ISSA Nutritionist Chapter 12: Client Assessment and Goal Setting

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Chapter Goals:

• Know the client assessments used by a nutrition coach.
• Be able to employ the right assessment forms with clients.
• Discuss the importance of setting goals with clients.
• Describe what SMART goals are.

Introduction

There are quite a few reasons for clients seeking guidance from nutrition coaches.

All clients will come with their own unique goals they wish to accomplish, from bettering their health all the way to making themselves feel better. 

Nutrition coaches need to assess the client before they make a program for them. 

Assessments

There are many assessments that a nutrition coach can perform, and these will oftentimes work to help with building rapport with their clientele. 

Personal Assessments

These begin the process of collecting data and start with the basic information like the address, contact info, emergency contact, and the initial starting goal ideas for the clients. 

These can be completed as questionnaires or a sit down with the client to talk. 

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Physical Assessments

These are vital for the health and fitness coach, as they will provide a picture of the client’s overall health.

The assessments here will look at objective data like height, weight, body composition, circumference measures, and skinfold measurements.

Some of the Pros and Cons for each will be:

• Weight is an easy measure to collect, but weight changes do not explain the actual stuff changing.
• Height is easily known off the top of someone’s head and it is helpful in body comp assessments, and there are no real Cons with it.
• Body composition gives in-depth details regarding both body mass and the amount of fat in the body. A con is that it may be difficult to calculate if the proper tools are unavailable. 
• Circumference measures help calculate body composition, and a con is that not all clients will know how to gather their data for this accurately.
• Skinfold measures are very helpful when it comes to the use of body composition, but most clients will not have the tools or the consistency when measuring such things.

Health Assessments

Health assessments use health history questionnaires to gather information about clients’ current and past health histories.

For the health history questionnaires, the questions that can be helpful are:

• Are there any specific needs for your diet?
• Are there any conditions that are complicated by dietary intake?
• Do you have any food allergies or other restriction forms?
• Have you had any blood sugar problems like hypoglycemia or diabetes?
• Do you have a family history that has any disease or addiction problems?
• And any questions along these lines.

The PARQ+ and health history screening questionnaire that trainers use is a great option for nutrition coaches to gather the right health data for you to keep on their files.

Physical Activity Assessments

The client’s current level of physical activity is important to understand, as this will look into their caloric needs and expenditures.

Exercise history questionnaires are useful here to see the current sports, frequency of activity, and fitness levels.

Photo Assessments

These are great ways to see the client’s progress throughout a nutrition coaching program and in the realm of fitness coaching.

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It allows the client to see their changes over time.

Behavioral Assessment

Behavioral assessments are within the scope of practice for nutrition coaches, and some examples of this would include looking at the nutrition behaviors and nutrition diaries.

We can use things like client dietary worksheets, 3-day diet records, and other similar forms to find this information. 

Some important questions in this category can be things like:

• Do you eat when you are bored?
• How often do you snack?
• What do you do when you have a lot of stress?
• Does food make you feel uncomfortable?
• Does eating give you comfort?

Psychological Assessments

These assessments include questions about the client’s motivations, what they may feel distracts them from their progress, and how they feel regarding their past and present nutrition journey.

This information allows the stages of the change model to be used and the actual stage the client is in to be determined. 

Pre-contemplation stage has the client with no intention of addressing a behavior.

The contemplation stage is when the client is aware of the need for change but has barriers to overcome. 

The preparation stage is when someone desires to change but also seeks a way to do it. 

The action stage is when someone takes the necessary steps to address and change their behaviors.

The maintenance stage is when someone continues to do what is needed for them to keep going with their desired behavior. 

Reassessment

This is done periodically and is required to measure progress and understand plateaus. Oftentimes a client should reassess with the use of nutrition diaries, physical assessments, and photos. 

Setting Goals

Goal setting is the process of establishing what someone wants to achieve and measuring timelines for doing it. 

Without goals, programming is not very effective. 

Types of Goals

There are many forms of goals, but only a few that nutrition coaches should use. 

We have physical goals, health goals, and behavior goals.

SMART Goals

S = specific

M = measurable

A = attainable

R = realistic 

T = Timely

Goal setting steps

1. Step 1 is to determine the desired result and willingness to do the work to achieve it.
2. Step 2 is to create a SMART goal plan.
3. Step 3 is to write down the goals.
4. Step 4 is to create a plan of action.
5. Step 5 is to establish some form of a timeline.
6. Step 6 is to act on the plan.
7. Step 7 is to reevaluate and assess progress.