Understanding Targeting from the Perspective of Program Providers in the Elderly Nutrition Program

Abstract

Providers' perspectives on need, strategies, and challenges are critical in targeting of programs. This study was undertaken to understand the meanings and challenges of targeting from the perspectives of program providers in the Elderly Nutrition Program (ENP). Qualitative in-depth interviews were done with a sample of 36 local ENP providers from six counties in upstate New York. Each interview was tape-recorded, transcribed, and analyzed. Qualitative analysis revealed four distinct meanings of targeting including maximum outreach, reaching out to the most needy, serving only the most needy, and evaluating coverage. Regardless of the meaning or type of targeting, local providers reported universal challenges for outreach, need assessment, and resources in implementing targeting. Understanding these different meanings about targeting could contribute to crafting better targeting policies and program procedures to deliver adequate nutrition service to elders in need in the community.

Helping Older Adults Meet Nutritional Challenges

“…Results from screening and assessment will enable the planning and implementation of tailored and appropriate programs such as meal service, congregate dining or home-delivered meals, group nutrition education or individual counseling, and special dietary prescriptions or nutrient supplements to meet the requirements of the individual. The necessity for nutritional risk screening and its usefulness in program planning and implementation is well documented (Sharkey, 2002(Sharkey, , 2004Weatherspoon et al, 2004;Lee, Frongillo, & Olson, 2005a, 2005b. Besides identifying needs, nutrition risk screening can raise awareness in the elderly regarding health issues, and can target limited resources (Rush, 1997;Chernoff, 2001).…”

Evaluating Nutrition Risk Factors and Other Determinants of Use of an Urban Congregate Meal Program by Older African Americans

“…While the program's design has challenges, it presents opportunity for more immediate local response to shifting population demographics. However, the great flexibility of this decentralized program hampers the formation of consensus on fundamental issues such as factors that influence utilization, barriers impinging on service use, and failure to reach older adults who are most vulnerable (6). Figure 1 illustrates the OAA flow of funds.…”

“…Still, studies are inconclusive as to whether efforts have been successful in reaching the neediest older African Americans. This may be due to local administration of nutrition program services, differences in methodology, or lack of consensus on definitions and standards for who is needy (6,8).…”

“…Program-oriented structural enablers are administrative actions that promote or restrict service use. Structural enablers are program-oriented enablers associated with performing activities to ensure that older adults are made aware of the services and that the services are accessible (6). Both personal and program-oriented structural enablers are examined in the context of this study.…”

“…Yet actual service use will not occur without the presence of program-oriented structural enablers. Studies are inconclusive as to whether efforts have been successful in reaching the neediest older African Americans (6,19,20). Lee, Frongillo, and Olson found that access strategies have not been well-defined, particularly for older adults most in need (6).…”