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Food SafetyNCT02719626

Improving The Safety And Nutritional Adequacy Of The Home Food Supply Of Elderly Recipients Of Home Delivered Meals

An observational study of Food Safety and Nutritive Value, run by Rutgers, The State University of New Jersey at 7 sites in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Rutgers University will partner with the Meals on Wheels America (MOWA) and affiliated agencies in five states to conduct a study designed to improve food safety nutrition and emergency preparedness among homebound elderly recipients of home delivered meals (HDM). Read more about this study

Who is it for?
Ages 60 years and older
Conditions the study is for
Food Safety, Nutritive Value, Homebound Persons
How many people
740 participants
Where
7 sitesUnited States
Study dates
Apr 2011to May 2013
Phase
Observational
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 60 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Study population: Home delivered meal recipients for at least 6 months, who: live alone, are 60 or more years old, have no overt cognitive impairment, and are from 5 states (AR, CA, IA, NJ \& SC; one site per state).

Who may be able to join

  • 60 or more years old
  • live alone
  • no overt cognitive impairment
  • receiving home delivered meals for at least 6 months prior to the in-home visit

Who cannot join

  • < 60 years old
  • do not live alone
  • overt cognitive impairment
  • receiving home delivered meals for less than 6 months prior to the in-home visit

Trial locations and contacts

7 sites in 1 country.

7 sites in 1 country

United States7 sites
  • Meals on Wheels America

    Arlington, Virginia, 22202

  • The Heritage Agency on Aging

    Cedar Rapids, Iowa, 52404

  • Greenville Meals on Wheels

    Greenville, South Carolina, 29605-1780

  • Linden Meals on Wheels

    Linden, New Jersey, 07036

  • CareLink

    Little Rock, Arkansas, 72119-5988

  • St. Vincent's Meals on Wheels

    Los Angeles, California, 90057

  • Rutgers University

    New Brunswick, New Jersey, 08902

Other trials in United States

About this study

Rutgers University will partner with the Meals on Wheels America (MOWA) and affiliated agencies in five states to conduct a study designed to improve food safety nutrition and emergency preparedness among homebound elderly recipients of home delivered meals (HDM). This population is at increased risk for food borne diseases, as a result of unique physiological and behavioral factors, and is particularly vulnerable to any disruptions in the food system because of their lack of mobility.

A multi-method research approach will be used with a target sample of 1,000 MOWA homebound elderly clients. Methods include the use of a novel UPC scanning technology that quickly and comprehensively catalogues all of the food in the clients' homes, a home food safety audit, and a face-to-face interview.

The goal of the study is to provide an improved understanding of the unique food safety threats to this at-risk population, suggest easy, cost-effective ways of reducing known food safety risk factors, and provide clear guidelines about the amount and types of food most needed by this population in emergency situations. Dissemination of research findings and recommendations will be done through a partnership with EDEN and MOWA, both of which have national constituencies poised to act on the recommendations.

Read the detailed description

Elderly homebound recipients of home delivered meals (HDM) are at increased risk for foodborne disease and particularly vulnerable to disruptions that might prevent the delivery or safe consumption of food. In addition, there is a great deal of variability in the cognitive and physical abilities of those within this population, as well as a range of access to financial resources and social support that may vary both individually and geographically. Moreover, the agencies serving this population depend heavily on the time and donations of volunteers to carry out their important work. Therefore, to ensure their implementation, interventions designed to address food safety issues within this population must be relatively simple, efficient, and cost effective.

To address these issues, a multi-method research approach will be used, incorporating Universal Product Code (UPC) scanning technology combined with a dynamically growing database of foods and their associated nutritional parameters to catalogue the in-home food supply, an extant home food safety audit form, modified for study use, and a computer-enhanced questionnaire administered during an in-home interview. This project will provide a useful understanding of the nutritional and food safety gaps in this at-risk population that will allow for the design and testing of interventions to improve the food safety of both the HDM and the in-home food available to the homebound elderly. It will also provide clear and useful guidelines about the amount and types of food most needed by this population in emergency situations. Dissemination of the resulting research findings and recommendations will be accomplished through a partnership with the Extension Disaster Education Network (EDEN) and MOWA, both of whom have national constituencies poised to act on the recommendations.

HDM agencies from 5 states (AR, CA, IA, NJ, SC) will be purposively selected because of the varied characteristics of their HDM clients, as identified in an analysis of HDM recipients by state. The purposive sample of states included at least one from each of four of the quintiles on the MOWA Senior Hunger state ranking, with two states from the top quintile. The chosen states also represented a range in terms of the percentage minority clients, with some high in minority population and one extremely low. Finally, the percentage of rural clients ranged from zero in one state to almost 70% in another. Each of the five agencies will be asked to complete the study protocol with 200 eligible HDM recipients drawn from those on their client rolls using random numbers generated by the study investigators. Sampling with replacement will be carried out until a quota of 200 participants is reached, or no additional eligible clients can be recruited within each agency. A targeted sample size of 200 participants for each agency was selected to provide an overall target sample of 1000 HDM recipients to yield an overall sampling error rate of ± 3.1%, based on a population of approximately 900,000 HDM recipients.

The study:

  1. Will analyze the food safety and quality parameters of the home food environments of homebound elderly recipients of HDM, and identify specific barriers to safe food-handling and storage practices by members of this high risk population. Refrigerator/freezer temperatures will be taken and adjustment made as needed to ensure that refrigerated foods are stored below 40 °F and frozen foods below 0 °F.
  2. Will estimate the nutrient density and adequacy of the home food supplies of homebound elderly recipients of HDM, and identify areas of nutrition in which this population is deficient and would benefit from specific supplemental nutrition, especially during emergencies.
  3. Two interventions will be proposed to improve food safety in homebound elderly recipients of HDM: the implementation of dating labels on the meals to help prevent the consumption of potentially unsafe older foods; checking refrigerator/freezer temperatures to determine temperature adherence/ maintenance, with adjustment made as needed.
  4. Will partner with nutritionists, emergency preparedness experts, MOWA, and the Extension Disaster Education Network (EDEN) to develop and disseminate food safety and emergency preparedness recommendations specifically tailored to the needs of the homebound elderly. Materials will be developed for emergency food providers, home delivery meal providers and the elderly themselves.

Rutgers will partner with the Meals on Wheels America (MOWA) and selected MOWA affiliated agencies in five states to conduct an in-depth study of this vulnerable population designed to improve the nutrition and safety of food consumed by homebound elderly recipients of HDM, and to strengthen the nation's food defense system by identifying and addressing the critical nutrition needs of this population, particularly during times of emergency.

Keywords
senior, nutrition, home delivered meals, food safety, emergency prep

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Food Safety Kitchen Audit Score

    A 7-scale home food safety kitchen audit score was calculated by summing the affirmative responses to the audit questions was calculated for each household. Items on each scale ranged from 3-12 for total score of 0 to 43 and all were weighted equally.

    Measured: Day 1

  2. Nutritional Adequacy Ratio (NAR)

    A household Nutrition Adequacy Ratio was calculated by summing nutrition values based on the daily values for a 2,000kcal diet for each food. NARs are ratios where 1 is recommended, >1 is more than recommended and <1 is inadequate.

    Measured: Day 1

Secondary outcomes (1)
  1. Nutritional Quality Score (QS)

    A household summary nutrition quality score was calculated by summing up the NARs for 6 recommended nutrients and dividing the result by the NARs for the non-recommended nutrients in the home food supply for each household.

    Quality Score is a ratio where 1 is recommended, >1 is more than recommended and <1 is inadequate.

    Measured: Day 1

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted25 Mar 2016 (estimated)
  2. Study startApr 2011
  3. Primary completionMay 2013
  4. Study completionMay 2013

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Case only
Time perspective
Cross-sectional
Enrolment
740 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02719626
Sponsor's protocol ID
10-551Mx
Other IDs
USDA NIFSI # 2010-51110-21078
Status last verified
Feb 2016
First submitted
3 Feb 2016
Last updated
25 Mar 2016
Results posted
No
Data monitoring committee
No
Individual data sharing
No: Aggregate results will be made available via website (in process).

Publications

  • Albertson AM, Wold AC, Joshi N. Ready-to-Eat Cereal Consumption Patterns: The Relationship to Nutrient Intake, Whole Grain Intake, and Body Mass Index in an Older American Population. J Aging Res. 2012;2012:631310. doi: 10.1155/2012/631310. Epub 2012 Oct 10.

    PubMed 23094158
  • Aldrich N, Benson WF. Disaster preparedness and the chronic disease needs of vulnerable older adults. Prev Chronic Dis. 2008 Jan;5(1):A27. Epub 2007 Dec 15.

    PubMed 18082016
  • Anderson AL, Verrill LA, Sahyoun NR. Food safety perceptions and practices of older adults. Public Health Rep. 2011 Mar-Apr;126(2):220-7. doi: 10.1177/003335491112600213.

    PubMed 21387952
  • Almanza BA, Namkung Y, Ismail JA, Nelson DC. Clients' safe food-handling knowledge and risk behavior in a home-delivered meal program. J Am Diet Assoc. 2007 May;107(5):816-21. doi: 10.1016/j.jada.2007.02.043.

    PubMed 17467379
  • Altshuler, N & Schimmel, J. USDHHS, Administration on Aging. Aging in Place: Do Older Americans Act Title III Services Reach Those Most Likely to Enter Nursing Homes? Research Brief Number 1, 2010. Available at: http://www.aoa.gov/aoaroot/program_results/docs/2010/AoA1_NursingHomes_012011.pdf Accessed on 06/23/14.

  • Barile JP, Thompson WW, Zack MM, Krahn GL, Horner-Johnson W, Bowen SE. Multiple chronic medical conditions and health-related quality of life in older adults, 2004-2006. Prev Chronic Dis. 2013 Sep 26;10:E162. doi: 10.5888/pcd10.120282.

    PubMed 24070034
  • Barrett, A & Schimmel, J. USDHHS, Administration on Aging. OAA Title III Services Target the Most Vulnerable Elderly in the United States. Research Brief Number 2, 2010. Available at: http://www.aoa.gov/Program_Results/docs/2010/AoA_2_HealthStatus_041311.pdf Accessed on 06/23/2014.

  • Blackburn ML, Bruhn CM, Miller LS, Ganthavorn C, Ober BA. Seniors, and their food handlers and caregivers, need food safety and nutrition education. Calif Agric. 2014;68(1):30-37. DOI: 10.3733/ca.v068n01p30.

  • Bouillon K, Kivimaki M, Hamer M, Shipley MJ, Akbaraly TN, Tabak A, Singh-Manoux A, Batty GD. Diabetes risk factors, diabetes risk algorithms, and the prediction of future frailty: the Whitehall II prospective cohort study. J Am Med Dir Assoc. 2013 Nov;14(11):851.e1-6. doi: 10.1016/j.jamda.2013.08.016. Epub 2013 Oct 6.

    PubMed 24103860
  • Buzby JC. Older adults at risk of complications from microbial foodborne illness. Food Review. 2002;25(2):30-35.

  • Byrd-Bredbenner C, Maurer J, Wheatley V, Cottone E, Clancy M. Food safety hazards lurk in the kitchens of young adults. J Food Prot. 2007 Apr;70(4):991-6. doi: 10.4315/0362-028x-70.4.991.

    PubMed 17477272
  • Byrd-Bredbenner C, Abbot JM, Cussler E. Nutrient profile of household food supplies of families with young children. J Am Diet Assoc. 2009 Dec;109(12):2057-62. doi: 10.1016/j.jada.2009.09.006.

    PubMed 19942024
  • Byrd-Bredbenner C, Schaffner DW, Maurer Abbot J. How food safe is your home kitchen? A self-directed home kitchen audit. J Nutr Educ Behav. 2010 Jul-Aug;42(4):286-9. doi: 10.1016/j.jneb.2010.01.008. No abstract available.

    PubMed 20579613
  • Cates SC, Kosa KM, Karns S, Godwin SL, Speller-Henderson L, Harrison R, Ann Draughon F. Food Safety Knowledge and Practices among Older Adults: Identifying Causes and Solutions for Risky Behaviors. J Nutr Elder. 2009 Apr;28(2):112-26. doi: 10.1080/01639360902949986.

    PubMed 21184361
  • Champion V & Skinner C. The Health Belief Model. In: Glanz K, Rimer B, Viswanath K, eds. Health behavior and health education: theory, research, and practice, 4th Ed. San Francisco: Jossey-Bass, 2008:45-66.

Questions about this trial

What is this clinical trial studying?

An observational study of Food Safety and Nutritive Value, run by Rutgers, The State University of New Jersey at 7 sites in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 25 Mar 2016. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 7 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Food Safety Kitchen Audit Score (time frame: Day 1). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT02719626, which also lists 108 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 25 Mar 2016.

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