Evaluation of a dietitian-led in-home nutrition education program for community-residing elder women

A randomized control group design was used to evaluate a 90-day dietitian-led in-home nutrition education program designed to improve the nutritional health, dietary practices, nutrition knowledge, readiness to change (RTC), nutrition attitudes, morale, and self-efficacy (SE) of elder community-residing women. Participants included 58 women (30 Control (CG), 28 Treatment (TG)) aged 54 to 83 years in Guilford and Forsyth counties NC. CG received two dietitian visits. TG had two dietitian visits plus two 30 to 60 minute dietitian-led education sessions. Nutritional status was measured using the MNA at initial visits (IV) and exit visits (EV). Three 3-day food records were analyzed by NDS-R. Nutrition knowledge was assessed with a 5-question quiz (HHQ) given at IV and EV. RTC was assessed with a 5-question RTC questionnaire at IV and EV. Nutrition attitudes (nutrition is important (NI), flexibility-rigidity (FR)), morale, and SE were measured using the Food and Nutrition Questionnaire for Seniors at IV and EV. Data were analyzed using SPSS 11.5. Statistical procedures included descriptive statistics, multivariate analysis, paired sample t-tests and independent T-tests. The majority were married, educated, financially secure Caucasian women who had served as a family caregiver. Participants perceived their health and efforts to stay healthy to be good. Overall MNA scores increased 1.09 points (p = .000) from IV to EV. TG had a.275 (p = .019) reduction in BMI. CG did not have marked BMI changes. Significant (p < .05) improvements for overall trans fat, sodium and cholesterol intake occurred. CG had significant (p < .05) improvements in energy and cholesterol intake. TG had significant (p < .05) improvements in trans fat and sodium intake. Average number of reported positive changes was 2 (+/-1.4). The majority was categorized as "somewhat compliant," meeting 3--4 dietary recommendations for each food record. The majority was categorized in RTC maintenance phase at IV and at EV. No changes (p ≥ .05) were detected for HHQ, NI, FR, or SE overall or by groups. Overall and CG morale improved (p ≤ .01) from IV to EV. Overall SEC-2 (ability to choose healthy foods) improved (p = .000) and overall SEC-3 (ability to follow general nutrition principles and practices) showed improvement (p = 0.065) from IV to EV. TG consumed significantly more fiber and trans fat than CG at FR3; no other differences between groups were noted. This in-home nutrition education program improved elder women's nutritional status, dietary practices, morale, and SE regarding their ability to choose healthy foods and to follow general nutrition principles and practices.