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Measurable behavior change may have been limited because of the short span of weeks in which treatment took place. Other considerations were (1) the environments of the congregate meal sites that varied in lighting, seating arrangements, distractions, and participant attentiveness and (2) the nutrition education on fruits and vegetables that the control group may have received from other sources prior to this study. Conclusions This study specifically examined the influence of nutrition education on the eating behaviors of older adults who resided in nonmetropolitan or semirural geographic areas and who were also participants of congregate meal programs. Based on recent trends, the nonmetropolitan or semi-rural older adult population is an important group to focus on because of factors such as the out-migration of younger persons in these areas and the sometimessegmented nutrition and health care services (ADA, 2000; Rogers, 1999). Further study is recommended of not only this geographic audience but also of a comparison of this audience with urban older adults who participate in congregate meal programs. Our findings indicate that the HELP nutrition lessons made a difference, measured by real and statistical significance, in how some older adults in the treatment group thought about changes, planned for changes, or made changes in their fruit- and vegetableeating behaviors. Additionally, there is merit to the use and further study of the questions on the Stages of Change instrument for fruit- and vegetableeating behaviors; that is, for the categorization of older adults’ behaviors into the Precontemplation, Contemplation, Preparation, Action, or Maintenance stages. Table 3. Post-test/pre-test sign test for Stages of Change computed for fruit- and vegetable-eating behaviors of elderly participants Treatment 1 Control 2 Fruits Percent Negative differences 24 16 Positive differences 22 20 Ties 54 64 Treatment 1 Control 2 Vegetables Percent Negative differences 8 17 Positive differences 41* 5 Ties 51 78 1 n = 37 for fruit-eating behaviors, and n = 37 for vegetable-eating behaviors. 2 n = 45 for fruit-eating behaviors, and n = 41 for vegetable-eating behaviors. *Differences in behavior changes from the pre-test to the post-test are significant, at p
References American Dietetic Association. (2000). Position of the American Dietetic Association: Nutrition, aging, and the continuum of care. Journal of the American Dietetic Association, 100(5), 580-595. American Dietetic Association. (1996). Position of the American Dietetic Association: Nutrition education for the public. Journal of the American Dietetic Association, 96(11), 1183-1187. Basiotis, P.P., Carlson, A., Gerrior, S.A., Juan, W.Y., & Lino, M. (2002). The Healthy Eating Index: 1999-2000. U.S. Department of Agriculture, Center for Nutrition Policy and Promotion. CNPP-12. Clarke, M.P., & Mahoney, S.M. (1996). A Healthy Eating for Life Program for Mature Adults. Kansas State University Agricultural Experiment Station and Cooperative Extension Service. Contento, I., Balch, G.I., Bronner, Y.L., Lytle, L.A., Maloney, S.K., Olson, C.M., et al. (1995). Nutrition education for older adults. Journal of Nutrition Education, 27, 339-346. Gerrior, S.A. (1999). Dietary changes in older Americans from 1977 to 1996: Implications for dietary quality. Family Economics and Nutrition Review, 12(2), 3-14. Hetzel, L. & Smith, A. (2001). The 65 Years and Over Population: 2000. Brief C2KBR/01-10. U.S. Census Bureau. Kristal, A.R., Glanz, K., Curry, S.J., & Patterson, R.E. (1999). How can stages of change be best used in dietary intervention? Journal of the American Dietetic Association, 99(6), 679-684. Laforge, R.G., Greene, G.W., & Prochaska, J.O. (1994). Psychological factors influencing low fruit and vegetable consumption. Journal of Behavioral Science, 17(4), 361-374. Nigg, C.R., Burbank, P.M., Padula, C., Dufresne, R., Rossi, J.S., Velicir, W.F., et al. (1999). Stages of change across ten health risk behaviors for older adults. The Gerontologist, 39(4), 473-482. Nunnally, J.C. (1967). Psychometric Theory. New York, NY: McGraw-Hill. Price, C.A. (2001). The Impact of Demographic Changes on Society. Presentation at Northwest District Family Nutrition Program In-Service on Aging. Columbus, Ohio. Prochaska, J.O., Norcross, J.C., & DiClemete, C.C. (1994). Changing for Good. New York, NY: William Morrow and Company, Inc./Avon Books. 2003 Vol. 15 No. 1 23
Page 1 and 2: Research Articles Special Issue Eld
Page 3 and 4: CENTER FOR NUTRITION POLICY AND PRO
Page 5 and 6: Research Articles Improving Calcium
Page 7 and 8: fiber, niacin, and vitamin C than d
Page 9 and 10: Researchers completed and compiled
Page 11 and 12: greens were a good source of dietar
Page 13 and 14: Marketing and education strategies
Page 15 and 16: Jackson, K.A., & Savaiano, D.A. (20
Page 17 and 18: The Influence of the Healthy Eating
Page 19 and 20: Box 1 - Basic definitions of the St
Page 21 and 22: Treatment and Analysis The HELP was
Page 23: Table 2. Pre-test and post-test com
Page 27 and 28: Using a Concurrent Events Approach
Page 29 and 30: her daughter and husband, who died
Page 31 and 32: money started to become depleted be
Page 33 and 34: References Administration on Aging,
Page 35 and 36: Measuring the Food Security of Elde
Page 37 and 38: Scaling Analysis: Do the Elderly an
Page 39 and 40: that of the item and affirmations o
Page 41 and 42: food sufficiency question (3.9 perc
Page 43 and 44: Figure 1. Comparison of item severi
Page 45 and 46: Table 3. Other food problems report
Page 47 and 48: References Andrews, M., Nord, M., B
Page 49 and 50: A Statewide Educational Interventio
Page 51 and 52: the Georgia Division of Aging Servi
Page 53 and 54: Table 2. Fruit and vegetable intake
Page 55 and 56: Many of the participants’ perform
Page 57 and 58: Table 4. Physical activity, knowled
Page 59 and 60: Hackman, R.M., & Wagner, E.L. (1990
Page 61 and 62: these cognitive demands (Buzzard &
Page 63 and 64: Phase II In this phase, 90 differen
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average educational attainment and
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increasing portion of the budget mu
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women often continue working past a
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Table 3. Diet and disease restricti
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In 1994, Midwest consumers faced fo
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Reduction in Modifiable Osteoporosi
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Baseline At baseline, heel BMD, wei
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Table 2. Baseline and post-interven
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Table 4. Ethnic differences between
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Katzman, R., Brown, R., Fuld, P., P
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More older men than older women lik
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Schools offer a mix of foods in add
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More families own stock Families ma
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Expenditures vary by age Expenses o
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Consumer Prices Consumer Consumer P
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2003 Vol. 15 No. 1 103
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Guidelines for Submissions to Famil
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