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Screening Isn’t a Checklist, It’s a Tool

By Veronica Villa, Student Mentee*

RDNs! An essential step you can take before starting your group program is to conduct an initial screening interview with your potential participants using motivational interviewing techniques.

Many factors lead to clients in groups reaching their goals. Some of these are having a great leader, effective communication, accessibility, and group cohesiveness.  One of the best ways to learn about potential group members is through an initial screening interview.

Why Screen Your Clients?

LifeSteps-Screening Client

When you know your clients’ intentions and needs, you can use them as you start your program.  This can lead to more focused and sustainable weight management sessions. tailored to your client’s needs.

There is very little research about screening clients specifically for weight management programs.  However, the Substance Abuse and Mental Health Services Administration Treatment Improvement Protocol discusses the importance of matching clients with groups. (1) Though this protocol is for substance abuse treatment, it still presents many great points for group weight management and lifestyle change program screening. It recommends that when you work with a group, it is essential that the group “moves as a whole”.  And trying to get everyone on the same page without any previous assessment can add some obstacles. 

The Screening Interview

According to the Substance Abuse and Mental Health Services Administration protocol, evaluating the following parameters during your screening interview helps you know if a potential client is suitable for participation in your group. These parameters can be adapted for weight management and lifestyle change initial interviews to include:

  • Characteristics and Needs- Key information about clients’ work and lifestyle,
  • Preferences -Specifically around food and activity
  • Readiness and Motivation for Change – Why now is a good time
  • History – Both health and nutrition history, including information about previous weight loss attempts

Using an open-ended, motivational interviewing questioning style elicits the prospective participant’s self-motivational statements and builds rapport.

Other Considerations

A group health coaching article notes that this kind of initial interview can be used effectively by also providing inclusion and exclusion criteria so you have clear referral pathways in place for those who might be better served by individual counseling or other types of services. (3)

A complete screening interview also incorporates anthropometric measures including BMI and waist circumference. The Academy of Nutrition and Dietetics Adult Weight Management (AWM) Guidelines (2), NHLBI and CDC all recommend using BMI as part of the initial screening interview, but caution that it does not diagnose body fatness or health. The following BMI and waist circumference cut points are recommended by all three for inclusion in weight management programs:

  • BMI
    • BMI is 25.0 to <30 falls within the overweight range.
    • BMI is >30.0 falls within the obesity range.
  • Waist circumference:
    • Men: More than 102cm (more than 40 inches)
    • Women: More than 88cm (more than 35 inches). (2)

When you conduct screening interviews that gather this information, it sets each client, the group, and you up for success.

LifeSteps®

A key component of LifeSteps® is a detailed Initial Interview that gathers all these pieces of information. With this tool, you will better understand your clients and plan accordingly.

Tracy Pfaffenberger, LifeSteps® Manager, notes that LifeSteps® Leaders not only find the Initial Interview helps to identify participants who will do well in a group setting, it has the added benefit of improving their program retention rate.

Learn More

If you would like to learn more about LifeSteps® and our Initial Interview process, please schedule a free information call with a LifeSteps® team member.

References:

  1. Center for Substance Abuse Treatment. Substance Abuse Treatment: Group Therapy. Treatment Improvement Protocol (TIP) Series, No. 41. HHS Publication No. (SMA)15-3991. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2005.
  2. Academy of Nutrition and Dietetics Evidence Analysis Library, Adult Weight Management Guidelines, Screening and Referral, https://www.andeal.org/topic.cfm?menu=5276&cat=4690, Accessed April 8, 2022.
  3. Armstrong C, Wolever RQ, Manning L, Elam R 3rd, Moore M, Frates EP, Duskey H, Anderson C, Curtis RL, Masemer S, Lawson K. Group health coaching: strengths, challenges, and next steps. Glob Adv Health Med. 2013 May;2(3):95-102. doi: 10.7453/gahmj.2013.019. PMID: 24416678; PMCID: PMC3833535

*Student Mentee from RD Mentorship Program, which partners Registered Dietitians (RD) with nutrition students from around the US.