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Nutrition Assessment Education Project

Spokane County

Assessing the Nutritional Health of Seniors

Overall Nutritional Status: Tables of Results

| Nutrition Risk Categories for National and Spokane Program Participants | | Overall Nutritional Score Results for Participants, Non-Participants, Homebound Participants, and Korean Elders | | Nutrition Risk of Meal Participants: National, Spokane, Congregate, and Home Delivered | | Nutrition Risk of Meal Participants: Participants, Non-participants, Homebound participants, and Korean Elders | | Morning Meals on Wheels Evaluation |

**Nutrition Risk Categories for National and Spokane Program Participants**
Nutrition Program	Good Nutritional Status	Moderate Nutritional Risk	High Nutritional Risk
Spokane, Congregate Meal Site (n = 640)*	25%	22%	53%
Spokane, Home Delivered Meals (n = 495)*	0%	1%	99%
National, Congregate Meal (n = 1,040)**	36%	42%	22%
National, Home Delivered Meals (n = 818)**	11%	40%	48%

*Values are aggregate values for Data gathered in Spokane County from 1994 through 1997.
** Values are from the national, Mathematica Study (1993-1995)

Note: Nutritional status is determined by number of items checked on the Nutrition Screening Tool

Good Status is 0-2 items
Moderate Nutritional Risk is 3-5 items
High Nutritional Risk is 6+ items

Overall Nutritional Score Results for Participants, Non-participants, Homebound Participants, and Korean Elders

**Nutrition Risk Categories**
Nutrition Program	Good Nutritional Status	Moderate Nutritional Risk	High Nutritional Risk
Spokane, Congregate Meal Site (n = 918)*	25%	23.5%	51.5%
Non Participants (n=71)**	31%	32%	8%
Spokane, Home Delivered Meals (n = 1036)*	2%	3%	95%
Pilot Group of Korean Elders (n = 22)	23%	23%	54%

*Values are aggregate values for Data gathered in Spokane County from 1994 through 1997.
** Seniors attending a wellness conference who did not attend congregate meal sites or receive home delivered meals.

Note: Nutritional status is determined by number of items checked on the Nutrition Screening Tool

Spokane County Senior Nutrition Assessment Results:
Nutrition Risk of Meal Participants

The following is a comparison between the nutrition risk results from the Mathematica Study (1993-1995) to the nutrition risk results from Spokane Senior Nutrition Program. The Mathematica study indicates 67% of Senior Nutrition participants are at moderate to high nutritional risk (12). Spokane indicates 75% to 100% are at risk..

**Question by Question Results:**
**National, Spokane, Congregate and Home Delivered**
Nutrition Screening Questions from the *Determine Your Nutritional Health Checklist*	National, Congregate n = 1,040	Spokane, Congregate n = 640	National, Home-Delivered n = 818	Spokane, Home-Delivered n = 495
I have an illness or condition that made me change the kind and/or amount of food I eat.	30%	41%	34%	98%
I eat fewer than 2 meals per day.	2%	25%	4%	40%
I eat few fruits or vegetables.	21%	59%	31%	75%
I eat or drink few milk products.	32%	45%	38%	68%
I have 3 or more drinks of beer, liquor or wine almost every day.	2%	4%	1%	2%
I have tooth or mouth problems that make it hard for me to eat.	-----	21%	-----	26%
I don't always have enough money to buy the food I need.	12%	44%	18%	55%
I eat alone most of the time.	51%	45%	61%	64%
I take 3 or more different prescribed or over-the-counter drugs a day.	40%	51%	61%	74%
Without wanting to, I have lost or gained 10 pounds in the last 6 months.	18%	22%	30%	-----

**Question by Question Results:**
**Participants, Non-participants, Homebound participants, and Korean Elders**
Nutrition Screening Questions from the *Determine Your Nutritional Health Checklist*	Congregate Meal Participants* (n=918)	Non- participants** (n=71)	Home Delivered Meal Participants* (n=1036)	Korean Elders (n=22)
I have an illness or condition that made me change the kind and/or amount of food I eat.	42.5%	44%	95%	36%
I eat fewer than 2 meals per day.	21%	3%	46%	18%
I eat few fruits or vegetables.	58%	23%	71%	73%
I eat or drink few milk products.	47%	35%	63%	86%
I have 3 or more drinks of beer, liquor or wine almost every day.	4%	3%	2%	0
I have tooth or mouth problems that make it hard for me to eat.	19%	10%	26%	27%
I don't always have enough money to buy the food I need.	38%	6%	55%	14%
I eat alone most of the time.	46%	42%	64%	41%
I take 3 or more different prescribed or over-the-counter drugs a day.	51%	41%	75%	41%
Without wanting to, I have lost or gained 10 pounds in the last 6 months.	17%	17%	43%	0
I am not always physically able to shop, cook and/or feed myself.	27%	24%	89%	68%

*Values are aggregate values for Data gathered in Spokane County from 1994 through 1997.
**Seniors attending a wellness conference who did not attend congregate meal sites or receive home delivered meals.

**Evaluation of Morning Meals on Wheels**
Projected Outcome	Measure/ Indicator	Actual	Evaluation and Comments
75% decrease in nutrition risk status as defined by numerical value of the "Determine Your Nutritional Health Checklist" (NSI).	Comparison of NSI scores before and after MMOW study for each participant.	82% decrease in nutrition risk as defined by numerical value of the NSI.	The Morning Meals-on-Wheels Program provided two meals per day, meeting 2/3 RDAs. Participants were spending less money on food which enabled them to have more money for other essentials. These factors alone reduced the average numerical value of nutrition risk from l4.13 to 9.51. Significant changes included: an increase in food intake, decreased food insecurity and an increase in weight stability.
90% report a healthful benefit from breakfast program as defined by pre-and post-evaluations.	Pre- and post-evaluations of self-perceptions. "Was/will the breakfast program be beneficial to your health?"	95% felt breakfast would be a benefit prior to study. 96% reported a benefit at completion of study.	Most participants at beginning of study were eating less than two meals per day 63%), were unable to buy all of the food they needed (81%), had recently experienced problems with maintaining their weight (84%) and were unable to shop and cook by themselves (92%). Due to all factors, a nutritionally balanced meal which was easy to prepare and not too costly would be of benefit to their health. At the end of the study, only 6% of participants were eating less than two meals per day, 49% reported having difficulty buying all of the food they needed and 34% experienced a 10 pound weight fluctuation. These factors decreased nutrition risk and were a perceived benefit to the participants.
60% report malnutrition risk education as beneficial as defined by pre- and post-evaluations.	Pre- and post-evaluations of client perception. "Did you find the nutrition education provided by the Senior Nutrition Program helpful?"	90% found nutrition education helpful at beginning of study. 72% found nutrition education helpful at completion of study.	Nutrition education during the "Determine Your Nutritional Health" was conducted prior to study. Education was based on client’s risk and nutritional need. This contact was of benefit to 90% of participants. At completion of study, although outcome was exceeded, fewer participants reported it as helpful, because they had already received the information.

**Morning Meals-On-Wheels: Participant Responses**
	YES		SOME- WHAT		NO
EVALUATION OF MORNING MEALS-ON-WHEELS	(PRE-)	(POST-)	(PRE-)	(POST-)	(PRE-)	(POST-)
Was or will the breakfast program be beneficial to your health?	95%	96%	3%	4%	2%	--
Was or will the breakfast program be beneficial to your caregiver?*	59%	45%	3%	9%	7%	2%
Did you find the nutrition education provided by the Senior Nutrition Program helpful?	90%	72%	8%	26%	2%	2%
Was or will this breakfast program be beneficial to our community and its homebound seniors?	98%	95%	2%	5%	--	--
Were or will you be able to eat all of your breakfast meal most of the time?	85%	74%	11%	25%	4%	1%

*31% of MMOW participants reported having no caregiver during pre-evaluation. 44% of MMOW participants reported having no caregiver during post-evaluation.

Clark County

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Last revised: 04/20/99

Comments: Donna Johnson (djohn@u.washington.edu)

http://depts.washington.edu/~commnutr/cases/spokane/s-tables.htm