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Interactive Lifestyle Assessment, Counseling and Education (I-ACE) software – A clinical tool for lifestyle modification Kathleen Abu-Saad, Arnona Ziv,

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Presentation on theme: "Interactive Lifestyle Assessment, Counseling and Education (I-ACE) software – A clinical tool for lifestyle modification Kathleen Abu-Saad, Arnona Ziv,"— Presentation transcript:

1 Interactive Lifestyle Assessment, Counseling and Education (I-ACE) software – A clinical tool for lifestyle modification Kathleen Abu-Saad, Arnona Ziv, Ofra Kalter-Leibovici Cardiovascular Epidemiology Unit Gertner Institute for Epidemiology and Health Policy Research Sheba Medical Center, Israel EIP-AHA WORKSHOP ON NUTRITION Rome, October 17, 2014

2 Patient Needs / state of mind Lifestyle modification Individually- tailored counseling Patient /client centered Motivational interviewing

3 Patient /client Lifestyle coach / counselor Decision support tool for interactive lifestyle counseling process Partners in personalizing the intervention

4 Lifestyle modification Assessment Counseling Education Assessment Counseling Education Individually-tailored and interactive Assessment provides the starting point for the lifestyle counseling and comparison of patient status to evidence-based lifestyle goals Simulation process focuses the counseling and education on specific lifestyle areas that need improvement

5 SELECTED FEATURES: Nutritional assessment and intervention

6 FFQ – Assessment Example FFQ designed for Arab adults with DM2 ~90 food items on FFQ list When frequency and amount of intake is entered… …contribution to average daily nutrient intake is immediately calculated and displayed Breads, Grains, Starchy Foods Bread Displayed portion size= 1 carbohydrate exchange portion Grains, Starchy Foods Add additional items, as needed

7 Stick figures show current status of patient/client Identify the parameters outside of the recommended ranges (color-coded green), and tailor counseling to specific areas in need of improvement Goal package % kcal Interim goal % kcal Min/wk Ideal goal Personalized goals can be set and modified throughout the consultation series Selected goal parameters for a 68 year-old woman with type 2 diabetes

8 Dietary Counseling/Education Whole grainProcessed grain Food made from processed grains: Has less fibres, healthy fats, vitamins Raises blood sugar level more Often high in calories Advantages of whole grains as opposed to processed grains: Why whole grains are good for you Why processed grains are less good Foods containing whole grains Foods containing processed grains Inside: carbohydrates, protein, vitamins Center: healthy fats, vitamins & more Outside: fibres, many vitamins Benefits of eating whole grains: Help lose weight Help balance blood sugar Lower cholesterol Lower risk of cardiovascular disease Inside: carbohydrates, protein, vitamins Outside: fibres, many vitamins Center: healthy fats, vitamins & more Natural grains which have not been processed or changed WHOLE GRAINS Embedded educational materials can be accessed from goal parameters screen

9 g/d FFQ – Simulation (g/d) % kcal When intake is above the recommended level, and should be reduced, a list of foods contributing to current intake can be generated: Sugar-sweetened drinks …so a simulation can be conducted Clicking on food name takes you to the item in the FFQ…

10 FFQ – Simulation Sugar-sweetened drinks None PartialFull Discuss & document willingness to change Conduct a simulated change…. …and demonstrate visually how the change brings the patient closer to the recommended intake level Discuss & document agreement to change

11 mg/d FFQ – Simulation When intake of a nutrient is below the recommended level, and needs to be increased, a list of foods rich in the selected nutrient can be generated… mg/d …and increased intake, according to patient preferences, can be simulated All agreed upon changes in the simulation stage are documented in the patient record and provided to patients as take-home print-outs or electronic documents. (mg)

12 Interactive menu builder – Individually-tailored sample menus Multiple menus can be created and named… Bread Grains-Starches-Legumes Spreads-Dips Dairy Products Chicken Red/Processed Meat Fish Mixed Dishes Vegetables. fresh/cooked Vegetables, pickled Fruit, fresh Fruit, dried/preserved Desserts Beverages, sweetened Nuts-Seeds Beverages, unsweetened Fast Foods Click on food group to open list of food items Drag and drop foods into the desired meal on the menu Menus are created from the list of foods the patient reported eating/agreed to eat in the assessment and simulation FFQs

13 Bread Grains-Starches-Legumes Spreads-Dips Eggs Dairy Products Interactive menu builder – Individually-tailored sample menus 0.75 container fruit yogurt 1 container low-fat fruit yogurt 1 container yogurt/leben 2 pieces salty cheese 1 slice yellow cheese 1 fried egg1 portion Arabic vegetable omelette 1 portion shakshouka 1 boiled egg 2 heaped Tbsp white/ cottage cheese 9% 2.5 heaped Tbsp white/cottage cheese 5% 2 heaped Tbsp Arabic labaneh 2 heaped Tbsp hummus salad Egg and Dairy Product Exchange List Click on Help Files to access exchange lists color- coded to correspond to the relevant food group…. View nutrient summaries per meal or per full menu

14 Follow-up visits: Assessment build upon the assessment and simulation conducted in previous visits by copying intake data and highlighting agreed upon changes Dark green = new changes agreed upon in the previous visit Light green = changes made and maintained from earlier visits

15 Follow-up visits: Assessment Re-assess intake of foods with green agreed-upon change indicators If agreed-upon reduction in intake of white pita bread only partially implemented… If agreed-upon change in light bread intake not implemented at all …agreed-upon change indicator automatically turns yellow …agreed-upon change indicator automatically turns red

16 Follow-up visits: Simulation Agreed-upon changes not fully implemented are flagged in the simulation stage of a follow-up visit Yellow and red agreed-upon change indicators are copied from the Assessment stage and flagged for discussion in the Simulation

17 Additional features Organizational management tool:  standardizes the lifestyle counseling process  reduces variability between healthcare providers/coaches and increases transparency Multiple research applications:  database creation  assessment of nutrient status of patient population  evaluation of interventions at participant and system levels, etc.

18 For additional information Contact: Kathleen Abu-Saad, PhD Cardiovascular Epidemiology Unit Gertner Institute for Epidemiology and Health Policy Research Sheba Medical Center, Ramat Gan, Israel


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