IMPROVING THE HEALTH SPAN OF AGING ADULTS THROUGH DIET AND PHYSICAL ACTIVITY.

• Sponsoring Institution: National Institute of Food and Agriculture
• Project Status: COMPLETE
• Funding Source: HATCH
• Reporting Frequency: Annual
• Accession No.: 1020745
• Multistate No.: NE-1939
• Project Start Date: Oct 1, 2019
• Project End Date: Sep 30, 2024
• Program Code: [(N/A)]- (N/A)

Recipient Organization
IOWA STATE UNIVERSITY
2229 Lincoln Way
AMES,IA 50011

Performing Department
Food Science and Human Nutrition

Non Technical Summary
As the population of aging adults continues to grow, better understanding of effective strategies aimed toward improving the health span is needed. Aging is a multifaceted area of study that is continually exploring how to promote health and well-being throughout the lifespan. An integrative, interdisciplinary approach toward healthy aging from the metabolic level to translational science is imperative as aging is influenced by our genetics, metabolic processes, environment, and lifestyle practices. In doing so, it is likely we will improve the healthspan (part of a person's life during which they are generally in good health) of aging adults (those age 40 years and older). This multistate project will focus on two main areas: 1) to conduct a comprehensive assessment of diet, physical activity and related factors affecting aging adults and 2) to develop, implement and evaluate interventions that improve health and well-being in aging adults in urban and rural environments. Given the diversity of the current team, which includes experts from metabolic nutrition to Extension and Outreach researchers, our team is well positioned to address the health and well-being of community-residing older adults from the laboratory to community. This provides a unique opportunity to work from the metabolic level to translational science.

Animal Health Component

40%

Research Effort Categories

Basic

20%

Applied

40%

Developmental

40%

Classification

Knowledge Area (KA)	Subject of Investigation (SOI)	Field of Science (FOS)	Percent
703	6010	3020	50%
724	6099	1010	50%

Knowledge Area
703 - Nutrition Education and Behavior; 724 - Healthy Lifestyle;

Subject Of Investigation
6010 - Individuals; 6099 - People and communities, general/other;

Field Of Science
3020 - Education; 1010 - Nutrition and metabolism;

Keywords

aging adult

nutrition

physical activity

older adult

Goals / Objectives
To conduct multidimensional assessments of diet, physical activity and related factors affecting aging adults. To develop, implement and evaluate interventions that preserve or improve health in aging adults living in rural and urban environments.

Project Methods
Objective1 methods:AREA 2 includes conducting needs and preference assessments to determine aging adults' perceptions and recommendations for community environmental supports for a food secure, culturally appropriate and healthy eating environments. Improving the general health, functionality and the quality of life (QOL). The purpose of these studies is to identify the most important and modifiable enablers and behavioral of healthy eating among aging adults. To accomplish this, mixed methodology approaches will be used, including both qualitative and quantitative methods such as focus groups and consumer surveys. Qualitative methodology is an effective way to engage groups of people in a conversation about topics in which there are gaps in the literature and results can be useful as formative data to create surveys. We anticipate that focus groups would include six to eight people and do as many as needed to reach a saturation point in the data. Saturation occurs when further data collection does not provide new knowledge. Open-ended questions will be used and questions will be developed to answer gaps in the literature review. All focus group discussions will be transcribed verbatim and will be analyzed using standard focus group protocols. Themes will then be identified from the most prevalent codes found amongst the transcriptions. Expanding on the NE-1439 produce access questionnaire project additional consumer surveys will be developed using literature reviews, formative data from focus group discussions, or from community service providers or community members in the rural and urban regions of the participating states. These surveys will highlight the most important and modifiable community settings to improve food access and dietary behaviors in older adults. Surveys will be pretested for clarity and reliability and then administered to consumers receiving services through home-delivered meal programs, congregate meal sites, food pantries, and other community centers serving older adults. Surveys will identify older adults' use of community supports for healthy eating, identify the types of supports used, identify where seniors access their foods and if they are food secure, and provide recommendations for improvement to foster healthy eating in older adults.AREA 3 entails determining, examining and understanding cultural, personal and accessibility barriers to dietary intakes and physical activity by aging adults. The purpose of these studies is to identify the geographic locations, cultural, and personal characteristics, and attitudes and beliefs that influence dietary behaviors and physical activity patterns. Based on these findings, we will propose and implement sustainable methods to eliminate identified barriers, including nutrition education and physical activity interventions. Quantitative and qualitative data will be collected on aging adults. Quantitative data such as demographics, dietary intake, physical activity, food security and food access will be collected using standardized, validated assessment tools across states. The methods for qualitative data collection will be focus groups and personal interviews as described above in Area 2. The information obtained through these studies will be shared with team members during the team's general meetings and the annual meetings. The findings will be used to inform the studies being conducted under Objective 2.Objective 2:Area 1 conduct qualitative and quantitative research examining nutrition- and physical activity related patterns and predictors of healthy aging. The purpose is to identify individual, family, clinical, community and health services nutrition- and physical activity-related factors for successful aging. All states implementing human studies will use the same assessment tools as applicable to the respective studies. These common assessment tools reflect the core variables being addressed across all human studies in this multistate project. These survey tools will collect the same: sociodemographic information, examine nutritional risk and dietary composition, food security, QOL, physical function, and physical activity. A common data set will be created to store data from all needs assessment and intervention studies conducted as part of this project. This large data set will be used to conduct modeling studies examining predictors of successful aging as well as cross-sectional data analyses to explore risk factors across states.Area 2 will involve developing theory-based nutrition and physical activity interventions based on identified needs and preferences. These interventions may focus on a variety of issues affecting aging adults such as weight loss, arthritis reduction, general health, and food security. A variety of methods will be utilized depending on the type of study being implemented. These methods may include community-based assessments and/or interventions, clinical trials, and epidemiological studies. The key predictors and outcome measures include anthropometric, biochemical, clinical, dietary, physical activity, socioeconomic, and environmental factors according to the study design.Area 3 is the development and testing of a theory-based, community-implemented, exercise and nutrition program (lifeSPAN [Sarcopenia Prevention through Activity and Nutrition] Program) capable of reducing the risk of and/or severity of sarcopenia among women ages 40-75 years. The long-term goal of the lifeSPAN Program is to promote the independence and well-being of community-residing aging and older women through an integrative, community-based exercise and nutrition intervention. The lifeSPAN program utilizes an interdisciplinary approach, applies sustainable lifestyle intervention approaches, and is designed for community-delivery through Extension. The lifeSPAN Program will include creating an exercise DVD that emphasizes resistance training (based on work completed by URI as part of the NE-1439 project) and a nutrition curriculum that promotes protein intake through whole foods (based on MacNab study 39). The key indicators may include physical function (grip strength, four-meter gait speed test, chair stand tests, isometric leg extensor strength), body composition (multi-frequency bioelectrical impedance analysis (MFBIA), height and weight), nutrition and food measures (multiple 24-hour recalls, nutritional risk and dietary intake frequencies, complete blood counts, serum selenium levels), and markers of inflammation. The intervention will be pilot-tested in a variety of community settings. Data analysis will be undertaken using general linear models methods, focused on testing for differences between Control and Treatment groups and controlling for relevant demographic and structural covariates. The lifeSPAN program will be implemented in both urban and rural areas.

Progress 10/01/19 to 09/30/20

Outputs
Target Audience:The target audience is community-residing adults ages 40 years and older. Changes/Problems: Nothing Reported What opportunities for training and professional development has the project provided?Through this project I trained 1 undergraduate student, 4 graduate students and 8 Extension specialists. They acquired skills in quantitative research (e.g., data collection, data entry, analysis), qualitative research (e.g., conducting focus groups, analyzing focus group data, etc.), professional writing (e.g., manuscripts, abstracts, theses), nutritional Status assessment (e.g., DST, MNA), physical activity assessment, program delivery and program evaluation. How have the results been disseminated to communities of interest?The findings have been shared through invited presentations at professional conferences and work groups. In addition our study findings have been shared via research presentations, abstracts and peer-reviewed journal articles. What do you plan to do during the next reporting period to accomplish the goals?I plan to complete our multistate nutrition and physical activity needs assessment of adults ages 40 years and older. I will also conduct a nutrition and physical activity training needs assessment of health care professionals. Further, I will continue exploring innovative ways to promote nutrition and wellness program using indirect outreach methods due to the COVID-19 pandemic. Finally, I will complete the statistical common tool codebook for the NE1939 team to use.

Impacts
What was accomplished under these goals? IMPACT: During the past reporting period, over 10,000 older Iowans participated in community education and/or research programs that increased awareness of food security resources, promoted familiarity with healthy lifestyle practices, and assessed program satisfaction and impact. The food security programs resulted in better nutrition choices and better understanding of SNAP.This work has resulted in one published peer-reviewed journal article, five poster presentations, two theses, five invited presentations, and three new Extension products. Objective 1.To conduct multidimensional assessments of diet, physical activity and related factors affecting aging adults. Through this project we launched a 7-state nutrition and physical activity needs assessment of 1200 adults ages 40 years and older from IA, IL, SD, MD, DC, RI, and WV (Objective 1, Area 3). I submitted a NIFA grant application to fund a five-year undergraduate Student Training in Aging and Research (STAR) internship experience for underserved students. Objective 2. To develop, implement and evaluate interventions that preserve or improve health in aging adults living in rural and urban environments. Nutrition and wellness programming was implemented and evaluation through Extension serving over 10,000 older Iowans (Objective 2, Area 2).The Stay Independent program reached 110 older Iowans prior to the COVID-19 pandemic and resulted in a significant increase in familiarity among participants with recommended lifestyle practices. Additionally, the commodity and supplemental food nutrition education program reached about 4,000 older adults. Of those surveyed, 93.5% used the information provided to make food choices, 95.7% stated the budget tips were useful, and 72.6% made at least one of the recipes at home. The SNAP outreach program reached nearly 6,000 older adults. Further, I completed two research studies examining the congregate nutrition program pilot project and the physical activity practices of older Iowans (Object 2, Area 1).

Publications

• Type: Conference Papers and Presentations Status: Published Year Published: 2020 Citation: Francis, S.L. Harrison, E., Contrady, A. **, Montgomery, D., Rudolph, C.S. **, & Broadnax, P., Physical Activity: What do Older Adults Need and Want? Poster presentation to be given at the Society for Nutrition Education and Behaviors annual conference, Online July 2020. https://doi.org/10.1016/j.jneb.2020.04.213
• Type: Other Status: Other Year Published: 2019 Citation: Francis, S.L.. Stay Independent: a healthy aging series. North Central Region Aging Network. Webinar. http://www.ncran.org/webinars/archive/ October 2019.
• Type: Conference Papers and Presentations Status: Other Year Published: 2019 Citation: Francis, S.L.. Stay Independent: Brain Health. 7th Annual Rock on in Retirement Symposium. ISU Alumni Center. Ames, IA. November 2019.
• Type: Conference Papers and Presentations Status: Published Year Published: 2020 Citation: Berg A., Francis, S.L., & Dahl, W.J. Nutrition and Aging Services: Screening, Innovating, Collaborating and Best Practices on Evaluating their Impact. 2020 SNEB Annual Conference Session for the Healthy Aging Division. July 2020.
• Type: Conference Papers and Presentations Status: Other Year Published: 2020 Citation: Francis, S.L.. ISU Extension: Promoting Health and Wellness of Older Adults. Iowa Aging Summit, Enhancing Older Adulthood through Education. September 17 and 18.
• Type: Conference Papers and Presentations Status: Other Year Published: 2020 Citation: Francis, S.L. & Margrett, J. Ageism: You, Me, and Us. Department of Food Science and Human Nutrition Seminar Series. ISU. August 2020.
• Type: Conference Papers and Presentations Status: Published Year Published: 2020 Citation: Francis, S.L., Schultz, S.**, Getty, T., Bauman, A. Linn County Innovation in Nutrition Program Increases Awareness and Utilization of the Heritage Area Agency on Aging Programming. Poster presentation accepted for the Iowa Governors Conference on Public Health. April 2020.
• Type: Theses/Dissertations Status: Published Year Published: 2020 Citation: Schultz, Savannah Rae, "A mixed-methods approach toward promoting and evaluating the Congregate Meal Program in Linn County" (2020). Graduate Theses and Dissertations. 18028. https://lib.dr.iastate.edu/etd/18028
• Type: Theses/Dissertations Status: Published Year Published: 2020 Citation: Contrady, Annette Elise, "Physical activity needs, preferences, perceptions, and current practices of community residing older adults" (2020). Graduate Theses and Dissertations. 18109. https://lib.dr.iastate.edu/etd/18109
• Type: Journal Articles Status: Published Year Published: 2020 Citation: Rudolph, C.** & Francis, S.L. Making home-delivered meal programs relevant for todays aging adult. Journal of Public Health: From Theory to Practice. Available at: https://doi.org/10.1007/s10389-020-01286-z
• Type: Conference Papers and Presentations Status: Published Year Published: 2020 Citation: Contrady, A.**, Francis, S.L., Montgomery, D., Hopkins, H. Physical Activity Perceptions and Preferences of Community-Residing Iowans. Poster presentation accepted for the Iowa Governors Conference on Public Health. April 2020
• Type: Conference Papers and Presentations Status: Published Year Published: 2020 Citation: Francis, S.L., Schultz, S. **, Rudolph, C. **, Keane, M. **, & MacNab, L. ** Nutrition Education With Seniors (NEWS)Helping Older Adults with Limited Resources Make Informed Food Choices. Poster presentation to be given at the Society for Nutrition Education and Behaviors annual conference, Online July 2020. https://doi.org/10.1016/j.jneb.2020.04.177