nutrition education for older adults · programs serving older adults zfood stamp program zsenior...

Eat Smart, Live Strong:Eat Smart, Live Strong:Nutrition Education for Older AdultsNutrition Education for Older Adults

Donna Johnson-BaileyUSDA Food and Nutrition Service

American Public Health Association Annual ConferenceNovember 7, 2006

Programs Serving Older AdultsPrograms Serving Older Adults

Food Stamp ProgramSenior Farmer’s Market Nutrition ProgramCommodity Supplemental Food Program Child and Adult Care Food ProgramNutrition Assistance Program in Puerto RicoFood Distribution Program on Indian Reservations. Food pantries Programs specific to local communities

AgeAge

The average older adult participant is 71. (2004)

0 %

1 0 %

2 0 %

3 0 %

4 0 %

A g e

6 0 - 6 4 6 5 - 6 9 7 0 - 7 9 8 0 +

Eat Smart, Live Strong:Eat Smart, Live Strong:Formative ResearchFormative Research

PurposePurpose

Understand the characteristics of older adults Identify interventions with some promise in addressing target behaviorsDevelop a concept to improve eating and physical activity among older adults participating in FNS programs

StepsSteps

Formative ResearchResearch, literature, and resource reviewPromising practices reviewInput from stakeholdersRecommendations for intervention

Promising PracticesPromising Practices ReviewReview

One source for intervention developmentIncreasingly used to develop national interventions and programs Challenge ------ how to guide and organize findings?

What is a What is a Promising Practice? Promising Practice?

An individual program component or activity?An integrated program with many components?A general principle based on many intervention studies?

Sources of DataSources of Data

Published evaluations of interventions (18)

Rated based on 12 criteria

Unpublished descriptions from interviews with program managers (21)

Evaluation data not available

Published review articles (4)Summarized principles – not activities

Recommendations from Recommendations from FindingsFindings

Priority Group (WHO)All needed to be

Low-income, 60 to 74Basically healthy

Test concepts with White, African-American Rural and urbanMajority female Majority living alone

FindingsFindings

Behavior (WHAT)Primary… to eat at least 5 servings of fruits and vegetables every day (at the time research was conducted, 2000 Dietary Guidelines were in effect and this was a successful and prevalent message)

Secondary … to participate in a physical activity on most days of the week

Key Factors/Determinants:Key Factors/Determinants:Eating FV Every DayEating FV Every Day

PsychosocialGive up traditional food; f&v are boring

EnvironmentalLack of social networks – why eat healthy??

Antecedent behaviorsHesitancy to try new food

Key Factors/Determinants:Key Factors/Determinants:Participate in Physical ActivityParticipate in Physical Activity

PsychosocialAnxiety about injuryDoctors recommend

EnvironmentalNo one to show me how Lack of resources

Antecedent behaviorsMake a public commitment Participate in intervention

Formative Research Findings Formative Research Findings Activities (HOW)Activities (HOW)

Didactic sessions and materialsOn benefits of the behaviorsImportant at any ageInformation on ways to exercise safely

Key recommendation from providers: Do MORE than just

didactic health education!!!!!!!!!

Formative Research FindingsFormative Research FindingsActivities (HOW)Activities (HOW)

Individualized goal setting with professional involvement

Motivational content tailored to the audience and theory-based

Tailored program based on readinessIndividual counseling about benefits and ways to overcome barriers


Feedback and monitoring activities

Color coding to record progressSubmit minutes walked

Rewards Coupons at sessionsIncentives for attaining goals


Empowerment and self-efficacy building activities

Recipes and demonstrationsSessions to learn exercise

Active participationGames and contests Role-playingTasting


Social support from professionals

Reminders (phone calls and magnets)Telephone supervision

Social support from peersGroup exercise sessionsMeetings planned by participants


Changes in the environment for long-term change

Meal and congregate eating programsWalking trails

Addressing barriers Food provided through intervention Accident prevention session

Formative Research Formative Research RecommendationRecommendation

Develop an

Activity Kit

Eat Smart, Live StrongEat Smart, Live StrongFormative TestingFormative Testing

PurposePurpose

To develop concepts for a behavior focused intervention for able

bodied, low-income older adults 60-74 years of age.

Key BehaviorsKey Behaviors

Increase fruit and vegetable consumptionParticipate in 30 minutes of physical activity most days of the week

Review Panel Site VisitsMaterials TestingField Review

Concept Development and Concept Development and TestingTesting

Eat Smart, Eat Smart, Live StrongLive Strong

Activity Kit

3 3 ½½ Cups & 30 MinutesCups & 30 Minutes

Message is based on…

1600 calorie dietFemaleSedentaryHave at least 1 chronic conditionRelatively easy to rememberAccurately reflects current DGA recommendations for a significant majority of the target audience

LeaderLeader’’s Guides Guide

• using the sessions• motivating older adults • adapting the materials

for people with physical limitations

• identifying resources for older adults

• promoting the behaviors and the intervention to participants and their communities

Provides guidance and tips about:

Session 1Session 1

Introduce goal settingSelf-assessment of key behaviors

Session 2Session 2

Reviews challenges and solutions specific to this populationEncourages health provider support –SMART Card

Session 3Session 3

Trying new foods through classic recipes Make something old new again; promoting self-efficacy

Session 4Session 4

Addresses cost of fruits and vegetablesPromotes nutrition assistance programs for the older adultsHelps promote awareness about local resources

HandoutsHandouts

Handouts for All SessionsHandouts for All Sessions

nutrition education for older adults · programs serving older adults zfood stamp program zsenior...

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