Grant Abstract: A Technological Intervention to Improve Nutrition among Older Adult Congregate Meal Participants during COVID-19

Grant Number: 1R01NR020303-01
PI Name: Ullevig
Project Title: A Technological Intervention to Improve Nutrition among Older Adult Congregate Meal Participants during COVID-19

Abstract: Inadequate nutrition and a lack of physical activity contributes to functional decline and complications from chronic diseases in older adults. The pandemic has halted or altered necessary Older Americans Act (OAA) nutrition services provided to vulnerable community-dwelling older adults in San Antonio, Texas. The “digital divide” or gap in technological access and knowledge, further heightens the detrimental effect of the COVID-19 pandemic on older adults who may be “digitally excluded” from social, economic, and health-related interactions. During the pandemic, seven San Antonio congregate meal sites located in areas with high poverty and digital exclusion remain partially open biweekly to distribute meals but no longer offer in-person nutrition education, physical activity classes, and social activities. The proposed project extends existing congregate meal programming infrastructure and partnerships with Older Adults Technology Services (OATS) to provide a sustainable approach focused on older adult health. This proposed digital nutrition intervention study will target technologically limited older adults enrolled in the congregate meal program (CMP) using a stepped-wedge cluster clinical trial to allow for sequential intervention enrollment with simultaneous control and intervention data collection timepoints. Key community partners with the Department of Health Services Senior Services Division and OATS will participate in the planning phase, research design, and implementation of the study. The 20-week intervention will include 5 weeks of technology training, including internet access and devices, followed by 15 weeks of a culturally tailored nutrition intervention via online sessions. The study will enroll 480 older adults recruited from seven at- risk congregate meal sites. Data will be collected at baseline, 3 months, 6 months, and 12 months. The study aims are: 1) To test the impact of a technology-based intervention on the primary outcomes of food security and diet quality; 2) To determine the effect of the intervention on secondary outcomes of technology knowledge and usage, physical activity, and social isolation and loneliness; 3) To examine the long-term impact and sustainability of technology use on food security, diet quality, physical activity, and social isolation. If successful, the impact of this program could be applied throughout the national OATS network and to similar CMPs to bridge the digital divide beyond the COVID-19 pandemic. PUBLIC HEALTH RELEVANCE: (2-3 sentences) The COVID-19 pandemic has disproportionally affected vulnerable older adult populations, including Older Americans Act services to congregate meal sites. This intervention study, designed with input from community partners and older adults, will provide a culturally tailored digital nutrition curriculum after providing technology resources and support at-risk older adults who attend congregate meal sites. If successful, this project has the potential for expansion to over 2000 older adult congregate meal participants throughout San Antonio and could be a model for other OAA funded nutrition services.

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