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Listening puts the focus on diet

14 February 2013

NDSU student Jana Millner listens carefully to a client during a dietetic consultation at the Lewis Goodhouse Wellness Center at United Tribes Technical College in Bismarck. DENNIS J. NEUMANN<>United Tribes News

BISMARCK (UTN) – A friendly smile and sympathetic ear are welcome in any setting but especially in health care. A new service at United Tribes, offered with care and without judgment, promises to go a long way toward helping people cope with unhealthy eating habits and poor diet.

The new pilot project offers medical nutrition therapy from a dietitian. Staff members of the tribal college in Bismarck are familiar with addressing nutrition and wellness as part of the academic curriculum. The addition of medical nutrition therapy amounts to a clinical approach in the campus setting.

“Food is more than just something to eat. It’s a very powerful, emotional and spiritual part of your being,” says Wanda Agnew, an instructor in UTTC’s Nutrition and Foodservice Program. “Often when people visit with a dietitian you encounter something that is a cross between confession and self-forgiveness. You really have to be prepared to recognize that there will be emotions shared.”

Medical nutrition therapy confronts Indian Country’s most challenging dietary issues: diabetes and obesity; and serves to help with other problems, such as food allergies and intolerances, eating disorders, chronic infectious diseases (HIV/AIDS or hepatitis), elevated cholesterol, irritable bowel syndrome, complications from cancer therapy, and sports nutrition.

United Tribes is offering the service in partnership with the Dietetics Program of North Dakota State University, Fargo, ND. It involves a senior NDSU dietetics student providing free consultations to UTTC staff members and students in the college’s Lewis Goodhouse Wellness Center.

“A lot of people know a little bit of what they’re supposed to do,” says Jana Millner, the first dietetics student to serve in the new program. “It involves making assessments and helping figure out the kind of diet they need for good health.”

Millner, who is formerly from Bismarck and also works in New Town, ND, had pursued a number of other degree paths but eventually settled on dietetics. She says she likes the nutrition part and helping people stay healthy. “It seems like something that’s always relevant. It’s very interesting and there’s a big need for it.”

Her spring semester internship is supervised by Agnew, a licensed and registered dietician. Both see the role of the dietitian as that of a guide – sort of a food counselor, helping sort out the mysteries of eating.

“It’s interesting to see how diet and lifestyle go together,” says Millner. I understand more of why things are the way they are.”

“I’m very excited for Jana. I think she’s going to get experience that she may not gain anywhere else,” says Agnew.

It may be good advice all around, but clearly the best approach for any dietitian to learn what a client needs is to talk less and listen more. In dietetics it’s known as “motivational interviewing.” All licensed, registered dieticians in North Dakota are trained in it.

“You want to learn as much about the patient as possible by asking open-ended questions and making it about them,” says Millner. “You don’t want it to be a lecture where you, as the health professional, are the only one talking. You want to hear what they have to say and teach what you can from there.”

Diabetes and weight loss are the most common concerns Millner has encountered thus far. She expects to see more of that during her eight week internship that ends in early March.

She will graduate from NDSU with a bachelor’s degree in dietetics in May. Some of her time at UTTC will be spent describing her program of study to students in the college’s two-year Nutrition and Foodservice program.

She’s excited to be the first dietetics intern in the clinical program and to help establish standards and practices for how the service will be offered in the future.

Those to benefit will have Agnew to thank for her enthusiasm and persistence. She explored the partnership with NDSU and gained cooperation on campus from the wellness center staff, headed by Brad Hawk, Assoc. VP of Community Wellness Services, and the staff of the college’s Land Grant and Nutrition and Foodservice programs. The new specialty will involve professional staff in student health, addiction counseling, fitness training, nutrition education and social work.

“We wanted an integrated team,” says Agnew. “It was received extremely well. Everybody’s so excited about this that it’s a little overwhelming.”

It seemed long-overdue to offer regular dietetic services. The move promises to enhance total wellness care, a goal that is driving plans for more services and health systems on the campus, including physician’s services. Dietitian services are also part of most third-party reimbursement systems, including Indian Health Service.

The current focus of the college’s Land Grant programs is general community wellness and nutrition education. Director Pat Aune says the new service is needed.

“The clinical aspect of nutrition education fits the Land Grant mission and may turn out to be an on-going essential for the team in the future,” says Aune. “We’re aware that many in the campus community cannot always access dietitian services when referred into health systems in the greater community.”

Agnew says she is not aware of any comparable service being offered at other tribal colleges and universities around the country. It amounts to showing leadership in food sovereignty for a tribal college to help people make good decisions based on their own needs, she says. “The education we can bring clinically and individually can make a difference.”

United Tribes staff and students may schedule appointments for the new dietician service, free of charge, by calling the Lewis Goodhouse Wellness Center at extension 1264. More information: Wanda Agnew 701-255-3285 x 1234, wagnew@uttc.edu.






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