Nutrition Services (NS) NS-3 Value Enhanced Nutrition Assessment

1 Maine Center for Disease Control and Prevention WIC Nutrition Program Effective: October 1, 2012 Policy No. NS-3 Revised: August 1, 2015 Value Enhanced Nutrition Assessment (VENA) Authority 22 MRSA §255 and §1951 WIC Policy Memorandum #2006-5, Value Enhanced Nutrition Assessment (VENA)—WIC Nutrition Assessment Policy, FNS, March 15, 2006 Policy 1. The State Agency shall provide Local Agency staff with guidance to ensure VENA (Value Enhanced Nutrition Assessment) competencies for all staff. 2. The Local Agency shall ensure that all staff are trained in VENA principles and utilize these skills in all encounters with participants. 3. The State Agency shall assure that Local Agency staff utilizes a thorough nutrition risk assessment process which includes application of VENA principles. Procedure 1. To ensure accurate and thorough nutrition assessment, Local Agency staff must have qualified staff members. VENA assumes the following competencies for counseling staff: 1.1. Life-cycle nutrition knowledge 1.2. Nutrition assessment processes 1.3. Anthropometric and hematological data collection techniques 1.4. Communication skills, including rapport building and techniques of open communication 1.5. Multicultural awareness 1.6. Critical thinking skills 2. The VENA WIC nutrition assessment process shall include: 2.1 Collection of relevant information 2.2 Clarification and synthesis of all data collected 2.3 Identification of pertinent and appropriate risk(s) as well as other related issues

Nutrition Services (NS) NS-3 Value Enhanced Nutrition Assessment

2 2.4 Documentation of assessment 2.5 Follow up on previous assessment(s), as appropriate. 3. A comprehensive WIC nutrition assessment shall include each of the following areas: 3.1 Anthropometric data 3.2 Biochemical data 3.3 Clinical and health conditions 3.4 Dietary patterns 3.5 Environmental and social information 3.6 Other health information 4. The assessment process should not stop once one risk has been identified. The VENA process shall include assessment of all health and nutrition areas. 5. The endpoint of the value enhanced WIC nutrition assessment is the identification of all applicable risk factors and a plan leading to positive health outcomes. 6. Nutrition assessment shall be followed by participant-centered counseling, with the goal of achieving positive health outcomes. 6.1 Counseling efforts should guide participants to establish achievable short-term goals in areas of their choice. 6.2 Short-term goals that lead to positive health outcomes should be suggested as needed. 6.3 Following-up on identified participant-led goals shall take place in order to assess progress, offer necessary assistance, and establish new short-term achievable goals. 7. Each participant must be informed, in a constructive and sensitive manner, of the risk factor(s) or barriers to positive health outcomes that have been identified. Participants may choose whether or not to set specific goals related to identified risks. 8. The State Agency shall direct Local Agency staff to follow procedures for documentation of nutrition risk (see Maine WIC Policy No. CE-3, Nutrition Risk Determination, Documentation and Priority Assignment). 8.1 Nutrition assessment documentation shall include all justification pertaining to assignment of each risk factor, which will streamline workflow by allowing WIC staff to initiate discussions at follow up appointments after minimal review of the participant electronic record. 8.2 Nutrition assessment documentation shall be reviewed during management evaluations or other program monitoring procedures, in order to evaluate thoroughness of assessment procedures and quality of WIC services provided.

Nutrition Services (NS) NS-3 Value Enhanced Nutrition Assessment

3 9. The Management Information System (MIS) is an important tool in the assessment process. 9.1 The MIS shall be used for: 9.1.1 Entering and storing all assessment and health information, as well as pertinent information gathered during participant appointments 9.1.2 Accurately assessing anthropometric risk, including BMI calculations, assessment of prenatal weight gain, and growth assessment of infants and children 9.2 The WIC MIS should never be considered as a replacement for critical thinking skills and professional judgment, nor should it replace dialogue and feedback between staff and participant(s) during WIC nutrition assessment and counseling appointments. 10. WIC staff shall maintain the necessary training and competencies in order to complete participant nutrition assessments as outlined in ME WIC Policy Number OM-5, Staff Training, and in the VENA Essential Staff Competency Tables for WIC Nutrition Assessment (Appendix NS-3-A).