Logic model and action plan for reducing old people with low nutritional tendencies

Abstract

Objective: Health Japan 21 (the second term) aims to decrease the proportion of older individuals with low nutritional tendencies (body mass index [BMI] ≤20 kg/m²) to less than 22% among those aged ≥65 years, and restrict the growing number of undernourished in this cohort. Despite the success of this program, further measures are needed to prevent increasing this number. The study aimed to present examples of individual measures and action plans based on a logic model and a ladder of interventions to reduce the proportion of undernourished older adults, as outlined in Health Japan 21 (the third term).

Methods: Immediate outcomes within the logic model were identified using indicators from long-term care and frailty prevention programs. Examples of output indicators that could evaluate individual measures were established. Individual measures were collected from the national and local governments, as well as relevant organizations.

Results: Intermediate outcomes included knowledge and skills, behavior, appetite, oral health, and nutrient and food intake. Individual measures corresponding to each level of the ladder of interventions are presented. An example of an action plan was presented, where “dining together” was incorporated into a frailty prevention activity. This action plan also promotes enjoying meals with a variety of foods, while considering the nutritional requirements of the elderly.

Conclusion: The action plans presented in this study are expected to help older adults in healthcare and weight management by creating a food environment that ensures adequate dietary intake to prevent undernutrition.