Meal Planning in Groups

Abstract

Medical nutrition therapy (MNT) and meal planning are an integral part of diabetes management. Diabetes MNT involves 1 ) assessment of a patient's nutrition knowledge and skills, 2 ) identification and negotiation of individually designed nutrition goals, and 3 ) nutrition interventions that include meal planning and other education materials to meet patients' needs.1,2 The Diabetes MNT guidelines3,4 can help patients acquire the knowledge and skills that are important for behavior change when implementing nutrition education. Group education is increasingly advocated as being as successful as, if not more successful than, individual counseling. This article discusses some of the issues involved in establishing and running group education for nutrition and meal planning. Group classes are advantageous and have become an essential method of teaching meal planning, given the reimbursement limitations for diabetes self-management training and MNT. Group education is the standard and is required by Medicare unless barriers to learning are identified. The Federal Balanced Budget Act of 1997 resulted in changes in reimbursement by the Centers for Medicaid and Medicare Services (formerly the Health Care Financing Administration) that supported group delivery of diabetes education.5 Medicare reimburses 10 hours in the first year for initial diabetes education and 2 hours of follow-up education per year. Medicare coverage for MNT is 4 hours for the first year and 2 hours for the second.6 Group education allows for better utilization of the coverage provided by Medicare and some insurance companies. The benefits of group education are many. It stimulates interactions among participants, which enhances learning. Many individuals with diabetes have faced the challenge of trying to follow a meal plan and make necessary changes to control blood glucose and lipids many times over. In group settings, participants have the opportunity to share these experiences and learn from others. …