Background in nutrition is now a recognized component of medical training, yet many medical programs still do not include it in their curriculum. It has been acknowledged that information alone is not sufficient to result in inclusion of nutrition assessment and intervention in clinical medical encounters. Behavioral strategies have repeatedly been documented to be necessary to move knowledge and information into practice. We propose to develop and deliver a nutrition assessment/intervention program that uses the most current evidence based information on nutrition and cardiovascular disease to present to medical students, residents, and attending physicians in a clinical setting of departments of medicine at three academic teaching sites. A strategic component of this program is the behavioral aspect that will train medical students, residents, and attending physicians to identify the stages of change and to encourage patients to move in the """"""""change model"""""""" from precontemplation, to contemplation, to action. A behavioral workshop will be given to residents and third year medical students that includes training in the """"""""change"""""""" skills using a """"""""standardized patient"""""""". Medical staff will be trained to motivate patients to a position of change, using a dietary assessment/intervention instrument that the patient can adapt to self-assess and monitor change. The physician is given a short intervention protocol appropriate to a clinical encounter, to begin the patient on the nutrition intervention. The program will start the process by using the """"""""Rate Your Plate"""""""" material which can be adapted to a behavioral format, along with the American Heart Association material. A dietary assessment/computer analysis program will also be tested for physician acceptance and patient efficacy. More, in depth intervention would be followed by a referral to a dietitian, if the patient wants to continue the change and wishes more guidance. Evaluation of the program will be via questionnaires developed to evaluate change in knowledge, attitude, perceived skills to administer the intervention and perceived efficacy of the program for the patients. Material from the program will be prepared for dissemination via Website and journal publications. The program will be flexible in order to be adaptable to different settings, as tested at our three sites.
