Health and Nutrition Assessment Handbook (HNAH)

Overview

To maximize the effectiveness of the WIC Program, the nutrition services provided must reflect current scientific knowledge and contemporary public health issues. Recognizing this need, the Food and Nutrition Services (FNS) developed the process of Revitalizing Quality Nutrition Services (RQNS), with the goal of continually improving program services. RQNS initiatives include:

• The WIC nutrition risk criteria policy ensures that all criteria are science-based; and
• The WIC Nutrition Services Standards (NSS) which are designed to improve the quality and delivery of WIC services.

Value Enhanced Nutrition Assessment (VENA) is the latest initiative under the umbrella of RQNS. VENA builds on the information provided in the WIC nutrition risk policy and the NSS.

VENA Guidance Document

VENA Guidance Document – Complete Document (PDF, 88 pages)

Nutrition Assessment Questions

The Missouri WIC Nutrition Program uses standardized questions when program eligibility is determined at certifications and as part of the mid-certification health assessment. The questions are specific to client category, age, and feeding status. These questions support WIC staff in conducting a complete nutrition assessment, determine WIC risk eligibility and start a dialogue with the client about what she or he wants and needs related to nutrition and health.

VENA Skills Checklist for Effective Counseling

The following skills checklist can be used by the CPA/nutritionist to rate themselves on a scale of 1 to 5 on how well each skill was performed.

A printable version of the checklist with rating and comment columns is available: Skills Checklist for Effective Counseling (PDF).

Establishing rapport

• Introduced self to client
• Displayed understanding for other culture
• Ensured privacy (kept voice low, closed door, moved to private location)
• Offered help when needed (“here are some books,” “feed baby here”)
• Used appropriate non-verbal communication (nodding head, eye contact, avoiding crossed arms, etc.)
• Used respectful language
• Focused on client when translator is used

Completing assessment forms

• Reviewed client’s past history
• Collected missing information on WIC forms without interrupting client
• Asked probing questions to clarify responses
• Avoided spending extensive time on irrelevant information
• Shared findings (Ht/Wt/Iron) in a non-judgmental manner

Identifying and exploring concerns

• Asked open-ended questions to explore client’s concerns
• Listened actively and allowed for silence
• Validated client’s concerns
• Referred client to outside sources when needed (social work, food bank…)
• Used counseling tools to start and guide conversation
• Identified and acknowledged client’s strengths (positive behaviors)
• Maintained focus on desired health outcome (healthy pregnancy, active family)
• Helped client explore feelings and attitudes about health concern
• Tried to lead discussion based on nutrition assessment data if nothing was offered by client
• Assessed the client’s readiness to change
• Worked with client to identify problem behaviors and ideas for change
• Provided simple, accurate nutrition messages if client was receptive
• Limited number of nutrition messages given to client per session
• Tailored messages based on client's age, gender, culture, and feedback

Setting goal

• Summarized the conversation
• Helped client set goal(s) that is specific & realistic for the family’s lifestyle
• Documented goal(s)

Closing on positive note

• Restated the goal and checked for understanding
• Expressed appreciation for client’s time
• Was enthusiastic about following up next time

Missouri WIC Program. Revised 07-2022.