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Lee JJ, Sultana N, Nishita C. Participant Assessment of an Alternative Flexible Congregate Nutrition Meal Program for Older Adults. J Nutr Gerontol Geriatr 2024; 43:134-150. [PMID: 38915295 DOI: 10.1080/21551197.2024.2367972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/26/2024]
Abstract
Congregate Nutrition Services have long been a pillar of public health assistance, championing the independence and community engagement of older Americans. The advent of COVID-19, however, restricted access to these services due to the closure of physical locations. In response, Lanakila Meals on Wheels initiated a virtual congregate meal program, Kūpuna U, in collaboration with community partners in Honolulu County. The program combined grab-and-go or home-delivered meals with virtual and in-person classes to improve both nutrition and socialization for older adults. This study aimed to capture participant feedback to assess and enhance the Kūpuna U program, developing it as a flexible and scalable congregate meal solution applicable nationwide. Five focus group discussions were conducted with program participants (n = 34). The majority of participants were female (74%), Asian (73%), and living alone (56%). Participants found the program beneficial, enhancing their nutrition, social engagement, and learning experiences on various topics tailored for older adults. Supportive staff played a crucial role in motivating participants to stay engaged. Participants also identified potential enhancements to the program, including more activities and courses, expanded hours, additional in-person options at various locations, and culturally tailored meals.
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Affiliation(s)
- Jenny Jinyoung Lee
- Thompson School of Social Work and Public Health, University of Hawai'i at Mānoa, Honolulu, Hawaii, USA
| | - Nargis Sultana
- Thompson School of Social Work and Public Health, University of Hawai'i at Mānoa, Honolulu, Hawaii, USA
| | - Christy Nishita
- Thompson School of Social Work and Public Health, University of Hawai'i at Mānoa, Honolulu, Hawaii, USA
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2
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Brady PJ, Askelson NM, Thompson H, Kersten S, Hopkins H, Ashida S, Nothwehr F, Janssen B, Frisvold D. A Qualitative Study of Factors Influencing Food Choices and Food Sources Among Adults Aged 50 Years and Older During the Coronavirus Disease 2019 Pandemic. J Acad Nutr Diet 2023; 123:602-613.e5. [PMID: 36055634 PMCID: PMC9428107 DOI: 10.1016/j.jand.2022.08.131] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 08/19/2022] [Accepted: 08/23/2022] [Indexed: 12/01/2022]
Abstract
BACKGROUND The coronavirus disease 2019 pandemic affected food availability and accessibility for many older adults, especially those experiencing food insecurity. Food citizenship is a theoretical framework that encourages the use of alternate over industrial food sources and can characterize where foods are acquired and how food choices are made. OBJECTIVE The purpose of this study is to explore how Iowans aged 50 years and older made choices about what foods to acquire and where to acquire foods during the coronavirus disease 2019 pandemic using food citizenship as a theoretical framework. DESIGN We used in-depth interviews with Iowans aged 50 years and older (N = 60). PARTICIPANTS We recruited respondents through Area Agencies on Aging, food banks, and food pantries. Individuals who contacted the research team, were aged 50 years and older, and spoke English were eligible. Half of the sample screened as food insecure. STATISTICAL ANALYSIS We conducted a thematic analysis to identify recurring themes. RESULTS Food costs, personal preferences, and the healthfulness of food were cited as the most influential factors. Respondents said that the pandemic had not changed how they make choices, but increased prices had made costs more salient. Respondents primarily got their food from industrial food retailers, government programs, or food pantries. More than half of the respondents also acquired food from an alternate food source, such as a farmers' market. Reasons for not using alternate food sources included cost and transportation barriers. CONCLUSIONS It is essential to ensure that older adults have access to affordable, healthy foods, especially during crises such as the coronavirus disease 2019 pandemic. Alternate food sources provided supplementary, healthy food for many respondents, but there are opportunities to expand the use of these food sources. Incentivizing the use of alternate food sources through government programs and connecting the emergency food system to local producers could increase the consumption of healthy food.
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Affiliation(s)
- Patrick J Brady
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, Minnesota.
| | - Natoshia M Askelson
- Department of Community and Behavioral Health, University of Iowa College of Public Health, Iowa City, Iowa; University of Iowa Public Policy Center, Iowa City, Iowa
| | - Helaina Thompson
- Department of Community and Behavioral Health, University of Iowa College of Public Health, Iowa City, Iowa
| | - Sarah Kersten
- Department of Community and Behavioral Health, University of Iowa College of Public Health, Iowa City, Iowa
| | | | - Sato Ashida
- Department of Community and Behavioral Health, University of Iowa College of Public Health, Iowa City, Iowa
| | - Faryle Nothwehr
- Department of Community and Behavioral Health, University of Iowa College of Public Health, Iowa City, Iowa
| | - Brandi Janssen
- Department of Occupational and Environmental Health, University of Iowa College of Public Health, Iowa City, Iowa
| | - David Frisvold
- University of Iowa Public Policy Center, Iowa City, Iowa; Department of Economics, Tippie College of Business, University of Iowa, Iowa City, Iowa
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Aday RH, Wallace JB, Jones SC, Pogacsnik AR, Leifker KF, Kibe-Pea EW. Understanding the Experiences of Food Insecurity in Older Adult Households. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2023; 66:239-262. [PMID: 35833580 DOI: 10.1080/01634372.2022.2098443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 07/01/2022] [Accepted: 07/02/2022] [Indexed: 06/15/2023]
Abstract
Food insecurity is a pressing multidimensional problem that negatively impacts the health and well-being of a significant number of the older population. Finding ways to better address nutritional issues among this vulnerable population is vital to their well-being. Using a mixed-methods approach, we conducted semi-structured phone interviews with a representative sample of 434 low-income older adult households in Tennessee. The aim of this study is to assess the prevalence of food insecurity, examine ongoing barriers, and, using qualitative data, to explore the diverse daily experiences older adults face when confronted with a food insecure lifestyle. Based on the USDA Adult 10-Item Household Screening Module, we found that 30% in our sample were designated as marginally, low or very low food secure. Many of those most vulnerable (older women, widowed or divorced, poor health and below the poverty line) constantly struggled with food insecurity. Being food insecure was attributed to limited financial resources, lack of transportation, health limitations, and a poor psychological state. Utilizing food stretching practicing, governmental agencies offering food supplements, family/friends, religious groups and personal resilience were common coping strategies. Implications and recommendations for service providers are offered.
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Affiliation(s)
- Ronald H Aday
- Department of Sociology & Anthropology, Middle Tennessee State University, Murfreesboro, TN, USA
| | - J Brandon Wallace
- Department of Sociology & Anthropology, Middle Tennessee State University, Murfreesboro, TN, USA
| | - Sandra C Jones
- Department of Psychology/Aging Studies, Middle Tennessee State University, Murfreesboro, TN, USA
| | - Amber R Pogacsnik
- Department of Sociology & Anthropology, Middle Tennessee State University, Murfreesboro, TN, USA
| | - Kimberly F Leifker
- Department of Sociology & Anthropology, Middle Tennessee State University, Murfreesboro, TN, USA
| | - Eva W Kibe-Pea
- Department of Sociology & Anthropology, Middle Tennessee State University, Murfreesboro, TN, USA
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Valliant JC, Burris ME, Czebotar K, Stafford PB, Giroux SA, Babb A, Waldman K, Knudsen DC. Navigating Food Insecurity as a Rural Older Adult: The Importance of Congregate Meal Sites, Social Networks and Transportation Services. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2022. [DOI: 10.1080/19320248.2021.1977208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
| | - Mecca E. Burris
- Sustainable Food Systems Science, The Ostrom Workshop, Indiana University, Bloomington, Indiana USA
| | - Kamila Czebotar
- Food Institute, Indiana University, Bloomington, Indiana USA
| | - Philip B. Stafford
- Sustainable Food Systems Science, The Ostrom Workshop, Indiana University, Bloomington, Indiana USA
| | - Stacey A. Giroux
- Department of Anthropology, Indiana University, Bloomington, Indiana USA
- Sustainable Food Systems Science, The Ostrom Workshop, Indiana University, Bloomington, Indiana USA
| | - Angela Babb
- Department of Anthropology, Indiana University, Bloomington, Indiana USA
| | - Kurt Waldman
- Food Institute, Indiana University, Bloomington, Indiana USA
| | - Daniel C. Knudsen
- Food Institute, Indiana University, Bloomington, Indiana USA
- Department of Geography, Indiana University, Bloomington, Indiana USA
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Brady PJ, Askelson NM, Thompson H, Ashida S, Nothwehr F, Janssen B, Frisvold D. Perceived Food-Related Responsibilities among Adults Aged 60 Years and Older. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2022. [DOI: 10.1080/19320248.2022.2088264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Patrick J. Brady
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, Minnesota, USA
| | - Natoshia M. Askelson
- Department of Community and Behavioral Health, University of Iowa College of Public Health, Iowa City, Iowa, USA
- University of Iowa Public Policy Center, Iowa City, Iowa, USA
| | - Helaina Thompson
- Department of Community and Behavioral Health, University of Iowa College of Public Health, Iowa City, Iowa, USA
| | - Sato Ashida
- Department of Community and Behavioral Health, University of Iowa College of Public Health, Iowa City, Iowa, USA
| | - Faryle Nothwehr
- Department of Community and Behavioral Health, University of Iowa College of Public Health, Iowa City, Iowa, USA
| | - Brandi Janssen
- Department of Occupational and Environmental Health, University of Iowa College of Public Health, Iowa City, Iowa, USA
| | - David Frisvold
- University of Iowa Public Policy Center, Iowa City, Iowa, USA
- Department of Economics, Tippie College of Business, University of Iowa, Iowa City, Iowa, USA
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Brady PJ, Askelson NM, Thompson H, Kersten S, Hopkins H. Meeting Older Adults' Food Needs: Interviews with Area Agency on Aging Staff, Food Bank Staff, and Older Adults. J Nutr Gerontol Geriatr 2022; 41:235-255. [PMID: 36016490 PMCID: PMC9679729 DOI: 10.1080/21551197.2022.2114569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
Area Agencies on Aging (AAAs) and food banks provide nutritious food for in-need older adults. The objective of this study was to identify successes, challenges, and opportunities associated with meeting the food needs of older adults. We used semi-structured telephone interviews with AAA nutrition staff (n = 5), food bank program coordinators (n = 5) and executives (n = 6), and older adults (n = 60) in Iowa. AAAs and food banks identified providing healthy food and client satisfaction as successes and funding and staff/volunteer capacity as challenges. Before the pandemic, the relationships between these organizations were limited, but both saw opportunities for collaboration. Older adults described coordination between AAAs and food banks during the COVID-19 crisis. AAAs and food banks play an important role in meeting older adults' food needs, but their effectiveness is limited by challenges related to funding and capacity. There is a need to identify feasible and sustainable strategies for collaboration past this crisis.
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Affiliation(s)
- Patrick J. Brady
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, 1300 S 2 Street Suite 300, Minneapolis, MN, 55455
| | - Natoshia M. Askelson
- Department of Community and Behavioral Health, University of Iowa College of Public Health, 145 N. Riverside Drive, Iowa City, IA 52246
- University of Iowa Public Policy Center, 310 S Grand Ave, Iowa City, IA 52242
| | - Helaina Thompson
- Department of Community and Behavioral Health, University of Iowa College of Public Health, 145 N. Riverside Drive, Iowa City, IA 52246
| | - Sarah Kersten
- Department of Community and Behavioral Health, University of Iowa College of Public Health, 145 N. Riverside Drive, Iowa City, IA 52246
| | - Haley Hopkins
- Iowa Department of Public Health, 321 E. 12 Street, Des Moines, IA, 50319
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Juckett LA, Hariharan G, Dodonova DC, Klaus J, Rowe M, Burak E, Mason B, Bunck L. Implementing a Community-Based Initiative to Improve Nutritional Intake among Home-Delivered Meal Recipients. Nutrients 2022; 14:nu14050944. [PMID: 35267919 PMCID: PMC8912420 DOI: 10.3390/nu14050944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 02/16/2022] [Accepted: 02/17/2022] [Indexed: 11/27/2022] Open
Abstract
Home-delivered meal (HDM) recipients are a highly vulnerable group of older adults at risk for malnutrition and subsequent health decline. To help HDM recipients increase their nutritional intake, HDM agencies may provide expanded meal options that allow older adults to have greater autonomy over their meal selection; however, the extent to which recipients are able to select nutritious meals that are responsive to their health complexities is unknown. This study examined the nutritional content of meals selected by HDM recipients enrolled in an expanded menu plan through a large HDM agency. Data were drawn from a retrospective chart review of 130 HDM recipients who had the option of selecting their own HDM meals and frequency of meal delivery. Findings indicate that older adults who selected their own meals chose meals that were significantly lower in protein, potassium, fat, and calories. The lack of these nutrients suggests that older adults enrolled in expanded menu plans should be referred to registered dietitian nutritionists who can provide skilled guidance in meal selection. To address this need, we also describe and provide preliminary data representing a referral program designed to connect HDM recipients to dietetic services with the goal of optimizing older adult nutrition and health-related outcomes.
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Affiliation(s)
- Lisa A. Juckett
- School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, OH 43210-2205, USA
- Correspondence: ; Tel.: +1-614-366-7543
| | - Govind Hariharan
- Coles College of Business, Kennesaw State University, Kennesaw, GA 30144-0405, USA; (G.H.); (D.C.D.)
| | - Dimitri Camargo Dodonova
- Coles College of Business, Kennesaw State University, Kennesaw, GA 30144-0405, USA; (G.H.); (D.C.D.)
| | - Jared Klaus
- Lifecare Alliance, Columbus, OH 43223-1809, USA; (J.K.); (M.R.); (E.B.); (B.M.); (L.B.)
| | - Melinda Rowe
- Lifecare Alliance, Columbus, OH 43223-1809, USA; (J.K.); (M.R.); (E.B.); (B.M.); (L.B.)
| | - Elana Burak
- Lifecare Alliance, Columbus, OH 43223-1809, USA; (J.K.); (M.R.); (E.B.); (B.M.); (L.B.)
| | - Benetta Mason
- Lifecare Alliance, Columbus, OH 43223-1809, USA; (J.K.); (M.R.); (E.B.); (B.M.); (L.B.)
| | - Leah Bunck
- Lifecare Alliance, Columbus, OH 43223-1809, USA; (J.K.); (M.R.); (E.B.); (B.M.); (L.B.)
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Brady PJ, Askelson NM, Ashida S, Nothwehr F, Janssen B, Frisvold D. The Relationship between Political, Economic, Social, and Cultural Vulnerability and Food Insecurity among Adults Aged 50 Years and Older. Nutrients 2021; 13:3896. [PMID: 34836150 PMCID: PMC8618552 DOI: 10.3390/nu13113896] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 10/27/2021] [Accepted: 10/29/2021] [Indexed: 11/17/2022] Open
Abstract
Individuals experience food insecurity when they worry about or have limited access to nutritious foods. Food insecurity negatively impacts older adults' health. Social exclusion is a theoretical framework describing how unequal access to rights, resources, and capabilities results in political, economic, social, and cultural vulnerability, which leads to health disparities. We used the Health and Retirement Study to cross-sectionally examine associations between vulnerability and experiencing food insecurity in adults 50 years and older using the social exclusion framework. We tested the association between experiencing food insecurity and indicators of political, economic, social, and cultural vulnerability using logistic regression controlling for demographic and health-related factors. Analyses were performed with all respondents and sub-group of respondents with incomes less than 400% of the federal poverty level (FPL). Assets (OR = 0.97 in both samples), income (OR = 0.85, 0.80 in 400% FPL sub-sample), perceived positive social support from other family (OR = 0.86, 0.84 in 400% FPL sub-sample), and perceived everyday discrimination (OR = 1.68, 1.82 in 400% FPL sub-sample) were significantly associated with food insecurity. Perceived positive social support from spouses, children, or friends and U.S. citizenship status were not significantly associated with food insecurity. Further research is needed to define and measure each dimension of vulnerability in the social exclusion framework. Interventions and policies designed to prevent food insecurity should address these vulnerabilities.
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Affiliation(s)
- Patrick J. Brady
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 420 Delaware Street SE, Minneapolis, MN 55455, USA
| | - Natoshia M. Askelson
- Department of Community and Behavioral Health, College of Public Health, University of Iowa, 145 N Riverside Drive, Iowa City, IA 52246, USA; (N.M.A.); (S.A.); (F.N.)
- Health Policy Research Program, Public Policy Center, University of Iowa, 310 S Grand Ave., Iowa City, IA 52242, USA
| | - Sato Ashida
- Department of Community and Behavioral Health, College of Public Health, University of Iowa, 145 N Riverside Drive, Iowa City, IA 52246, USA; (N.M.A.); (S.A.); (F.N.)
| | - Faryle Nothwehr
- Department of Community and Behavioral Health, College of Public Health, University of Iowa, 145 N Riverside Drive, Iowa City, IA 52246, USA; (N.M.A.); (S.A.); (F.N.)
| | - Brandi Janssen
- Department of Occupational and Environmental Health, College of Public Health, University of Iowa, 145 N Riverside Drive, Iowa City, IA 52246, USA;
| | - David Frisvold
- Department of Economics, Tippie College of Business, University of Iowa, 21 E Market Street, Iowa City, IA 52242, USA;
- Social and Education Policy Research Program, Public Policy Center, University of Iowa, 310 S Grand Ave., Iowa City, IA 52242, USA
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9
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Mills CM. Food Insecurity in Older Adults in Canada and the United States: A Concept Analysis. CAN J DIET PRACT RES 2021; 82:200-208. [PMID: 34286614 DOI: 10.3148/cjdpr-2021-016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
A concept analysis using the method of Walker and Avant was undertaken to clarify the concept of food insecurity in older adults in Canada and the United States. A literature review was undertaken to conduct a concept analysis of food insecurity in older people. Food insecurity is associated with multiple negative health outcomes and may be experienced differently by older adults as compared to younger adults. It is therefore important to understand the concept of food insecurity as is relates to older adults. Four defining attributes of food insecurity in older adults in Canada and the United States were identified: (i) inability to acquire or prepare enough food, (ii) compromising on food quality or preference, (iii) uncertainty or anxiety around the ability to acquire or prepare food, and (iv) socially unacceptable or non-normative practices. These attributes may allow for improved policies and programs aimed at addressing food insecurity in older adults by better meeting the needs of older individuals. Additional research into food insecurity as experienced by Canadian and American older adults could help to further clarify the concept.
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Affiliation(s)
- Christine Marie Mills
- School of Rehabilitation Therapy, Aging and Health, Queen's University, Kingston, ON
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Sadarangani T, Chong S, Park S, Missaelides L, Johnson J, Trinh-Shevrin C, Brody A. A Qualitative Analysis of the Delivery of Person-Centered Nutrition to Asian Americans With Dementia in the Adult Day Health Care Setting. J Appl Gerontol 2021; 40:179-188. [PMID: 32129126 PMCID: PMC7483203 DOI: 10.1177/0733464820910030] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Adult day service centers (ADSCs) provide community-based long-term care, including meals, to racially diverse older adults, 47% of whom have dementia and consequently experience elevated nutritional risk. We examine nutritional behaviors for Chinese and Vietnamese persons living with dementia (PLWD) in ADSCs and evaluate the extent to which ADSCs provide person-centered nutritional care. Multi-stakeholder interviews were conducted. Data were coded using Dedoose and analyzed using Braun and Clarke's six-step method. The Model for the Provision of Good Nutritional Care in Dementia guided analysis. Barriers to food intake included distracting meal environment, rigid mealtimes, and excessively restrictive diets. Conversely, peer relationships, culturally tailored meals and celebrations, and consistent staff assisting with feeding benefited PLWD. ADSCs can support healthy nutritional behaviors and quality of life among PLWD through person-centered nutritional care. To optimize nutritional services, further exploration is needed with respect to the ADSC environment, users' culture and ethnicity, and liberalized diets for PLWD.
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Affiliation(s)
- Tina Sadarangani
- New York University Rory Meyers College of Nursing, New York, New York, United States
| | - Stella Chong
- New York University Langone Health, New York, New York
| | - Susie Park
- New York University Rory Meyers College of Nursing, New York, NY
| | | | | | | | - Abraham Brody
- New York University School of Medicine, New York, New York
- Hartford Institute for Geriatric Nursing, New York University Rory Meyers College of Nursing, New York, New York
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Crowley J. Social Vulnerability Factors and Reported Post-Disaster Needs in the Aftermath of Hurricane Florence. INTERNATIONAL JOURNAL OF DISASTER RISK SCIENCE 2021; 12:13-23. [PMCID: PMC7607545 DOI: 10.1007/s13753-020-00315-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/18/2020] [Indexed: 06/24/2024]
Abstract
This research examines the relationship between social vulnerability factors and reported needs following Hurricane Florence. Weighted least squares regression models were used to identify predictor variables for valid registrations that reported needs pertaining to emergencies, food, and shelter. Data consisted of zip codes in North Carolina and South Carolina that received individual assistance for Hurricane Florence (N = 406). The results suggest that when controlling for event-specific factors and flood mitigation factors, the proportions of the population that is female, the population over 65, the population aged 5 and under, the population older than 5 years not speaking English, and the minority population were all predictors of the per capita reported emergency needs. When controlling for the same variables, the proportions of the population over the age of 25 with a Bachelor’s degree, the female population, the population aged 5 and under, the population above 5 years old that does not speak English, and the minority population were all predictors of the per capita reported food needs. With the same variables controlled for, three variables—the proportions of the population over 65, the population aged 5 and under, and the non-English-speaking population above 5 years of age—were all predictors of the per capita reported shelter needs. The results suggest that more attention should be given to these vulnerable populations in the pre-disaster planning process.
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Affiliation(s)
- Julia Crowley
- Department of Criminology and Criminal Justice, Western Carolina University, Cullowhee, NC 28723 USA
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Sadarangani TR, Beasley JM, Yi SS, Chodosh J. Enriching Nutrition Programs to Better Serve the Needs of a Diversifying Aging Population. FAMILY & COMMUNITY HEALTH 2020; 43:100-105. [PMID: 32079966 PMCID: PMC7880699 DOI: 10.1097/fch.0000000000000250] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Racial minorities experience a high burden of food insecurity relative to non-Hispanic whites. Government-subsidized nutrition programs can positively impact food insecurity and nutritional risk among older adults. Yet, in New York City, where nearly 60% of people over 65 years are non-white, older minorities participate in government nutrition programs at very low rates. In this commentary, we focus on 2 programs: the Child and Adult Care Food Program and Older Americans Act Nutrition Services Programs. We identify opportunities for strengthening these programs to improve their reach and engagement with diverse older adults in New York City and similarly diverse urban communities.
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Affiliation(s)
- Tina R Sadarangani
- NYU Rory Meyers College of Nursing, New York (Dr Sadarangani); Departments of Medicine (Drs Beasley and Chodosh) and Population Health (Drs Yi and Chodosh), NYU School of Medicine, New York; and VA New York Harbor Healthcare System, New York (Dr Chodosh)
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13
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Rockler BE, Grutzmacher S, Smit E, Notarianni M. Participant Perceptions of the Double Up Food Bucks Program at Oregon Farmers' Markets. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2020; 52:1043-1051. [PMID: 32268970 DOI: 10.1016/j.jneb.2020.02.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 02/19/2020] [Accepted: 02/24/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE To explore perceptions of program impact among Double Up Food Bucks participants in Oregon. METHODS Data were collected from 1,223 Double Up Food Bucks participants at 42 Oregon farmers' markets. Chi-square tests of independence and logistic regressions were used to examine associations among key variables. RESULTS Most participants reported buying more fruits and vegetables (FVs) (91.0%), trying new FV types (82.2%), eating less processed food (69.8%), having more food available at home (81.1%), and perceiving improvements in health (87.9%). Perceptions of affordability were higher among younger adults (P < 0.001) and households with 3-5 people (P = 0.02), with children (P < 0.001), and without chronic disease (P = 0.003). Perceptions of increased FV purchases were higher in households with children (P = 0.009) and reported overall health improvements were higher among non-White participants (P = 0.04). Perceptions of increased FV purchases and affordability were associated with other positive program outcomes. CONCLUSIONS AND IMPLICATIONS Participants may perceive barriers to purchasing FVs from farmers' markets, which are not fully addressed by the increased purchasing power from a FV incentive. Targeted redesign, outreach, and education may improve program experiences among groups with less positive perceptions. Further research to identify explanations for variation in program experience is needed.
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Affiliation(s)
- Briana E Rockler
- School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR.
| | - Stephanie Grutzmacher
- School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR
| | - Ellen Smit
- School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR
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Juckett LA, Lee K, Bunger AC, Brostow DP. Implementing Nutrition Education Programs in Congregate Dining Service Settings: A Scoping Review. THE GERONTOLOGIST 2020; 62:e82-e96. [PMID: 32833007 DOI: 10.1093/geront/gnaa109] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Nutrition education programs implemented in congregate dining service (CDS) settings have the potential to improve healthy eating behaviors among older adult populations. However, little is understood about the types of nutrition education programs that are implemented at CDS sites and the factors that impede or promote implementation efforts. The purpose of this scoping review was to examine the characteristics of CDS nutrition education programs, barriers and supports to program implementation, and opportunities to enhance implementation of programming. RESEARCH DESIGN AND METHODS We adopted a scoping review methodology to assess the relevant literature published January 2000 - January 2020 by accessing CINAHL, SocINDEX, MEDLINE, AgeLine, and Academic Search Complete. RESULTS We identified 18 studies that met our inclusion criteria. The majority of nutrition education programs were led by trained facilitators, included the use of interactive activities, and also incorporated written or video materials. Programs that were adapted to the needs of older participants were perceived as supports to implementation whereas participants' needs and resources (e.g., lack of resources, lower health literacy) were occasionally found to limit effective implementation of programming. DISCUSSION AND IMPLICATIONS As the older adult population continues to access CDS sites to address their health and nutritional needs, purposeful efforts are needed to examine the specific approaches that can support nutrition education program implementation. Future research is needed to assess strategies that are effective for mitigating barriers to implementing nutrition education programming in the CDS setting.
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Affiliation(s)
- Lisa A Juckett
- Division of Occupational Therapy, School of Health and Rehabilitation Sciences, The Ohio State University, Columbus
| | - Kathy Lee
- School of Social Work, University of Texas at Arlington
| | | | - Diana P Brostow
- Department of Veterans Affairs, Rocky Mountain Mental Illness Research Education and Clinical Center, Aurora, Colorado
- School of Medicine, University of Colorado-Anschutz Medical Campus, Aurora
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15
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Petersen CL, Brooks JM, Titus AJ, Vasquez E, Batsis JA. Relationship Between Food Insecurity and Functional Limitations in Older Adults from 2005-2014 NHANES. J Nutr Gerontol Geriatr 2019; 38:231-246. [PMID: 31144612 DOI: 10.1080/21551197.2019.1617219] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Background: Food insecurity refers to the physical, social, and economic inability to access and secure sufficient, safe and nutritious food. Food insecurity has been found to be associated with poor health status, obesity, and chronic disease. To date, a relationship between food insecurity and functional limitations has not been described in of older adults. Methods: We examined 9309 adults ≥60 years old from the 2005-2014 National Health and Nutrition Examination Surveys (NHANES). Food security was categorized as full, marginal, low, and very low. Functional limitations were assessed as having difficulty in physical, basic or instrumental activities of daily living. Results: Of adults ≥60 years old (mean age: 70.5 ± 0.08, 51% female), the prevalence of full, marginal, low, or very low food insecurity was 7572 (81%), 717 (7%), 667 (8%), and 353 (4%), respectively. The prevalence of any functional limitations was 5895 (66.3%). The adjusted odds (OR [95%CI]) of having any functional limitation in marginal, low, and very low food security levels compared to full food security are: 1.08 [1.02-1.13], 1.16 [1.10-1.22], 1.14 [1.07-1.21], respectively. The association between levels of food insecurity and functional limitation is modified by race/ethnicity. Conclusions: Functional limitation is significantly associated with increasing food insecurity in older adults.
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Affiliation(s)
- Curtis L Petersen
- a The Dartmouth Institute for Health Policy & Clinical Practice, Geisel School of Medicine at Dartmouth , Lebanon , NH , USA.,b Department of Epidemiology, Geisel School of Medicine at Dartmouth , Lebanon , NH , USA.,c Quantitative Biomedical Sciences Program, Geisel School of Medicine at Dartmouth , Lebanon , NH , USA
| | - Jessica M Brooks
- d Department of Psychiatry, Geisel School of Medicine and Centers for Health and Aging, Dartmouth College , Lebanon , NH , USA.,e Department of Rehabilitation and Health Services, University of North Texas , Denton , TX , USA
| | - Alexander J Titus
- b Department of Epidemiology, Geisel School of Medicine at Dartmouth , Lebanon , NH , USA.,c Quantitative Biomedical Sciences Program, Geisel School of Medicine at Dartmouth , Lebanon , NH , USA
| | - Elizabeth Vasquez
- f Department of Epidemiology, School of Public Health, SUNY Albany , Albany , NY , USA
| | - John A Batsis
- a The Dartmouth Institute for Health Policy & Clinical Practice, Geisel School of Medicine at Dartmouth , Lebanon , NH , USA.,g Sections of General Internal Medicine and Weight & Wellness Center, Dartmouth-Hitchcock , Lebanon , NH , USA
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Oldewage-Theron W, Abu BAZ, Nguyen B, Saha S. Food insecurity and food access among seniors in Lubbock, Texas. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2018. [DOI: 10.1080/19320248.2018.1512920] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Wilna Oldewage-Theron
- College of Human Sciences, Department of Nutritional Sciences, Texas Tech University, Lubbock, Texas, USA
| | - Brenda A. Z. Abu
- College of Human Sciences, Department of Nutritional Sciences, Texas Tech University, Lubbock, Texas, USA
- Wegmans School of Health and Nutrition, College of Health Sciences and Technology, Rochester Institute of Technology, Rochester, New York, USA
| | - Bong Nguyen
- College of Human Sciences, Department of Nutritional Sciences, Texas Tech University, Lubbock, Texas, USA
| | - Sanjoy Saha
- College of Human Sciences, Department of Nutritional Sciences, Texas Tech University, Lubbock, Texas, USA
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17
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Grønning K, Espnes GA, Nguyen C, Rodrigues AMF, Gregorio MJ, Sousa R, Canhão H, André B. Psychological distress in elderly people is associated with diet, wellbeing, health status, social support and physical functioning- a HUNT3 study. BMC Geriatr 2018; 18:205. [PMID: 30180808 PMCID: PMC6123986 DOI: 10.1186/s12877-018-0891-3] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Accepted: 08/24/2018] [Indexed: 11/16/2022] Open
Abstract
Background The increasing proportion of people growing old, demands expanded knowledge of how people can experience successful aging. Having a good life while growing old is dependent on several factors such as nutrition, physical health, the ability to perform activities of daily living, lifestyle and psychological health. Furthermore, unhealthy food intake is found to be a modifiable risk factor for depression in elderly people. To promote elderly’s health and wellbeing, the influence of nutrition, lifestyle, physical functioning, and social support on psychological distress needs exploring. Therefore, the purpose of this present study is to investigate the associations between psychological distress and diet patterns when adjusting for other life style behaviors, wellbeing, health status, physical functioning and social support in elderly people. Methods The present study is cross sectional, using data from wave three of the Nord-Trøndelag Health Study (2006–2008). Data include psychological distress measured by the Hospital Anxiety and Depression Scale (HADS), sociodemographic information, measurements of lifestyle behaviours (including diet patterns), wellbeing, health status, social support and physical functioning. Results The sample consisted of 11,621 participants, 65 years or older. Cluster analysis categorized the participants in two food clusters based on similarities in food consumption (healthy N = 9128, unhealthy N = 2493). Stepwise multivariable linear regression analyses revealed that lesser psychological distress in the elderly was dependent on gender, diet, smoking, better scores on health and wellbeing, social support and less problems performing instrumental activities of daily living. Conclusion Knowledge about the influence of diet patterns in relation to psychological distress provide valuable insights into how society can promote healthy lifestyles to an ageing population, e.g. by increasing older people’s food knowledge.
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Affiliation(s)
- Kjersti Grønning
- Department of Public Health and Nursing, Center for Health Promotion Research, Norwegian University of Science and Technology (NTNU), Postbox 8905, 7491, Trondheim, Norway.
| | - Geir A Espnes
- Department of Public Health and Nursing, Center for Health Promotion Research, Norwegian University of Science and Technology (NTNU), Postbox 8905, 7491, Trondheim, Norway
| | - Camilla Nguyen
- Department of Public Health and Nursing, Center for Health Promotion Research, Norwegian University of Science and Technology (NTNU), Postbox 8905, 7491, Trondheim, Norway
| | - Ana Maria Ferreira Rodrigues
- CEDOC, EpiDoC Unit, NOVA Medical School, Universidade Nova de Lisboa, Lisbon, Portugal.,EpiSaude Association, Evora, Portugal
| | - Maria Joao Gregorio
- CEDOC, EpiDoC Unit, NOVA Medical School, Universidade Nova de Lisboa, Lisbon, Portugal.,EpiSaude Association, Evora, Portugal
| | - Rute Sousa
- CEDOC, EpiDoC Unit, NOVA Medical School, Universidade Nova de Lisboa, Lisbon, Portugal.,EpiSaude Association, Evora, Portugal
| | - Helena Canhão
- CEDOC, EpiDoC Unit, NOVA Medical School, Universidade Nova de Lisboa, Lisbon, Portugal.,EpiSaude Association, Evora, Portugal
| | - Beate André
- Department of Public Health and Nursing, Center for Health Promotion Research, Norwegian University of Science and Technology (NTNU), Postbox 8905, 7491, Trondheim, Norway
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Sheppard CL, Dubé L, Ducak K, Myers AM. Development and Evaluation of Let's Do Lunch: A Congregate Meal Program at an Urban Senior Center. J Nutr Gerontol Geriatr 2018; 37:49-58. [PMID: 29913115 DOI: 10.1080/21551197.2018.1478760] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
A mixed-methods needs assessment was conducted in an urban senior center serving lower-income seniors in Toronto, Ontario, to determine whether they should offer a congregate meal program. Methods included three focus groups with participants (n = 31), a focus group with staff (n = 8), a center-wide survey (n = 36), and a community scan of programs in the area. Interviews with five coordinators at other seniors' centers who offered meal programs were also used to gauge interest and assist with program development. The results of these activities supported offering a twice weekly lunch program with user fees. Over a 6-month pilot period, process evaluation was conducted, comprising observations, record review, and focus groups with participants (n = 9) and staff/volunteers (n = 7) to examine delivery, usage, and costs. Results indicated that the program was well-received and affordable, and that demands on staff were reasonable when a facilitator with culinary training was available. The lessons learned can be used to guide other senior centers in developing and evaluating congregate meal programs.
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Affiliation(s)
- Christine L Sheppard
- a School of Public Health and Health Systems , University of Waterloo , Waterloo , ON , Canada
| | - Lise Dubé
- a School of Public Health and Health Systems , University of Waterloo , Waterloo , ON , Canada
| | - Kate Ducak
- a School of Public Health and Health Systems , University of Waterloo , Waterloo , ON , Canada
| | - Anita M Myers
- a School of Public Health and Health Systems , University of Waterloo , Waterloo , ON , Canada
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O'Dare Wilson K. Community food environments and healthy food access among older adults: A review of the evidence for the Senior Farmers' Market Nutrition Program (SFMNP). SOCIAL WORK IN HEALTH CARE 2017; 56:227-243. [PMID: 28271967 DOI: 10.1080/00981389.2016.1265631] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Although an array of federal, state, and local programs exist that target food insecurity and the specific nutritional needs of seniors, food insecurity among older adults in the United States remains a persistent problem, particularly in minority and rural populations. Food insecurity is highly predictive of inadequate fresh fruit and vegetable (FFV) consumption in particular. The Senior Farmers' Market Nutrition Program (SFMNP) is a community-based program to help seniors purchase FFVs at farmer's markets in their neighborhoods. The SFMNP continues to grow; however, little is known about the effectiveness of the program. The purposes of this article are to (1) highlight the importance of community and neighborhood based food insecurity programs, specifically emphasizing the importance of FFV access for seniors, (2) review the current state of the evidence on the SFMNP, and (3) provide recommendations for researchers and policy-makers wishing to continue to advance the knowledge base in neighborhood-based food security among older adults.
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Affiliation(s)
- Kellie O'Dare Wilson
- a Department of Social Work , University of West Florida , Pensacola , Florida , USA
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20
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Brostow DP, Gunzburger E, Thomas KS. Food Insecurity among Veterans: Findings from the Health and Retirement Study. J Nutr Health Aging 2017; 21:1358-1364. [PMID: 29188901 DOI: 10.1007/s12603-017-0910-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVES We examined the prevalence of food insecurity in an older population, specifically assessing factors associated with food insecurity among U.S. military Veterans. METHODS Data from the 2012 wave of the Health and Retirement Study and the 2013 Health Care and Nutrition Mail Survey of 2560 male participants (1254 Veterans) were used to estimate the prevalence of food insecurity and to identify significant predictors of food insecurity among male Veterans. RESULTS Among male Veterans, 6.4% reported food insecurity, compared to 11.9% of male non-veterans (p < 0.01). Younger age, difficulty with daily activities and depression were significantly associated with increased odds of food insecurity among male Veterans aged 50 to 64. In male Veterans age 65 years and older, current smoking, a psychiatric diagnosis and depression were significantly associated with increased odds of food insecurity. CONCLUSIONS This study identified significant factors that may be used to target interventions to improve nutritional status among older male Veterans.
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Affiliation(s)
- D P Brostow
- Diana P. Brostow, Denver VA Medical Center, 1055 Clermont St. Denver, CO 80220 USA,
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Abstract
The number of older adults living in the USA, 65 years of age and older, has been steadily increasing. Data from the National Health and Nutrition Examination Survey (NHANES), 2007-2010, indicate that more than one-third of older adults, 65 years of age and older, were obese. With the increased rate of obesity in older adults, the purpose of this paper is to present research on different methods to prevent or manage obesity in older adults, namely dietary interventions, physical activity interventions, and a combination of dietary and physical activity interventions. In addition, research on community assistance programs in the prevention of obesity with aging will be discussed. Finally, data on federal programs for older adults will also be presented.
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Affiliation(s)
- Stella Lucia Volpe
- Department of Nutrition Sciences, Drexel University, Room 381, 3rd Floor, Parkway Building, 1601 Cherry Street, Mail Stop 31030, Philadelphia, PA, 19102, USA.
| | - Deeptha Sukumar
- Department of Nutrition Sciences, Drexel University, Room 381, 3rd Floor, Parkway Building, 1601 Cherry Street, Mail Stop 31030, Philadelphia, PA, 19102, USA
| | - Brandy-Joe Milliron
- Department of Nutrition Sciences, Drexel University, Room 381, 3rd Floor, Parkway Building, 1601 Cherry Street, Mail Stop 31030, Philadelphia, PA, 19102, USA
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