Digital Nutrition Intervention for Older Adults

Not Applicable

Active, not recruiting

• Conditions: Nutrition Poor; Social Isolation; Physical Inactivity
• Interventions: Behavioral: Technology intervention; Behavioral: Digital Nutrition Intervention

• Registration Number: NCT05220631
• Lead Sponsor: The University of Texas at San Antonio

Brief Summary

The "digital divide" or gap in technological access and knowledge, for older adults has worsened during the COVID-19 pandemic, leading to disruptions in services like congregate meal programs funded by the Older Americans Act. Seven San Antonio congregate meal sites remained partially open biweekly to distribute meals but no longer offer in-person nutrition education, physical activity classes, and social activities. The proposed project will test the efficacy of digital nutrition intervention with at-risk older adults who attend congregate meal center in areas of high poverty and digital exclusion.

The study is uses a stepped-wedge cluster clinical trial. Key community partners with the Department of Health Services Senior Services Division and Older Adult Technology Services (OATS) will participate in the planning phase, research design, and implementation of the study.

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

Detailed Description

This project will target community-dwelling older adults who are "congregate meal" program (CMP) participants living in areas at-risk of the digital divide. The CMP is funded by the Older Americans Act and serves over 2000 San Antonio older adults who live 33% below the poverty level and 18% considered at high nutritional risk. During the pandemic, seven San Antonio sites in areas with high poverty and digital exclusion remain partially open biweekly to distribute meals but did not hold 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), a national leader in creating health service programs focusing on older adults. The goal of the proposed study is to remove the digital barrier to receiving essential, evidence-based nutrition programming online, utilizing OATS' five-week technology "Essential Series," which has successfully educated thousands of older adults nationwide by providing support for technology and internet connectivity.

This proposed nutrition intervention will enrolled congregate meal participants using a stepped-wedge cluster design with two cohorts to allow for sequential intervention enrollment with simultaneous control and intervention data collection timepoints. Key community partners within Department of Health Services Senior Services Division and OATS will participate in the planning phase, research design, and implementation of the study. Feedback from congregate meal participants in focus groups will guide the development of the intervention.

The 20-week intervention will include 5 weeks technology training, including internet access and devices, followed by 15 weeks of a culturally tailored nutrition intervention via online sessions. The study will recruit 440 older adult from seven at-risk congregate meal sites. Data will be collected at baseline (T0), during the online intervention (T1), after the online intervention (T2) and 6 months post-intervention (T3).

The successful outcome of our study will be impactful because of the potential broader application of this program throughout the national OATS network and to similar CMPs to bridge the digital divide through and beyond the COVID-19 pandemic.

Study Timeline

• Study First Submitted: 2022-01-19
• Study First Submitted QC: 2022-02-01
• Study First Posted: 2022-02-02
• Study Start: 2022-06-01
• Primary Completion: 2024-09-30
• Status Verified: 2024-12
• Last Update Submitted: 2024-12-17
• Last Update Posted: 2024-12-20
• Study Completion: 2025-06-30

Recruitment & Eligibility

• Status: ACTIVE_NOT_RECRUITING
• Sex: All
• Target Recruitment: 369

Inclusion Criteria

• 60 years of age
• Inadequate or no working technology device (computer, smart-phone, tablet), no or poor internet connectivity at home, or lack of knowledge and usage of technology
• Food insecurity or low diet quality

Exclusion Criteria

• Blind
• Terminal disease or illness
• Diagnosis of dementia or Alzheimer's disease
• Unable to read or write in English or Spanish

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: SEQUENTIAL

Arm && Interventions

Group	Intervention	Description
Cohort 1	Technology intervention	Cohort 1 will start the intervention directly after randomization.
Cohort 2	Technology intervention	Cohort 2 will serve as the control while cohort 1 is in the intervention stage. Cohort 2 will start the intervention after cohort 1 concludes the intervention.
Cohort 1	Digital Nutrition Intervention	Cohort 1 will start the intervention directly after randomization.
Cohort 2	Digital Nutrition Intervention	Cohort 2 will serve as the control while cohort 1 is in the intervention stage. Cohort 2 will start the intervention after cohort 1 concludes the intervention.

Primary Outcome Measures

Name	Time	Method
Diet Quality as measured by the Healthy Eating Index	Change in diet quality from baseline to 3 and 6 months	Two non-consecutive 24-hour dietary recalls will be collected and the Healthy Index will be calculated to determine diet quality.

Secondary Outcome Measures

Name	Time	Method
Technology Use and Access	Change in technology use and access from baseline to 3 and 6 months	Technology use questionnaire from the National Health \& Aging Trends Study
Physical Activity	Change in physical activity from baseline to 3 and 6 months	Physical activity measured by the Physical Activity Scale for the Elderly (PASE)
Social Isolation	Change in social isolation from baseline to 3 and 6 months	Social isolation measured by The Social Disconnectedness Scale and the Perceived Isolation Scale
Attitudes Towards Technology	Change in attitudes towards technology from baseline to 3 and 6 months	Adapted from Attitudes Towards Computers Questionnaire (ATCQ)
Food Security	Change in food security from baseline to 3 and 6 months	Food security measured by the USDA's US Adult Food Security Survey Module
Loneliness	Change in loneliness from baseline to 3 and 6 months	Loneliness assessed by the 3-item UCAL Loneliness Scale
Malnutrition	Change in malnutrition from baseline to 3 and 6 months	Malnutrition measured by the Mini Nutrition Assessment Short-Form

Trial Locations

Locations (1)

University of Texas at San Antonio; 🇺🇸 San Antonio, Texas, United States