Progress 09/01/10 to 08/31/14
Outputs
Target Audience: We have reached out to a number of different audiences throughout this reporting period. -We have shared research results with the agencies that participated in our research project. -We have shared research results with the MOWAA network of directors and employees of home delivered meal agencies and Area Agencies on Aging. -We have shared research results with the scientific community through conference presenations and manuscrips. Changes/Problems:
Nothing Reported
What opportunities for training and professional development has the project provided? We provided a webinar for dieticians at Area Agencies on Aging and home-delivered meal agencies to receive Continuing Professional Educations (CPE) credits to the Academy of Nutrition and Dietetics, administered through MOWAA. How have the results been disseminated to communities of interest? We have provided individual reports to the partner agencies that completed the project. We have provided a webinar for HDM agencies and Areas Agencies on Aging. We have made conference presentations for other academics, and have a manuscript ready submit for peer review. What do you plan to do during the next reporting period to accomplish the goals?
Nothing Reported
Impacts
What was accomplished under these goals?
We have analyzed the food safety and quality parameters of the home food environments of homebound elderly recipients of HDM, and identified specific barriers to safe food-handling and storage practices by members of this high risk population. We have estimated the nutrient density and adequacy of the home food supplies of homebound seniors who recieve HDMs, and identified areas of nutrition in which this population may be deficient and would benefit from specific supplemental nutrition, especially during emergencies. We have identified and researched the feasibility of two interventions to improve food safety in homebound elderly recipients of HDM, including the implementation of dating labels on the meals to help prevent the consumption of potentially unsafe older foods, and a refrigerator/freezer temperature scan and adjustment designed to ensure that refrigerated foods are stored below 40 degrees F and frozen foods below 0 degrees F. We found that a number of agencies already use food dating, and that while it is very easy to adjust the refrigerators of the clients during our extended interview, it is extremely difficult for interested agenices to conduct a follow-up evaluation. We have partnered with nutritionists and MOWAA, to develop and disseminate food safety and emergency preparedness recommendations specifically tailored to the needs of the homebound elderly. Materials are being developed for emergency food providers, home delivery meal providers and the elderly themselves, and will be posted via the Extension Disaster Education Network (EDEN).
Publications
- Type:
Other
Status:
Published
Year Published:
2014
Citation:
Hallman, W.K., Cuite, C.L., Getty, T. (September, 2014). "Safe Foods for Seniors Begins in the Home: Knowledge, Practices, Risks and Interventions for Homebound Older Adults. Invited webinar presented to Agency on Aging and Meals on Wheels Association of America members. Washington, DC.
- Type:
Conference Papers and Presentations
Status:
Published
Year Published:
2014
Citation:
Hallman, W. K., Cuite, C. L., McWilliams, R. M., & Senger-Mersich A. (December 9, 2013). Scald and food safety risks posed by unsafe water, refrigerator, and freezer temperatures in residences of Meals on Wheels recipients in 4 US states. Poster presented at the 33rd annual meeting of the Society for Risk Analysis, Baltimore, Maryland.
- Type:
Conference Papers and Presentations
Status:
Submitted
Year Published:
2015
Citation:
Cuite, C., Hallman, W., Nelson, T. (2015). Empirically-based Interventions: Food Safety, Emergency Preparedness and Nutrition for Homebound Seniors. Submitted to n4a, 2015.
- Type:
Conference Papers and Presentations
Status:
Submitted
Year Published:
2015
Citation:
Byrd-Bredbenner, C., McWilliams, R., Senger-Mersich, A., Cuite, C. & Hallman, W. (2015). In-home Food Supply among Elderly Home-Delivered Meal Recipients with High Blood Pressure or Diabetes. Submitted to Experimental Biology, 2015.
- Type:
Conference Papers and Presentations
Status:
Published
Year Published:
2014
Citation:
McWilliams, R. M., Cuite C. L., Senger-Mersich A., Byrd-Bredbenner C., Hallman, W. K. (November 19, 2014). Food supply among elderly home-delivered meal recipients with high blood pressure. Poster presented at the 142nd Annual Meeting of the American Public Health Association, New Orleans, Louisiana. https://apha.confex.com/apha/142am/webprogram/Session40684.html
- Type:
Conference Papers and Presentations
Status:
Published
Year Published:
2014
Citation:
Hallman, W. K., Byrd-Bredbenner, C., Cuite, C. L., Netterville, L., McWilliams, R. M., Senger-Mersich, A., & Sastri, N. (May 8, 2014). Improving the Safety and Nutritional Adequacy of the Home Food Supply of Elderly Recipients of Home Delivered Meals. Poster presented at the National Institute of Food and Agriculture (NIFA), National Integrated Food Safety Initiative (NIFSI) Project Directors Meeting, Washington, D.C.
- Type:
Journal Articles
Status:
Under Review
Year Published:
2015
Citation:
Hallman, W., Byrd-Bredbenner, C., Cuite, C., McWilliams, R., Senger-Mersich, A., Sastri, N., Netterville, L. (2014). Nutritional Adequacy and Quality of the Home Food Supply Quality of Elderly Recipients of Home Delivered Meals. Manuscript submitted for publication.
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Progress 09/01/12 to 08/31/13
Outputs
Target Audience: We have reached a number of target audiences during the reporting period. We have reached academic audiences through our conference presentations. We have reached senior nutrition progrmas through direct communicatons, which included a researcher going to train new data collectors at one site, as well as helping another agency provide data to its board of directors. Changes/Problems:
Nothing Reported
What opportunities for training and professional development has the project provided? One of the co-investigators (Cuite) traveled to Arkansas to conduct training for two new data collectors, after the departure of the two orignal data collectors from the agency. Training took place over three days. How have the results been disseminated to communities of interest? PI Hallman was invited to attend the Meals on Wheels Association of America annual conference to speak to senior nutrition agencies about homebound senior food safety issues. What do you plan to do during the next reporting period to accomplish the goals? In the final year, we will finish collecting data. We will complete all analyses, and focus on the outreach goals (4) and evaluation goals (5). Initially we will provide feedback to each agency that participated in the study about their clients. We will also present findings to emergency preparedness experts, MOWAA, and to Cooperative Extension personnel using eXtension. We will present food safety and emergency preparedness recommendations specifically tailored to the needs of the homebound elderly, as well as providing an overview of the nutritional quality of in-home food supplies of the HDM recipients. We will work on disseminating materials for emergency food providers, as well as home delivery meal providers and the elderly themselves via the Meals on Wheels Association of America.
Impacts
What was accomplished under these goals?
During the reporting period, we collected data from the homes of 191 home delivered meal recipients. We collected data from 52 homes in Arkansas, one home in California, 103 homes in Iowa, and 35 homes in New Jersey. During this period, we conducted preliminary analyses, and developed an automated analysis program that will produce immediate nutritional density analyses on a home by home basis. We created a framework for analyzing emergency preparedness that will highlight emergency preparedness needs on an individual and state-by-state basis. In addition, we created a food safety scale, that allows us to rate the food safety of individual homes, but also can be aggregated.
Publications
- Type:
Conference Papers and Presentations
Status:
Published
Year Published:
2012
Citation:
Hallman, W. K. (August 22, 2012). Food Recalls: What does it mean for your clients? Invited presentation at the Meals on Wheels Association of America Annual Conference, National Harbor, Maryland.
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Progress 09/01/11 to 08/31/12
Outputs
OUTPUTS: As of September, 2012, we have collected data from over 550 Meals on Wheels clients in five states. We have met our quota of 200 clients in New Jersey and South Carolina, with fewer participants in Iowa, Arkansas and California. Our study participants are 64% female; their ethnicity breakdown is 64% White, 29% African American, and 7% other; and they have a median age of 82 years. Through the course of this project, we have developed and refined a new data collection protocol, including an original computer application that allows us to measure the nutritional content of all the food in each clients home. This program is based on FoodWorks, originally created by co-Investigator Carol Byrd-Bredbenner. The program is able to produce an analysis of all the food in the clients home (individually and in aggregate), and indicate how the food supply compares to the USDA nutritional guidelines. We have built a database of foods, including all nutritional information, Universal Product Codes (UPC) and container size information. We have added over 22,500 new foods to the database, for a total of just over 100,000 foods. This database is accessed using the new application. In terms of dissemination, PI Bill Hallman presented a poster with initial results at the International Association of Food Protection annual meeting in July, 2012. In August of 2012, PI Bill Hallman presented a talk at the Meals on Wheels Association of America national conference, where he discussed the research project. We have also provided data and feedback to the individual agencies about the needs of their clients, and plan to provide more formal feedback once the project is completed. PARTICIPANTS: During this time period, we had two partner agencies complete the project. These were Meals on Wheels of Greenville (Greenville, SC) and Union County Meals on Wheels (Linden, NJ). We continued our collaboration with three partner agencies, St. Vincents Meals on Wheels (Los Angeles, CA), Heritage Agency (Cedar Rapids, IA) and Carelink (North Little Rock, AR), as well as with the national group, Meals on Wheels Association of America. TARGET AUDIENCES: Nothing significant to report during this reporting period. PROJECT MODIFICATIONS: Nothing significant to report during this reporting period.
Impacts
In terms of change in knowledge, we learned about specific food safety and emergency preparedness issues with this population. In terms of food safety, only 7% had a thermometer in their refrigerator or freezer. While the USDA recommends that refrigerator temperatures be at or below 40 degrees Fahrenheit (FSIS, 2012), we found that the temperature was above 40 degrees in 24% of the homes. In terms of overall kitchen cleanliness, we found that countertops were not clean or were damaged in 24% of the homes, food preparation equipment was not clean in approximately 30% of the homes, and almost 20% of the kitchens had evidence of insect infestation. In terms of emergency preparedness, the majority (65%) report having food set aside specifically for emergencies, but only 34% have water set aside specifically for emergencies. Approximately three quarters have an operating flashlight and first aid supplies. Approximately half have a cell phone and/or radio. In terms of the foods present in the homes, we found a large variation in the number of unique food items in each home, with a mean of 30 unique food items. Common items found include (with % of households that had them) dairy, such as milk, cheese, and yogurt (75%), sweets, such as cake, candy, and soda (74%), bread (64%), eggs (61%), peanut butter/nuts (58%), cold cereal (56%), ice cream/frozen yogurt (36%), frozen meals (33%). We found that 40% of the homes had no fresh fruits or vegetables. In summary, the key issues we see in these homes include unsafe refrigerator temperatures, problems with overall cleanliness in kitchens, a lack of recommended emergency water stores, very low amounts of fresh produce in the homes, excessive amounts of processed foods and sweets.
Publications
- No publications reported this period
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Progress 09/01/10 to 08/31/11
Outputs
OUTPUTS: During the first year of the project, the research team engaged in a range of activities in order to prepare for data collection. This included creating instruments, developing a novel computer application for data collection, conducting a training for data collectors, and evaluating the accuracy of the data collectors in their home states. Each of these are discussed below. A face-to-face survey instrument was developed for the project. The instrument uses some well established scales (e.g., Instrumental Activities of Daily Living; Lawton & Brody, 1969) as well as novel items designed to address the research questions specific to this project (e.g., questions about tooth and mouth problems that affect what a respondent can eat). This instrument was pre-tested with Meals on Wheels clients, and revised as needed. In addition, the research team developed a food safety kitchen audit, to be completed by the data collector (rather than self-assessment), and based on an instrument developed by Byrd-Bredbenner in a study on college students (Byrd-Bredbenner, Abbot & Schaffner, 2010). This instrument was revised after a reliability analysis revealed some items that needed higher inter-rater reliability. Finally we created a new program to collect nutrition information about the food products in respondents' homes. This program is based on co-PI Byrd-Bredbenner's nutritional analyses software "FoodWorks." This program builds on existing databases of foods, UPCs, and nutritional information. In order to minimize the time spent in clients' homes for data collection, an undergraduate research assistant spent two semesters adding to the database through internet searches. We trained 10 Meals on Wheels employees and volunteers in how to collect data for the project, over a 3 day training session held in New Brunswick, NJ. Information technology staff at the Rutgers Food Policy Institute worked with our research team to collaboratively design a new computer application (using Microsoft Access) designed to allow seamless data collection, connects a respondent's interview, food safety audit, food scanning data, and background information entered by the data collector. We began data collection, and had approximately 100 homes collected at the end of our first year. News of the work we are doing has been disseminated at a number of conferences attended by Linda Netterville, co-PI and Vice President of Grants Management at Meals on Wheels Association of America. References: Byrd-Bredbenner, C., Abbot, J., Schaffner, D. (2010) How Food Safe is Your Home Kitchen A Self-Directed Home Kitchen Audit. Journal of Nutrition Education and Behavior, 42:286-289. Lawton, M.P., and Brody, E.M. "Assessment of older people: Self-maintaining and instrumental activities of daily living." Gerontologist 9:179-186, (1969). PARTICIPANTS: We held a three day training meeting at Rutgers University in January 2011. We invited 12 data collectors from the five participating agencies to attend, and co-PI Linda Netterville attended, as well as two Meals on Wheels Association of America. There was an excellent exchange of ideas, where the data collectors learned the data collection protocol, and helped us to refine it by teaching us about how they conduct their intakes, what scales and other standardized measures are used during their intakes, how often re-evaluations are conducted, and other administrative constraints that affect the data collection protocol. In addition, the data collectors worked with the researchers to trouble shoot all aspects of the data collection procedures, and adjustments were made as needed to ensure that data collection could be done in a uniform way, across the five states, in a uniform manner. The agencies that are collecting data, as well as Meals on Wheels Association of America, are listed below, with their address and URL. Carelink, 706 West 4th Street, North Little Rock, AR 72114, www.care-link.org; Heritage Agency, 6301 Kirkwood Blvd SW, Cedar Rapids, IA 52406, www.heritageaaa.org; Linden, NJ Meals on Wheels c/o The Gregorio Center in Linden, 330 Helen Street, Linden, NJ 07036, www.mowaa.org; Meals on Wheels Greenville, 15 Oregon Street, Greenville, SC 29605, www.mealsonwheelsgreenville.org; St. Vincent's Meals on Wheels, 2201 Miramar Street, Los Angeles, CA 90057, www.stvincentmow.org; Meals on Wheels Association of America, 203 South Union Street, Alexandria, Virginia 22314, www.mowaa.org. TARGET AUDIENCES: The target audience is the homebound elderly and the meals on wheels agencies that serve them. PROJECT MODIFICATIONS: We have encountered difficulties recruiting participants, as the amount of time and commitment involved in being in the study is significant. In addition, the data collection procedure is taking longer than anticipated, because of the large number of hypotheses being addressed and the necessary measures that need ot be collected from each participant. Because of this, we have simplified the protocol by not introducing date labeling on meals during the early stages of data collection. We are planning to do this analysis wiht a subsample of homes on with
Impacts
As a result of this project, we now know that fresh produce is sorely lacking from the diets of these meals on wheels clients. Less than 5% of the calories in their homes are from fresh produce, and this knowledge has led to discussions about how to improve this situation with a number of meals on wheels agencies as well as the national Meals on Wheels Association of America. It is our goal that as more data come in we will continue to alert the meals on wheels providers about what components of their clients' diets are most lacking. In addition, the data collection protocol and computer applications developed for this project can be used to study this population for other purposes. We look forward to additional outcomes and impacts as the data are collected.
Publications
- No publications reported this period
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