Diet is one of the least understood and complied with aspects of treatment in patients with CF. In one assessment study of adherence to dietary recommendations, Gudas found that 40% of children and 47% of parents disagreed with their physician on whether diet was a formal recommendation. Henley reported many misconceptions of symptoms and treatment of malabsorption and diet. Any education program targeting dietary treatment in children with CF needs to address two knowledge and/or skill components: Nutrition Knowledge and Parent-Child Interactions. The current study is an ongoing, multi-site, clinical trial examining two innovative approaches to diet education. One treatment, Nutrition Education (NE), addresses the issue of lack of dietary knowledge by providing families an intensive 7-session program of nutritional suggestions for meeting the CF RDA for energy on a meal-by-meal basis. This intervention differs from the standard of care nutritional support typically offered by CF Centers in its intensity (weekly meetings) and specificity (individualized sessions on a meal-by-meal basis). The second intervention, Behavior Education (BE), combines the nutrition education component plus training on behavioral child management skills, such as contingent attention to appropriate eating, ignoring behaviors incompatible with eating, and use of contingent privileges for meeting calorie goals.
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