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A Nutrition Field Experience with the Kentucky Department for Human Resources

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A Nutrition Field Experience with the Kentucky Department for Human Resources University of Tennessee, Knoxville TRACE: Tennessee Research and Creative Exchange Masters Theses Graduate School 8-1974 A Nutrition Field Experience with the Kentucky Department for Human Resources Jane G. Baxter University of Tennessee, Knoxville Follow this and additional works at: https://trace.tennessee.edu/utk_gradthes Part of the Nutrition Commons Recommended Citation Baxter, Jane G., "A Nutrition Field Experience with the Kentucky Department for Human Resources. " Master's Thesis, University of Tennessee, 1974. https://trace.tennessee.edu/utk_gradthes/3980 This Thesis is brought to you for free and open access by the Graduate School at TRACE: Tennessee Research and Creative Exchange. It has been accepted for inclusion in Masters Theses by an authorized administrator of TRACE: Tennessee Research and Creative Exchange. For more information, please contact [email protected]. To the Graduate Council: I am submitting herewith a thesis written by Jane G. Baxter entitled "A Nutrition Field Experience with the Kentucky Department for Human Resources." I have examined the final electronic copy of this thesis for form and content and recommend that it be accepted in partial fulfillment of the requirements for the degree of Master of Science, with a major in Nutrition. Mary Nelle Traylor, Major Professor We have read this thesis and recommend its acceptance: Jane R. Savage, Robert H. Kirk Accepted for the Council: Carolyn R. Hodges Vice Provost and Dean of the Graduate School (Original signatures are on file with official studentecor r ds.) To the Graduate Cotu1cil: I am submitting herewith a thesis written by Jane G. Baxter entitled "A Nutrition Field Experience with the Kentucky Department for Human Resources." I recommend that it be accepted in partial fulfillment of the requirements for the degree of Master of Science, with a major in Nutrition. We have read this thesis and recommend its acceptance: Accepted for the Cotu1cil: Vice Chancellor Graduate Studies and Research ACKNOWLEDGMENTS Sincere appreciation is given to Miss Mary Nelle Traylor, De­ partment of Nutrition, The University of Tennessee, for guidance and support during the graduate program and in the preparation of this thesis. The author also appreciates the assistance of Dr. Jane Savage, Department of Nutrition, and Dr. Robert Kirk, Department of Health and Safety. The author is grateful for the assistance of Miss Peggy Kidd, Administrator, Nutrition Office, during the field experience. She also extends gratitude to Mrs. Katharine Riddle in Rowan County and to the entire staff of the Nutrition Office for their cooperation. Greatest appreciation is extended to the author's family for encouragement, patience, and understanding support throughout her graduate program: to her husband, Richard, to her children, Beth, Jo Ellen, and Richard, and to her parents, Mr. and Mrs. G. G. Gibson •. Further appreciation is extended to individual friends who enabled the author to pursue her graduate program. ii A NUTRITION FIELD EXPERIENCE WITH THE KENTUCKY DEPARTMENT FOR HUMAN RESOURCES A Thesis Presented for the Master of Science Degree The University of Termessee Jane G. Baxter August 1974 ABSTRACT This thesis reports and anaJ.yzes the seven-week field exper­ ience in public health nutrition spent by the student nutritionist with the Kentucky Department for Human Resources. The purpose of this field experience was to apply the scientific principles learned at the university to "real world" problems encountered in the practice of public heaJ.th nutrition. Further, the purpose of participation in a federaJ. supplementaJ. foods program was to explore the various roles and functions of the public health nutritionist in a defined program. The period of the field experience provided many opportunities for experiences that combined to accomplish the objectives. A major part of the student nutritionist's time was spent in Morehead, Kentucky; the remainder of the period in April-�, 1974, was spent with nutritionists in the Nutrition Office, Bureau for Health Services. She was able to explore the role and function of the public health nutritionist as administrator, educator, counselor, and consultant through observation of and participation in nutrition services. Through the analysis of her performance in these functions, she could examine the role and evaluate her skill. The experiences in the county and at the state office strength­ ened the student nutritionist's philosophy of public health, that is the promotion of comprehensive health care for all citizens and the support of individual responsibility for health maintenance. She sees the public health nutritionist as a health professional who can conduct iii iv effective program planning and serve as a link in the health delivery system. The student nutritionist has observed the changing structure of a state public health organization and has observed how this process sharpens the basic dedication to service required by the public health professionals. The frustrations of· this process call for leaders and sta.;ff who can see the real purpose of their work and relate their objectives to emerging structure and programs. TABLE OF CONTENTS CHAPTER PAGE I. INTRODUCTION. 1 II. CHARACTERISTICS AND PUBLIC HEALTH NEEDS OF KENTUCKY . 3 Geography and History• . 3 Population. 6 Economy. 8 Education . 10 Vital and Medical Statistics. 12 Birth rate. 12 Infant mortality. 13 Leading causes of death . 13 Health Studies. 16 Ten-State Nutrition Survey-. ' . 16 Infant feeding practices•• 18 III. BUREAU FOR HEALTH SERVICES. • . 20 Functional Units•••••• 22 Health administration . 22 He�th policy and technical assistance•• 25 Health Delivery System •• . ' . 26 Regions • •• • •• • • 26 Area Development Districts•• 26 Local health tu1its••• 28 V vi CHAPTER PAGE IV. NUTRITION SERVICES. 30 Administration•••• 30 Program planning••• 31 Implementing the programs and services. • •• 33 Evaluating . • • • • 33 Nutrition Education . 35 Individual. • • • • 35 Group work with nonprofessionals•• 37 Professional in-service . 38 Counseling. • • . 38 Consultation. • 42 Technical Assistance. • ••••••••••••••• 43 Maternity and Infant Care Project ••••••••• 44 Inspection and Licensure•••••• 45 Coordination with Other Programs•• 47 Children and Youth Project. 47 Food Stamps Program•• ••• 48 National Nutrition Program for the Elderly. • ••• 49 v. PARTICIPATION IN THE SPECIAL SUPPLEMENTAL FOOD PROGRAM FOR WOMEN, INFANTS, AND CHILDREN (wrc). 51 Background and Basis of Need•••••• 51 Need for WIC program in Rowan County. • 53 Supplemental foods. • •• 55 Nutrition education 56 1 vii CHAPTER PAGE V. (Continued) Outreach. 56 Nutritional status. 56 . Objectives. • � •• • • . •• • . 51 Implementation•• . 58 Administration. 58 Observations of the WIC Food Delivery System. 59 Nutrition education 60 Counseling. •• • •• • • 63 Consultation•••• 65 Self-Evaluation of Performance•• 66 Administration••• 66 Nutriti9n education . 67 Counseling. • 68 Consultation••••• 68 -VI. SUMMARY AND CONCLUSIONS. 69 LITERATURE CITED•• 72 APPENDIXES. 75 A. CLASSSPEC IFIC ATIONSFO R NUTRITION ISTS' POSITIONS. 76 B. MANAGEMENT BY OBJECTIVE . 81 VITA. 82 CHAPTER I INTRODUCTION The field experience in public health nutrition is designed to integrate scientific principles introduced to the student at her educa­ tional institution with practical service while working at the assigned field agency. The educational experience of supervised participation in the actual functioning of. a public health agency puts to use principles learned in the classroom. In this period of seven weeks in the spring of 1974, the author's objectives for the field experience were: 1. to strengthen her philosophy and understanding of public health; 2. to study the mission, function, and responsibilities of the state public health agency, especially the functioning of the nutrition unit; 3. to observe all facets of operation of a local public health agency, and to observe the operation of other health care ae;encies in the area; 4. to broaden her experiences in dietetics, patient counseling, and diet therapy; 5. to participate in developing, planning, executing, and evalu­ ating nutrition education activities. The Kentucky Department for Human Resources was chosen as the field agency. This location was selected to give the student·nutritionist 1 2 some appreciation of the characteristics of a different area of the country. A major part of the student nutritionist's time was spent in Morehead, Kentucky, with the Rowan County Health Department. This experience was designed to provide more opportunities for direct servic� to patients. The remainder of the period April-� was spent with nutri­ tionists in the Nutrition Office, Bureau for Health Services. This pro­ vided an opportunity to increase the student nutritionist's knowledge of the characteristics of the state which affect the public health needs, as well as the nature of nutrition services in the state. Chapter II describes the Commonwealth of Kentucky and the needs which determine the programs and services of the Kentucky Bureau for Health Services. In Chapter III the design of the health delivery system within the organization of the Department for Human Resources is discussed. The role and £unction of the public health nutritionists in Kentucky is related in Chapter IV. In Chapter V the nutrition stu­ dent analyzes her performance in a specific service activity. The closing summary and conclusions are in Chapter VI. CHAPTER II CHARACTERISTICS AND PUBLIC HEALTH NEEDS OF KENTUCKY
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