Title: Healthy Eating for Successful Living in Older AdultsTM
1Healthy Eating for Successful Living in Older
AdultsTM
- NCOA Model Programs Project Boston Team
- National Council on Aging/American Society on
Aging Joint conference - Mar 15, 2006
- Anaheim California
-
2NCOA Model Programs Project
- Developed, tested and disseminated four
evidence-based model health programs - Models designed to improve health of older adults
and be readily implemented by community-based
aging services organizations - Utilized regional advisory panels
- Four model programs
- Physical Activity-Los Angeles, CA
- Depression-Houston, TX
- Diabetes Self Management-Portland, OR
- Nutrition-Boston, MA
3Key Concepts Incorporated into the Model Program
Design
- Linkages among community agencies and primary
health care and/or mental health providers - Evidence-based effective approaches to behavior
change included - Promoting older adults central role in managing
his/her health - Recognizing the importance of promotion and
prevention
4Key Concepts Incorporated into the Model Program
Design
- Evidence-based effective approaches to behavior
change included - Providing older adult with the skills of goal
setting, action planning and problem solving - Providing ample opportunity to practice these new
behaviors - Encouraging peer support
- Talking about health promotion, not illness and
disability
5Advantages of Evidence-based Approach
- Increases likelihood of successful outcomes when
agencies move away from decision-making that
relies too heavily on history, anecdotes and
pressure from policy makers - Enhances the ability to use common health
indicators and match health programs to needs - Makes it easier to defend or expand an existing
program - Provides hard data to advocate for new programs
- Generates new knowledge about what works and
how to do it that can help others
6The Nutritional Model Program Healthy Eating
for Successful Living in Older Adults
7The Team
- Joseph Carlin MS,MA,RD, FADA
- Regional Nutrition Specialist, Administration on
Aging - Shirley Chao MS, RD, LD/N
- Director of Nutritional Services,
- MA Executive Office of Elder Affairs
- Rosanne DiStefano, MUA
- Executive Director
- Elder Services of Merrimack Valley
- Marta Frank MS
- Executive Director,
- Boston Home Care
- Ruth Palombo PhD, RD
- Assistant Professor of Public Health and Family
Medicine - Tufts University
- Margie Doyle MBA
- Program Director, Lahey Clinic
- Chris Economos PhD
- Jean Mayer USDA Human Nutrition
- Tufts University
- Robert Schreiber, MD
- Team Leader
8Why Nutrition Chosen?
- It is critically important in aging population
- Epidemic of arteriosclerosis vascular disease,
diabetes and osteoporosis - There is clear evidence documenting the
effectiveness of sound nutritional strategies in
preventing progression or prevention of disease
in diabetes, hypertension, CAD, cancer
9Essential Elements for Successful Behavior Change
- Goal Setting
- Problem Solving
- Action-planning
- On-going support
- Monitoring
10Goals of Healthy Eating for Successful Living
- Designed to increase knowledge about enhancing
heart and bone health through healthy diet
choices and physical activity - Adapt to culturally diverse populations
- Foster improvement in nutrition life-style to all
seniors through peer-led behavioral change - Participants learn how to set reasonable goals
and solve problems related to common nutrition
self-management issues, what community resources
are available and how to use them
11The Nutrition Program
- Six sessions meet weekly for 21/2 hours
- A restaurant outing to test knowledge and skills
is included as a seventh session - Focus on heart and bone health
- Peer leaders are trained to facilitate using
scripted curriculum - Registered Dietitian/ Nutritionist serves as a
resource - Classes are small 8-12 facilitating active group
participation
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13Main Components of the Program
- Self-assessment and management of dietary
patterns by each participant - Goal setting, problem solving, and group support
- Education, relying on both group interaction and
the expertise of a Registered Dietitian/Nutritioni
st, when needed - Behavior change strategies
14Target Populations
- Over age 60 cognitively intact
- Mobile, ability to attend programs
- Held in community based site
- Senior or community centers, congregate housing,
religious centers and community dining center. - Need to have access to food or have someone who
will be able to provide food
15Framework of the Intervention
- Uses My Pyramid as the central framework to help
participants create a nutritional lifestyle that
meets individual needs - Sessions are highly participatory with distinct
components - Education
- Hands-on activities
- Support
- Resource connections
16Outline of the Sessions
- Week 1 My Pyramid, Dietary Guidelines,
Water and Exercise - Week 2 Grains, Fruits, Vegetables and Water
- Week 3 Meat , Eggs, Legumes, Milk and Exercise
- Week 4 Milk, Sweets, Fats, and Exercise
- Week 5 Label Reading and Grocery Shopping
- Week 6 Putting It all Together
- Meal preparation or cooking
demonstration - Week 7 Restaurant Dining
17Peer Leader Role
- Not experts in nutrition or health
- Participate in two days of training to learn how
to use a detailed script, behavioral change and
group dynamic strategies to guide the process - Play a key role in some of the hands-on activities
18Nutritionist Role
- Serves as a consultant to the peer leaders and to
the participants - Participates in the program sessions as needed to
help with patient information needs
19Community Nutrition Sites
- Kit Clark Senior Services Boston 46
participants - Vietnamese (17), Cape Verdean (14)
- Montachusett Opportunity Council Fitchburg
- 37 participants
- Hispanic (6)
- Andover Senior Center Andover
- 57 participants
- Mostly Caucasian
20Diverse Populations Adaptations
- Peer Leaders of same culture for the groups
- Challenges
- Translating Information
- Adapting food choices for ethnic preferences
- Journaling
- Literacy
21Measurement Tool
- Participant satisfaction survey after each
session - Brief final survey of participant self-reported
changes in achieving personal goals and changes
in eating habits - Change in knowledge, cooking and shopping
behaviors, dietary intake
22Findings
- Distinctly different dietary habits in accordance
with ethnic backgrounds and demographics - Issues in Vietnamese and Cape Verdean ability to
use participant manuals - Participants empowered and able to apply new new
knowledge and skills - Program was well-received by participants from
diverse cultural backgrounds
23Reunion Data 1 Year Follow-upAndover
- 56 out of 57 participants attended the reunion
- Reading labels (almost everyone)
- Watching portion size
- Increased fluid intake
- Decreased fats and sugars
- More whole grains, fiber, fruit and vegetables
- Increased self awareness of intake
24Proposed Changes
- Conduct monthly follow up support groups
- Develop new modules for follow-up sessions
- Streamline survey tools and record keeping
- Provide information on calories
- Enhance physical activity component
- Translate model program into Spanish for expanded
dissemination
25Next Steps
- Expand evaluation for include outcome measures
- Work with Executive Office of Elder Affairs to
identify additional sites, e.g. HUD housing
sites, SCOs, and train personnel to implement
program - Conduct additional trainings for interested new
Massachusetts sites - Orchard Cove
- Burlington and Wilmington Senior Centers
- Pepperhill and Shirley Senior Centers
- Elder Services of Merrimack Valley
26Next Steps
- Secure funding for testing model using a proposal
with outcome measures - HSL Center effort involving Adrienne Rosenberg,
Sue Nonemaker, Richard Jones, Rob Schreiber,
Philanthropy - Translating Model into Spanish with opportunity
to disseminate in Latin America (El Salvador)
through PAO - Collage Consortium
27For more information, please contact Anne-Reet
Ilves Annunziata, PhD RD LDN Project
Director Healthy Eating Program annereet_at_yahoo.com
Shirley Chao, MS RD LDN Director of
Nutrition Massachusetts Executive Office of Elder
Affairs 617-222-7469 Shirley.chao_at_state.ma.us