Investigators plan to test the effect of a Cardiovascular disease (CVD) risk reduction program targeted to improve nutrition and self-management of chronic cardiovascular conditions among older adults participating in congregate meal programs offered at community senior centers.
This project proposes utilizing community health workers (CHWs) to deliver targeted health programming to participants in congregate meal programs as part of the Title III-C Nutrition Services Program. By integrating a targeted intervention into these community settings, this proposal aims to enhance individual health outcomes and support healthy nutrition among older adults. This approach prioritizes an evidence based, responsive, community-based solution to the increasingly complex health needs of this expanding population, fostering healthier aging and more resilient communities. The purpose of this study is to examine the feasibility of a CVD risk reduction program targeted to improve nutrition and self-management of chronic cardiovascular conditions among older adults participating in congregate meal programs offered at community senior centers. The specific aim is to examine the feasibility of a CVD risk reduction program (CAN-DO) delivered to older adults participating in a congregate meal program. The rates of recruitment, retention, acceptance, and participant satisfaction of the intervention protocol, and processes for training and engaging a CHW for intervention delivery in preparation for a larger, fully powered trial will be assessed. Secondary aims will include health outcomes that indicate promise of the intervention's potential effect on cardiovascular risk reduction and will include measurement of hemoglobin A1c, lipid panel, blood pressure, body anthropometrics and nutritional intake (food frequency questionnaire, diet quality with HEI (healthy eating index) scoring, Veggie Meter scores as an indicator of adherence to intervention). These risk factor outcomes will be measured at baseline, 18 weeks (intermediate feasibility) and at 30 weeks to evaluate long term feasibility of the project among older adults participating in a congregate meal program.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
PREVENTION
Masking
NONE
Enrollment
50
usual programing offered as part of the congregate meal program plus 18 weekly group education sessions related to CVD risk reduction and nutrition.
University of Kentucky
Lexington, Kentucky, United States
Proportion of eligible individuals who enroll in the study
Feasibility will be measured by recruitment rates, the proportion of eligible individuals who enroll during the time required to reach enrollment targets.
Time frame: 6 months
Number of participants enrolled at each timepoint
Retention rates at each time point will be quantified
Time frame: Baseline, week 18, and week 30
Change in Veggie Meter scores
The participant's adherence to the intervention will be assessed using the veggie meter, which uses light reflectance spectroscopy to provide an estimated skin carotenoid composite score. Score ranges from 0 to 800, with higher scores associated with greater fruit and vegetable intake.
Time frame: Baseline, week 18, and week 30
Participant Satisfaction with intervention
Overall satisfaction will be measured using a likert type scale 0-5, with a higher score equating to greater satisfaction, satisfaction will include measurement of frequency, duration and timing of intervention, total scores will range from 0-15, a mean score for overall satisfaction will be reported
Time frame: 30 weeks
Change in hemoglobin A1c
Hemoglobin A1c will be measured with the Bayer HgA1c point of care machine
Time frame: baseline, 18 weeks and 30 weeks
Change in total cholesterol per lipid panel
Lipids will be measured using Cholestech LDX point of care machine using fingerstick non-fasting blood samples,
Time frame: Baseline, 18 and 30 weeks
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Change in systolic blood pressure
Measurement of systolic blood pressure will be obtained using a digital BP machine
Time frame: baseline, 18 and 30 weeks
Change in diastolic blood pressure
Measurement of diastolic blood pressure will be obtained using a digital BP machine
Time frame: baseline, 18 and 30 weeks
Change in waist circumference
Waist circumference will be measured using a cloth measuring tape at the point of the umbilicus with minimal clothing
Time frame: baseline, 18 and 30 weeks
Change in diet quality using an HEI index score
Diet quality will be assessed using a Frequency Questionnaire (FFQ). The NDSR FFQ provides the data that allows for calculating the Healthy Eating Index. We will use the 2015 index rules. Healthy Eating Index (HEI) 2015 Score and individual component scores will be calculated from the FFQ according to the HEI-2015 guidelines to assess changes in overall diet quality and changes within each component. The range of scores for the Healthy Eating Index 2015 is 0-100. A higher score is considered better and represents meeting more of the recommended dietary guidelines
Time frame: baseline, 18 and 30 weeks