and Prescription Prevalence

HighestProportion

White

Q4

Q3

Q2

LowestProportion

White

Opioid overdose deathsA

LowestIncome

Q2 Q3 Q4 HighestIncome

3.7 2.54.0 1.31.6

5.6 5.0 4.0

4.35.25.5

5.3

3.8

6.6

6.8

8.4

6.77.812.2

6.4

7.29.411.9

15.6

9.6Highestdeath rate

Lowestdeath rate

HighestProportion

White

Q4

Q3

Q2

LowestProportion

White

Opioid prescription prevalenceB

LowestIncome

Q2 Q3 Q4 HighestIncome

20.3 18.621.2 16.116.9

26.7 23.7 21.4

21.624.727.2

24.3

17.9

25.5

28.2

28.6

37.2

25.4

44.2

30.1 27.7

29.7

30.5

35.4

34.5Highestprescriptionprevalence

Lowestprescriptionprevalence

A, Annual age-standardized opioid overdose death rates per 100 000 people.B, Annual prevalence of receiving at least 1 prescription for an opioid amongindividuals 15 years or older. Both figures represent the entire state of California,showing quartiles of mean annual rates during the 2011 through 2015 studyperiod. The y-axis represents the percentage of individuals in each zip code

tabulation area identifying as non-Hispanic white, by quintiles (Qs). The x-axisrepresents quintiles of the mean per capita annual income at the zip codetabulation area level. Values for all 25 quintile-quintile pairs are shown withcolor and text.

Assessment of Racial/Ethnic and Income Disparities in the Prescription of Controlled Medications in California Original Investigation Research

jamainternalmedicine.com (Reprinted) JAMA Internal Medicine April 2019 Volume 179, Number 4 471

© 2019 American Medical Association. All rights reserved.

Downloaded From: https://jamanetwork.com/ by a University of California - Davis User on 06/05/2020

Friedman J, et al. JAMA Intern Med. 2019;179:469-76


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cultural competencein the nutrition care process

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Chapman-Novakofski K & Diaz Rios LK. In: Krause and Mahan’s Food & The Nutrition Care Process. 15th ed. Elsevier; 2021. Ch 13, pg 229-30

“It is not enough to know the past of the people you interpret. You must know your own past”

—Michael W. Twitty in The Cooking Gene

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cultural competence



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motivational interviewingpartnershipacceptancecompassionevocation

survey client’s deep culture attributes affecting their eating choices & perceived nutritional status

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diaz rios | 44Based on BMI-for-age & sex ≥ 95th %ileHales CM, et al. NCHS Data Brief. 2017;(288):1-8.

nutrition indicators

FPL, Federal Poverty LevelColeman-Jensen et al, 2019 (USDA-ERS 2018)

0%

5%

10%

15%

20%

25%

30%

All Boys Girls

White non-Hispanic Asian non-Hispanic

Black non-Hispanic Hispanic

child obesityU.S. prevalence 2-19 years old, 2015-16

food insecuritypercent of U.S. households, 2018

6.5

31.3

34.4

38.3

16.8

25.2

10.4

21.1

≥ 1.85 FPL

< 1.85 FPL

< 1.30 FPL

< 1.00 FPL

Hispanic

Black non-Hispanic

White non-Hispanic

All households

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diaz rios | 45U.S. Census Bureau. Income and Poverty in the United States: 2018

incomehousehold median, 1967–2018

U.S. Census Bureau Income and Poverty in the United States: 2018 5

($84,464), followed by household-ers aged 35 to 44 ($80,743), house-holders aged 55 to 64 ($68,951), and householders aged 25 to 34 ($65,890). Householders aged 65 and over ($43,696) and household-ers aged 15 to 24 ($43,531) had the lowest median incomes.19

19 The difference between the 2018 median household income among those with house-holders aged 15 to 24 ($43,531) and house-holders aged 65 and over ($43,696) was not statistically different.

Nativity20

Between 2017 and 2018, the real median income of households maintained by a native-born person increased 1.4 percent, from $63,377 to $64,243, the fourth consecutive annual increase in median household

20 Native-born households are those in which the householder was born in the United States, Puerto Rico, the U.S. Island Areas of Guam, the Commonwealth of the Northern Mariana Islands, American Samoa, the Virgin Islands of the United States, or was born in a foreign country but had at least one parent who was a U.S. citizen. All other households are considered foreign-born regardless of the date of entry into the United States or citizenship status. The CPS does not interview households in Puerto Rico. Of all householders, 84.4 percent were native-born; 8.6 percent were foreign-born, naturalized citizens; and 7.0 percent were not U.S. citizens.

income for native-born households. The 2018 real median income of households maintained by a foreign-born person ($58,776) was not statistically different from 2017 (Figure 1 and Table A-1). The foreign-born can be classified into two cat-egories: those who are naturalized U.S. citizens and those who are not U.S. citizens. Neither group expe-rienced a statistically significant change in their median household income between 2017 and 2018.21

21 The difference between the 2017–2018 percent changes in median income for house-holds by specific nativity status were not statistically significant.

!

"!#!!!

$!#!!!

%!#!!!

&!#!!!

'!#!!!

(!#!!!

)!#!!!

*!#!!!

+!#!!!

$!"*$!"!$!!'$!!! "++'"++!"+*'"+*!"+)'"+)!"+('"+'+

Figure $,Real Median Household Income by Race and Hispanic Origin! "#$% to &'"(

Notes: The data for 2017 and beyond reflect the implementation of an updated processing system. See Appendix D for more information. The data for 2013 and beyond reflect the implementation of the redesigned income questions. See Table A-2 for historical footnotes. The data points are placed at the midpoints of the respective years. Median household income data are not available prior to 1967. For more information on recessions, see Appendix A. For more information on confidentiality protection, sampling error, nonsampling error, and definitions, see <https://www2.census.gov/programs-surveys/cps/techdocs/cpsmar19.pdf>.

Source- U,S, Census Bureau# Current Population Survey# "+(* to $!"+ Annual Social and Economic Supplements,

$!"* dollars Recession

$*)#"+&

$)!#(&$

$(%#")+

$'"#&'!

$&"#%("All races

White# not Hispanic

Black

Asian

Hispanic (any race)

45

diaz rios | 46Values are percentagesU.S. Census Bureau. Income and Poverty in the United States: 2018

povertyrate, 2018

nativ

ityra

ce /

eth

nici

ty

17.5%

9.9%

13.8%

11.4%

17.6%

10.1%

20.8%

8.1%

10.1%

11.8%

Not a cit izen

Naturalized cit izen

Foreign-born

Native-born

Hispanic (any race)

Asian

Black

White, not Hispanic

White

Tota l

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diaz rios | 47U.S. Bureau of Labor Statistics. Labor Force Characteristics by Race and Ethnicity, 2018

labor force participationrate, 2018

68.5%

59.6%

66.3%

63.5%

62.3%

62.8%

62.9%

Native Hawaiian, Pacific Islander

American Indian, Alaska Nat ive

Hispanic, Lat ino

Asian

Black, African American

White

Tota l

47

diaz rios | 48U.S. Bureau of Labor Statistics. Labor Force Characteristics by Race and Ethnicity, 2018

occupationemployed people, 2018

0%

25%

50%

75%

100%

Total Whi te Black, AfricanAmerican

As ian Hispanic, Latino

Production, transportation, and material moving occupationsNatural resources, construction, and maintenance occupationsSales and office occupationsService occupationsManagement, profess ional, and related occupations

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stress & health

diaz rios | 49Pascoe EA, Richman LS. Psychol Bull. 2009;135:531-54American Psychological Association. Fact Sheet: Health Disparities and Stress. 2012

hypertension & diabetes

adverse birth outcomes

depression & anxiety disorders

substance use & dependence

worsen diet quality & malnutrition

perceived discrimination

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stress & health

diaz rios | 50Pascoe EA, Richman LS. Psychol Bull. 2009;135:531-54

mental & physical health

heightened stress

response

worsen health

behaviorssocial support

stigma internalizationcoping style


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stress & health

diaz rios | 51Pascoe EA, Richman LS. Psychol Bull. 2009;135:531-54American Psychological Association. Fact Sheet: Health Disparities and Stress. 2012

acculturativestress

hypertension & diabetes

adverse birth outcomes

depression & anxiety disorders

substance use & dependence

worsen diet quality & malnutrition


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diaz rios | 52Adapted from: Satia JA. Appl Physiol Nutr Metab. 2010;35(2):219-223

dietary acculturation

beliefs, attitudes, values

ethnocultural norms

religion & spirituality

living in ethnic enclave

taste preferences

knowledge, attitudes, beliefs related to diet & disease

traditional eating patterns vs. assimilation values

availability, accessibility, affordability of traditional ingredients, foods, meals

convenience of consumption

advertising & media access

food choices & food preparation:

maintainedadoptedbicultural

migration: status, wave, war

policy: international, national, local, organizationalsex, age, education, income,

employment, household composition, marital status

age at immigration, years in the United States, country of origin, area of residence, host language fluency

acculturative

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cultural competence



PES 1: Inconsistent CHO intake related to CHO-counting knowledge deficit as evidenced by wide variations of blood glucose levels

PES 2: Limited access to culturally appropriate food related to lack of time to plan meals as evidenced by limited supply of nutrient-dense food in home

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survey client’s deep culture attributes affecting their eating choices & perceived nutritional status

Mary, the outpatient dietitian at a large teaching hospital, was extremely annoyed when Juan Martinez, a 44-year-old man recently diagnosed with hypertension and type 2 diabetes arrived 20 minutes late for his appointment. She became more agitated when he arrived with three other adults and two children. In order to keep to her schedule, Mary asked the family members to sit in the outer office and omitted taking a diet history. She got “right to the point” and immediately began explaining how to count carbohydrates, frequently asking “Juan, do you understand?” Mary was satisfied when Juan responded yes. Mary was able to finish Juan’s diet instruction in a record 30 minutes. Rather than seeing Juan to the door and shaking his hand, Mary explained that she had another meeting and gestured for Juan and his relatives to exit. Two weeks later Mary was surprised when Juan did not return for his follow-up appointment.

53

cultural competence

Chapman-Novakofski K & Diaz Rios LK. In: Krause and Mahan’s Food & The Nutrition Care Process. 15th ed. Elsevier; 2021. Ch 13, pg 229-30 54


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cultural competence



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cultural competence



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actively practice cultural awareness, centering client’s cultural perspectives, needs, and wants

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cultural competence



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cultural competence

diaz rios | 58Bruening M, et al. J Acad Nutr Diet. 2015;115:1699-1709

ability to productively engage clients from different cultural

backgrounds

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diaz rios | 59Adapted from: Academy of Nutrition and Dietetics, Code of Ethics for the Nutrition and Dietetics Profession, 2018

code of ethics

professionalism“Contribute to decisions that affect the well-being of

patients/clients“Demonstrate respect, constructive dialogue, civility and

professionalism in all communications“Communicate at an appropriate level to promote health literacy

social responsibility for local, regional, national,global nutrition and well-being

“Collaborate with others to reduce health disparities and protect human rights

“Promote fairness and objectivity with fair & equitable treatment

“Contribute time and expertise to activities that promote respect, integrity, and competence of the profession

competence & professional development in practice

“Act in a caring and respectful manner, mindful of individual differences, cultural, and ethnic diversity

integrity in personal and organizational behaviorsand practices

“Respect patient/ client’s autonomy

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diaz rios | 60

readings +

The Spirit Catches You and You Fall Downby Anne Fadiman

The Cooking Geneby Michael W. Twitty

Cuisine & Empireby Rachel Laudan

Pressure Cookerby Sarah Bowen,Joslyn Benton, Sinikka Elliott

Freedom Farmersby Monica M. White

Podcastsequitable healthcare consulting services

Body and Soulby Alondra Nelson

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¡gracias!

karina díaz rios, PhD, RD

@DrDiazRios

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Upcoming Event

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Tuesday, August 25, 202011:00 a.m. – 12:00 p.m. EST

Event Page: MilitaryFamiliesLearningNetwork.org/event/69340

This webinar will present strategies for nourishment to promote healthy brain aging.

Continuing education credit will be available for this webinar!

Keeping Our Brains Healthy as We Age

For archived and upcoming webinars visit: MilitaryFamiliesLearningNetwork.org/AllEvents/

Gerd Altmann / Pixabay CC0

Canva / CC0

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https://militaryfamilieslearningnetwork.org/allevents/

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Evaluation & Continuing Education

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This webinar has been approved for the following continuing education (CE) credits:

• 1.0 CPEU from the Commission on Dietetic Registration for Registered Dietitians and Dietetic Technicians

Go to the event page for evaluation and post-test link.

Evaluation Link

Questions?Email Kristin DiFilippoat [email protected]

Event Page: https://militaryfamilieslearningnetwork.org/event/64660/

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