Implementing Nutrition Education Programs in Congregate Dining Service Settings: A Scoping Review

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.

Culinary Nutrition Education Programs in Community-Dwelling Older Adults: A Scoping Review

“…Programs based on a behaviour change theory showed positive changes in dietary outcomes. This aligns with previous findings in the literature that showed favourable behaviour change using a theoretical framework to design health promotion programs (21,25). Furthermore, findings showed that some study teams engaged with end-users as co-researchers, either through the conducting of focus groups with end users prior the program, and/or conducting of continuous evaluation during program to identify and ensure programs met their population needs.…”

“…Engaging stakeholders and end-users in the design of programs can play a significant role in its effectiveness. Culinary nutrition education and cooking classes are more likely to succeed if they first identify participant needs and involve them in the design process (25,71), as this ensures the program is relevant and beneficial for the stakeholders (72).…”

“…Depending on the style of program delivery and if the program is group-based these programs allow participants to meet new people and expand their social networks (21). Programs based on behavioural theory are more likely to achieve the desired change as they focus on activities that help individuals to reflect upon their risk behaviours and help change them to healthier habits, specifically addressing barriers and facilitators to eating (21,25). Various theoretical frameworks have been used in the design of interventions based on the health problem, intervention goals, and practices (26).…”

Implementing a Community-Based Initiative to Improve Nutritional Intake among Home-Delivered Meal Recipients

“…Some states require that nutrition counseling be provided on an as-needed basis by RDNs specifically, while other states provide nutrition education on a monthly basis by non-RDN professionals who have expertise in nutritional support [ 1 , 20 ]. Although nutrition education has been found to improve outcomes for older adults and is an expectation of federally funded nutrition programs [ 21 ], in 2019, only 7.6% of HDM recipients indicated that they had a nutrition counselor who offered nutritional advice on the basis of their health conditions [ 7 ]. This alarmingly low rate of nutrition counseling provided to HDM recipients is particularly concerning for several reasons.…”

Frequency and gender differences in the use of professional home care in late life. Findings from three German old-age cohorts

“…Moreover, it has been shown that quality of life of the individuals in need of care can be increased through being cared at home (6). Other professional home care services can also be of great benefit for older individuals with e.g., culinary dependencya support need, when someone is not able to prepare all meals by themselves (8,9). Culinary dependency is commonly associated with malnutrition (8) which in turn may have adverse health consequences (10,11).…”