By: Kerri Schumacher

“Clank.” “Beep.” “Whoosh.” As I looked over my schedule on Monday, August 31, 2020, these are some of the sounds I expected to hear that first day walking into the Maryland Food Bank. I thought my rotation was going to be full of food cans clanking, trucks backing up into the loading docks, and the whooshing sound of sorting, packing, and distribution machines. Little did I know, the only sounds I would encounter would be the traffic outside my window and my fingers typing on my keyboard. As we continue to get through this pandemic, I have had to be very quick-witted, creative, technologically advanced, and able to adjust to many changes. Cultivating these skills has already helped me get the most out of the physically distant rotations of my dietetic internship.

The Maryland Food Bank is a nonprofit organization providing food to those in need all over the state of Maryland. I worked specifically with the Maryland Food Bank in Baltimore, MD. During my time at this rotation, I gained exposure to the magnitude of the food bank’s outreach. It has completely changed my perspective and I am excited that it continues to grow. Before this rotation, I hadn’t thought about where food banks get the food they distribute, and how their sources impact their services. I learned that who they partner with impacts what food is brought into the food bank. The cycle of production and distribution of food is way beyond my original expectation. 

I also learned about how they categorize and stock the food in the warehouse. They organize through a system called SWAP which stands for Supporting Wellness at Pantries. It separates the food into three categories based on set nutritional criteria. These categories include:

• Green, for foods you should eat a lot of, 
• Yellow, for foods you should only have sometimes, and 
• Red, for foods that you should try to avoid. 

This ranking system has provided nutrition education and convenience to customers who come into the food bank to receive groceries. This struck me as very simple, but these categories make an enormous difference. An activity that I did when I first began was to gather three different household grocery items and figure out what categories they belonged to. I was suddenly in the position of the consumer. I was surprised that my assumptions about the foods I picked were wrong. The nutritional content of food can be deceiving and I was shown how much of a challenge it could be for someone trying to buy healthy food.

However, my main duties of this rotation were focused on nutrition education. The food bank primarily delivered education activities and materials right in their backyard, at the Maryland Food Bank garden. Because of the impacts of COVID-19, in-person activities and learning opportunities for children were no longer an option. My preceptor introduced the idea of creating virtual workshops and online videos for elementary-age kids and parents to access; I knew I was up for the challenge. Throughout the 3-week rotation, my partner, Jennifer, and I created six virtual workshop scripts for the food bank to translate into videos. The six workshops each had a specific theme, forming a bridge between the food bank’s garden and nutrition education. The topics consisted of:

1. Veggie Superheroes
2. Fruit and Vegetable Categories
3. Herbs
4. My Plate
5. Liquids/Added Sugars
6. Vitamins.     

I had so much fun creating these scripts because it was a chance to explore another side of myself… one that was daring and brave. I strived to become relatable to kids, using kid-friendly language while also effectively conveying essential information as a nutrition educator. Although none of this work was created onsite, l believe I received the best beginning to this program that I could have ever asked for. With this being said, I did face challenges and had to critically think through potential problems to complete the final product before the deadline. Honestly, it was rigorous at times, especially when I experienced the true meaning of “writer’s block.” Scriptwriting was completely new to me and I learned so much by working on this project. I appreciate that my preceptor gave me the freedom to be inventive. In closing, I cannot wait to see everything that was once just ideas in my head translated into actual videos that the food bank can use to engage and educate children.

Perhaps the most important thing I learned during this rotation is the importance of keeping an open mind. Initially, I worried that I wouldn’t learn much from a virtual rotation, but that fear was unfounded. The need of the Maryland Food Bank to find ways to connect virtually to its clients provided me the opportunity to work on new and exciting projects. The virtual world does not have to be negative; it seems as if it is going to continue to be our “new normal.” I already realize how wrong I was to have this premade notion fabricated in my mind. I am very enthusiastic to tackle future tasks and projects, whether they be virtual or in person. I’m ready, and I’m set…Let’s go!

 

 

By Hannah Lundeen

SNAP, SNAP-Ed, FNS. What does it all mean? For my first rotation, I was able to spend two weeks at SNAP-Ed (Supplemental Nutrition Assistance Program- Education) Connection. This USDA-funded program provides resources and support for individual state programs who in turn provide nutritional benefits to low-income Americans. Not all state agencies go by the name SNAP. For example, California goes by CalFresh Healthy Living Program and Oregon goes by Food Hero. The Food and Nutrition Service (FNS) is the organization within the USDA that oversees and funds SNAP and SNAP-Ed. The goal of SNAP-Ed is to improve the likelihood that persons eligible for SNAP will make healthy food and lifestyle choices. Within my first rotation, I built upon past experiences, learned how the national SNAP-Ed team supports the state agencies, and explored new interest areas.  

As an undergraduate, I worked on Food Hero’s social marketing platform, performed regular website maintenance, and assisted with in-person education events and data entry. I was able to relay this through a 20 minute presentation on the Food Hero campaign to the SNAP-Ed Connection team. I spoke on how I got involved, website features, resources for educators, social marketing, and success stories. Although it was over Zoom, this experience allowed me to practice my public speaking skills and my ability to summarize information in a succinct manner. 

The SNAP-Ed Connection website showcases success stories specific to each state. Implementing agencies can submit success stories in order to be featured nationally. My partner and I were asked to reach out to our home state and offer the opportunity to write a success story. Since I already had an understanding of the Food Hero campaign, I took the initiative and wrote the success story myself. I wrote about Food Hero’s Spring Break Bingo project, an initiative aimed at increasing health-promoting behaviors for children outside of school. In 2019, bingo cards with healthy activity ideas were sent home before spring break in 56 Oregon schools (Food Hero, 2019). Results showed that the bingo cards did help to increase healthy behaviors. For example, 1384 students ate breakfast, 1316 students had dinner with their family, and 1143 students chose a fruit or vegetable for a snack (Food Hero, 2019). Additionally, to show how Food Hero works to meet the needs of its target audiences, I explained how they reached families during the COVID-19 pandemic through an online Bingo at Home page. Find the published story here. 

Furthermore, SNAP-Ed Connection website houses excellent resources that state programs can use, such as the SNAP-Ed library. States can submit electronic materials that they deem helpful. These materials are reviewed by SNAP-Ed Connection faculty and then added to the library. States use the library to research what has been done in the past in other regions as they create and implement new programs.  One of the final projects I worked on was reviewing and providing feedback on the SNAP-Ed library submission form in order to make it more user-friendly. 

An area that I was excited to gain new experience in was food photography. When my preceptor asked if I would be interested in taking photos of recipes for the SNAP-Ed connection website, I eagerly agreed. The morning of the photoshoot, my partner and I set about to collect the ingredients for five recipes. Once we got home, we were enthusiastically sharing ideas on how to best take the photographs. As the afternoon went on and we made our way through the recipes, our sense of appreciation for food photographers grew – it is not as easy as it looks. We considered many technical details in order to get the best possible shot. Some of the insights gleaned from this experience included learning how to utilize lighting, props, and camera angles to make the food look as aesthetically pleasing as possible. For example, we learned how important the backdrop is by testing out different areas around the house. We took photos in different rooms as well as outside, trying out a variety of backdrops. We found that areas near windows or outside yield the best results. We also practiced editing photos in Adobe Lightroom, which allows users to adjust factors such as exposure, contrast, and shadows, resulting in better lighting. Below is a photo of the SNAP Salsa Pinto Beans recipe that is now up on the USDA MyPlate Kitchen website. 

As I wrapped up my time at SNAP-Ed Connection, I thought that since each state-run SNAP organization functions semi-independently, it’s great to have an organization such as SNAP-Ed Connection to both support the state organizations and highlight how the programs make a difference across the country. Through utilizing past experience as well as being open to new opportunities, I made the most out of my first internship rotation. 

Sources:

(2019). Statewide Impact 2019 Spring Break BINGO Report. Food Hero. https://www.foodhero.org/sites/default/files/health-tools/2019_spring_break_bingo_statewide_final.pdf

By Myranda Vig

The day I had been dreaming about and working towards for years was finally here. Imaging what the first day of my dietetic internship would be like, I pictured myself experiencing pure enthusiasm and joy. Instead, I was flooded with nerves and questioning everything. I left my house extra early to ensure I would arrive ahead of schedule. As I pulled in, I saw the Food and Friends sign. “This is it,” I told myself, “no going back now.” Fortunately, my first rotation gave me a great start to the internship. At Food and Friends, I spent four weeks shadowing four dietitians and working in the kitchen and expo/grocery area. Entering the building I was greeted with smiles and kindness. During the first week, I learned more about Food and Friends and what they offer to the community. Food and Friends is a non-profit community resource working to provide nourishment for individuals with HIV/AIDS, cancer, and other serious illnesses through nutrition counseling, home-delivered meals, and groceries to go.

Shadowing the dietitians the first week I saw so much passion and excitement among the staff. The dietitians are assigned different clients and they speak to them every one to six months, depending on their health status and needs. Each dietitian focuses on appetite, gastrointestinal tract, and weight loss to ensure all the clients’ quality of life is being improved. Each dietitian has a different area of interest, however, so they all counsel each client with a different approach. One of the dietitians is very passionate about the quality of sleep on one’s health. She makes it a priority to ask the clients how their sleep schedule is. Another dietitian is focused on brain health and omega fatty acids. When she speaks to clients who may be feeling depressed, she brings up the benefits of omegas.

I listened in on many of the counseling sessions between the dietitians and their clients. This has helped to deepen my understanding of several serious illnesses and their symptoms. Additionally, I learned to ask clients about any side effects to medications they are on to ensure I appropriately offer them guidance. I leave each day feeling very inspired and excited about the new information I’m learning. I have learned so much about HIV/AIDS during this rotation.

When I wasn’t with one of the dietitians, I was designing educational resources or working upstairs in the kitchen/expo area. In my independent work time, I designed three infographics regarding low sodium seasoning tips, choosing whole grains and high fiber fruits/vegetables, and the benefits of small frequent meals for lung and heart disease. I wrote a blog post style resource for these topics as well. I enjoyed designing these educational resources for the clients to refer to and to offer them some tips and guidance.

Let me tell you, I was not expecting how quickly I would be working to prepare hundreds of fruit cocktails, produce bags, and fruit for the grocery deliveries. I had so much fun working with the volunteers to ensure we got all the work done efficiently. Food and Friends offer many different types of meals and groceries for their clients, such as heart-healthy, diabetic, renal, gastrointestinal friendly, vegetarian, no fish, no dairy, and pureed diets. This is to meet the nutritional needs of all the clients. I also did a kitchen inspection with one of the dietitians to check that everything was properly working and all sanitation procedures were being met in the facility and among staff.

Overall, I’m enjoying my time at Food and Friends. I have one more week till my next rotation, and I’m so excited about all I have left to learn at my time here. This was a great first rotation site that offered exposure to community nutrition and foodservice. The nerves I felt on my first day quickly dissipated with the welcoming staff at Food and Friends. Any future interns that have a chance to come here should be very excited.

By Rachel Eldering

When dreaming about my dietetic internship, I never imagined the commute to my first rotation would be so short. It was ten steps from my breakfast table to my computer where I would start my community rotation with Moveable Feast. But, I truly believe one of the best qualities a person can have is the ability to roll with the punches. Many aspects of the internship are different this year, and it’s up to me to adapt and learn as much as I can. I’m so grateful that my community rotation at the Baltimore nonprofit Moveable Feast was able to give me an insightful and meaningful experience while being virtual. 

Every day Moveable Feast provides meals to individuals suffering from food insecurity, which lessens their need to make tough choices like choosing between food and medicine or bills. In order to truly understand how Moveable Feast impacts the community I focused on one specific target audience — the food insecure who also struggle with illnesses. A study from 2013 found that individuals with diabetes that experience food insecurity have increased hospital visits, worse glycemic control, higher HbA1C, and a lower medication compliance (Berkowitz, Baggett, Wexler, Husky, and Wee, 2013). 

Moveable Feast’s mission is to provide individuals living with HIV/AIDS, cancer, and other diseases healthy, medically-tailored meals twice a day, seven days a week. It’s important to recognize the term “medically-tailored” as this is a big factor that sets Moveable Feast apart from other meal delivery organizations. The medically-tailored meals are provided so individuals with different nutritional needs can get the food they need to stay healthy. For example, Moveable Feast tailors meals to those who need renal or diabetic diets. Moveable Feast’s core philosophy, and one that really speaks to me, is “food is medicine.” I love the reinforcement that what we eat matters and it impacts our health more than you may think. In order to begin receiving Moveable Feast meals, clients must be referred by a primary care provider. There is typically a waitlist to join the program.

One of the first things I learned in this rotation is how vital volunteers are in the fight against food insecurity and hunger. According to 2019 statistics Moveable Feast has made 656,158 meals and served 4,365 clients. That comes down to an average of 1,800 meals made every day. Daily volunteers helped to make these meals happen. One difficulty Covid-19 presented was the inability to have volunteers. While Moveable Feast is still making sure all their clients get their meals, it showed me just how valuable those volunteers are. 

One of the reasons I am fond of community work is because of the hands-on impact I want to make in people’s lives. I am happy to learn how impactful these dietitians are with their clients. Moveable Feast dietitians are not just providing medically-tailored meals; they are a support system and education source. Listening to the dietitians speak with their clients I could tell how meaningful the relationships were. They were able to banter and speak candidly about a client’s habits and introduce simple goals to steer them in the right direction. I’ve questioned before whether motivational interviewing techniques were really effective. However, hearing this strategy in real life the method felt very constructive and sincere.  

A project that I worked on for Moveable Feast was editing handouts they provide to clients. Some examples of their handouts include tips to eat more fruits and vegetables, renal snack ideas, and seated exercises. The information in these handouts need to be easy to comprehend for the average person. Here is an example of a handout my partner and I edited. 

A challenge I felt with this rotation was my lack of personal connection with clients. Of course this comes with time, but it also confirmed the importance of relationships in community dietetics. Another challenge due to Covid-19 was the inability to make home visits. Typically a Moveable Feast dietitian will assess a client in their home. This is beneficial for a multitude of reasons, including being able to do a nutrition focused physical exam and getting a better understanding of the client’s resources. When meeting with clients in person it can feel personal and comfortable more quickly. Currently, Moveable Feast dietitians are interviewing clients for brief check-ins and full assessments by phone. At first my partner and I would just listen to the dietitians make calls, but we soon started to make calls ourselves. I learned how to move through the online charting system while speaking and listening. I also worked with the dietitians to understand gauging levels of risk. No case was black and white, so it definitely was a learning curve for me. Sometimes speaking to clients over the phone was challenging since I couldn’t pick up on nonverbal cues, such as smiles, frowns, posture, or eye contact. An additional challenge came with how often clients were not available by phone. Many times I would prepare to speak with a client by going through their case notes for 20 minutes and then was not able to reach them. 

When I spoke with clients the conversations revealed so much more than what was in their case notes. It was an important reality check that everyone is dealing with more than what’s on the surface. There are so many factors that influence a person’s food and lifestyle choices. I believe there is never a place for judgement in community dietetics. I’m thankful for these experiences and will use my new skills going forward, whether in my next rotation, my next job, or even my everyday life.

By Grace Horgan

One great way to capture someone’s attention is with a sample of free food. I found this to be true with kids and adults during my two week community rotation with FSNE (Food Supplemental Nutrition Education FSNE). FSNE provides nutrition education for Maryland residents that are eligible for SNAP (Supplemental Nutrition Assistance Program) benefits. During this rotation, I first learned all about FSNE and what services they provide in the community. Then I went into the field, helping to provide nutrition education to both students at an elementary school and customers at a food bank. FSNE reaches Maryland residents of all ages.

I was a little nervous walking into an elementary school to teach a second grade class about nutrition and MyPlate. I didn’t really know what to expect. Were they going to know what I was talking about? Would they be interested in what I had to say? The FSNE nutrition educators were each assigned to different elementary schools throughout the state and conducted education sessions once a month. On our first school visit with one of the educators, my partner, Claire, and I taught the students about MyPlate and then made a “MyPlate salsa.” The salsa had components of each food group from MyPlate except dairy; black beans (protein), mango (fruit), tomato salsa (vegetable) and we served it with tortilla chips (grains). Claire and I built the salsa with the students and discussed each ingredient. The students were asked to determine which food group they belonged to.  All the students were required to try one bite of the food that was being served that day. They have a special rule in the classroom called “Don’t Yuck my Yum,” where students are not allowed to say “yuck” after trying the food.

One of the most surprising parts of my visit to the school was that all the students in grades K-2 knew what MyPlate was and were familiar with all the food groups. After our first three class sessions that day, I noticed all of the students in each class also knew the educator by name. I was impressed because they only see the nutrition educator once a month. It appeared their nutrition lessons were something they really looked forward to each month. Thinking back to my grade school experience, I tried to remember when I had learned about basic nutrition and I don’t think it was until Middle School or High School. I think it is extremely valuable that these children are learning practical nutrition information at such a young age. It can build a strong foundation of wellness for their future. Additionally, they can bring some great nutritional information home to their parents or guardians.

During another one of our days at FSNE, we were able to help out at the Howard County Food Bank. Once or twice a month the FSNE educators go to their assigned county’s food bank to provide samples of a low cost recipe. The recipe consists of items that customers can get at that food bank that day. The educators display the food items in the recipe so customers know exactly what is needed. On our day at the food bank, we offered samples of a vegetable crockpot stew. The customers really enjoyed this and some even came back for seconds! I was extremely surprised at how organized and clean the food bank was. There was a wide variety of food, including several frozen items and numerous gluten-free foods.

Overall, I really enjoyed my time with FSNE. The educators were very welcoming and allowed us to get hands-on experience teaching the students and even adding our own twist to things. It was really incredible to see how big of an impact FSNE had on the community. The FSNE programs give children and their families sound nutritional education and encourages them to make healthy choices.