2019 Volume 77 Issue 4 Pages 85-96
Objectives: To implement outcome evaluation, process evaluation, and structure evaluation of a nutrition care program for community-dwelling older adults. Prior to conducting this study, we developed process and structure evaluation sheets on the program.
Methods: The nutrition care program was conducted three times in a series for the prevention of malnutrition in which 29 older adults (7 men and 22 women, mean age 71.8 ± 4.9 years) participated. For nutrition assessment, data from blood tests, physical measurements, and nutritional intake were collected before and after the program. From the data, the stages of dietary behavior change and energy/protein intake were set as primary and secondary outcomes, respectively. The process and structure of the program implementation were evaluated by two registered dietitians using the evaluation sheets consisting of 14 process items and 9 structure items on a four point scale.
Results: Dietary behavior improved in 31.0% of the participants after the program. Energy intake increased significantly from 2,124 ± 746 kcal to 2,398 ± 808 kcal (p = 0.005) along with protein intake from 95.7 ± 41.4 to 111.7 ± 41.1 g/d (p = 0.005). The process and structure evaluation revealed that appropriate program planning and implementation, and multidisciplinary collaboration contributed to the outcome obtained, and that insufficient "Check" and "Action" in the PDCA cycle was the issue.
Conclusion: An improvement in both dietary behavior and nutrient intake were observed through the nutrition care program. In addition, the process and structure evaluations were conducive to managing the quality of the program.
