Nutrition intervention in older populations: Modeling the dietary behavioral intentions of congregate meal site participants

Lionel M. Thomas, Purdue University

Abstract

Individuals of low socioeconomic status have been a focus of the Centers for Disease Control and Prevention (CDC), the United States Department of Health and Human Services, the United States Administration on Aging, and the United States Department of Agriculture (USDA) for years because of their lack of financial resources and access to proper health care, poor dietary practices, and physical inactivity. The amount of concern is increased for older individuals of low socioeconomic status because they have had a lifetime of disadvantages related to health care, resources, and poor dietary practices. Particular concern has been shown for socially isolated rural elderly individuals because of their generally compromised health, poor dietary practices, susceptibility to and mismanagement of chronic diseases, lack of health care insurance, and mistrust of health care services. These aspects of rural culture have made them more susceptible to chronic conditions, encouraging the development of poor dietary habits, and likely dependent on themselves to manage their chronic conditions. Congregate meal site participants often represent rural individuals with low socioeconomic status in need of nutrition assistance. Nutrition interventions are intended to promote healthy lifestyle practices, improve nutrition knowledge, and change the beliefs, attitudes, and behaviors of the older population in hopes that their dietary practices would improve. Designers of nutrition interventions have found that changing the attitudes and beliefs of rural elderly individuals has been a daunting task due to the cultural significance of food, the length of time participants have practiced poor dietary habits, and the quality and quantity of resources available to assist rural elderly individuals with improving their dietary practices. The study used the test-intervention-retest methodology to determine whether nutrition interventions specifically designed for the rural elderly population can help to improve basic awareness of health expert dietary recommendations, beliefs, attitudes, and dietary behavioral intentions. Results of the study show that congregate meal site participants possess knowledge of nutrition recommendations regarding the intake of vegetables, sugar, fatty foods, fiber, sugar, and fruit; however, they were not able to apply this knowledge of appropriate behaviors to specific chronic conditions that these practices may help prevent or improve. Exposure to a month long nutrition intervention did not improve the participants' ability to identify nutrition expert recommendations or pair dietary behaviors with specific conditions; however, participants properly identified the consumption recommendations for all food items except meat. Congregate meal site participants view program aspects associated with socialization to be more important than food-related aspects. However, food-related aspects of the program were viewed as important overall. Participants indicated that they prefer nutritional information to be provided to them in a manner that is practical. Practical to these individuals means that they can consult the nutrition information regarding food items they will consume in the near future. Analysis of the structural equation model paths shows that congregate meal site participants' beliefs about nutritious foods influence both their attitudes about diet and attitudes about the impact of nutrition on health. Their attitudes about diet interact with their attitudes about the impact of nutrition on health and together they influence nutrition-information supported dining intentions. Attitudes about diet influence health-related dining intentions. Attitudes about diet did not have a significant impact on nutrition-information supported dining intentions. Attitudes about the impact of nutrition on health did not have a significant impact on health-related dining intentions. Also, nutrition-information supported dining intentions and health-related dining intentions were not significantly related. This study shows that measuring attitudes toward eating nutritious foods does not provide a complete picture of an individual's dining behaviors. It also suggests that there are many potential influences that can affect the behavioral intentions of congregate meal site participants which include meal site directors, family members, friends, and perceived barriers.

Degree

Ph.D.

Advisors

Ghiselli, Purdue University.

Subject Area

Gerontology|Nutrition

COinS