MODULE 3:
USING THE NUTRITION
ASSESSMENT INSTRUMENT (NAI)
HEATHER GIBBS, M.S., R.D., L.D.N.
PH.D. CANDIDATE, UNIVERSITY OF ILLINOIS
OBJECTIVES
Participants will be able to:
1. Correctly use the NAI with clients.
2. Match appropriate materials with levels of
learning.
NUTRITION LITERACY ASSESSMENT
INSTRUMENT (NAI)-PAGE 1
Instructions: All clients should complete page one of the instrument. The following algorithm
will assist you in determining whether clients should complete subsequent pages. This
algorithm should be completed during the assessment phase of nutrition education, before
any education is provided.
Nutrition Literacy Assessment Algorithm
Will the client need to understand concepts of macronutrients? (Examples: Carbohydrate counting, Low
fat diet)
Yes [ ] Check knowledge of macronutrients (p. 2)
No [ ]
Will the client need to learn portion sizes? (Examples: carbohydrate counting, renal diet, weight loss)
Yes [ ] Check knowledge of household measurements (p. 3-4)
No [ ]
Will the client need to read labels? (Examples: carbohydrate counting, low fat diet, allergy restrictions)
Yes [ ] Check numeracy (p. 5)
No [ ]
Will the client need to be able to group foods? (Examples: carbohydrate counting, low fat diet, renal diet)
Yes [ ] Check knowledge of food groups (p. 6)
No [ ]
EXAMPLE: SODIUM RESTRICTION
Nutrition Education: Food labels and high sodium foods
Nutrition Literacy Assessment Algorithm
Will the client need to understand concepts of macronutrients? (Examples: Carbohydrate counting, Low
fat diet)
Yes [ ] Check knowledge of macronutrients (p. 2)
✓
No [ ]
Will the client need to learn portion sizes? (Examples: carbohydrate counting, renal diet, weight loss)
Yes [ ] Check knowledge of household measurements (p. 3-4)
✓
No [ ]
Will the client need to read labels? (Examples: carbohydrate counting, low fat diet, allergy restrictions)
✓
Yes [ ] Check numeracy (p. 5)
No [ ]
Will the client need to be able to group foods? (Examples: carbohydrate counting, low fat diet, renal diet)
✓
Yes [ ] Check knowledge of food groups (p. 6)
No [ ]
This client will complete pages
1, 5, and 6 of the NLI
SCORING
• Scoring is completed on the last page of NLI
• Score sections chosen by using the algorithm only
• All clients complete “Nutrition and Health” section
• Result Options
• High likelihood of inadequate nutrition literacy
• Marginal nutrition literacy
• Adequate nutrition literacy
WHAT DO I DO WITH THE
RESULTS?
TARGETING THE CLIENT’S LEVEL OF UNDERSTANDING
WI TH A PPROPRIATE TEA CHING METHODS
INADEQUATE NUTRITION
LITERACY
• Limit the number of messages to 1 or 2 per session
• Provide specific examples for behavioral changes
• Do not make suggestions implied!!
• Written materials: Use few
• 6th grade reading level or lower
• Active voice
• Common words (i.e. “doctor” vs. “physician”)
• Provide pronunciation key and definition for difficult words, such
as “cholesterol”
• Bullet points vs. paragraphs or sentences
• Simple pictures or illustrations that supplement text
• Adequate white space
MARGINAL NUTRITION LITERACY
• Choose up to 3 messages per session (depending
on time constraints)
• Provide specific examples of behavior changes
• Written materials
•
•
•
•
9th grade reading level or lower
Active voice
Step by step instructions
Simple pictures or illustrations
ADEQUATE NUTRITION LITERACY
• More complex information can be shared, but
avoid overload
APPROPRIATE FOR ALL LEVELS
• Open-ended questions
• Provide written information only if reviewed with
client
• “Teach back” method
• Writing menus
• Choosing foods from restaurant menus
• Naming foods to treat low blood glucose