The purpose of this paper is to identify: motivations and perceived barriers associated with food choices made by homebound older adults; whether motivations and perceived barriers vary according to social demographic characteristics; and whether motivations and perceived barriers are associated with dietary quality.
This was an observational study using standard interview methods where participants were administered a questionnaire and completed three 24-hour dietary recalls.
Participants were interviewed in their homes.
185 homebound older adults were included.
Motivations were assessed using a modification of The Food Choice Questionnaire and perceived barriers were assessed using the Vailas Food Enjoyment Questionnaire. Participants answered questions regarding social demographic characteristics. Dietary quality measures of adequate intakes of calories, protein, vitamin D, and vitamin B12 were obtained from the three 24-hour dietary recalls.
Mean age was 78.9; 80% were female; and 36% were African American. Key motivations in food choice included sensory appeal, convenience, and price. Key barriers included health, being on a special diet, and being unable to shop. These varied little by social demographics, except for age. Dietary quality varied according to different motivations and barriers.
Food choices are based upon a complex interaction between the social and environmental context, the individual, and the food. Efforts to change eating behaviors, especially community-based interventions involving self-management approaches, must carefully take into account individuals’ self-perceived motivations and barriers to food selection. Incorporating foods that are tasty, easy to prepare, inexpensive, and that involve caregivers are critical for successful interventions.
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McLeroy KR, Bibeau D, Steckler A, Glanz K. An ecological perspective on health promotion programs. Health Education Quarterly 1988;15:351–377.
Hovell MF, Wahlgren DR, Gehrman C. The behavioral ecological model: Integrating public health and behavioral science. In: DiClemente RJ, Crosby R, Kegler M, eds. New and Emerging Theories in Health Promotion Practice & Research. San Francisco, California: Jossey-Bass Inc.; 2002.
Rimer B, Glanz K. Theory at a Glance: A Guide for Health Promotion Practice, 2nd Ed. US Department of Health and Human Services, National Institutes of Health, National Cancer Institute. 2005; http://cancer.gov/aboutnci/oc/theory-at-aglance/print
Locher JL, Sharkey JS. An ecological model for understanding eating behavior in older adults. In CW Bales & CS Ritchie (Eds.). Handbook of Clinical Nutrition and Aging, 2nd Ed. Totowa, NJ: Humana Press; 2009 expected.
Locher JL, Ritchie CS, Robinson CO, Roth DL, West DS, Burgio KL. A multidimensional approach to understanding under-eating in homebound older adults: The importance of social factors. The Gerontologist, 2008;48:223–234.
Millen BE, Silliman RA, Cantey-Kiser J, Copenhafer DL, Ewart CV, Ritchie CS, et al. Nutritional risk in an urban homebound older population: The nutrition and healthy aging project. Journal of Nutrition, Health and Aging, 2001;5:269–277.
Millen Posner BE, Smigelski CG, McLaren Krachenfels MS. Dietary characteristics and nutrient intake in an urban homebound population. Journal of the American Dietetic Association, 1987;8:452–456.
Payette H, Gray-Donald K, Cyr R, Boutier V. Predictors of dietary intake in a functionally dependent elderly population in the community. American Journal of Public Health, 1985;85(5):677–683.
Sharkey JR, Branch L, Zohoori N, Giuliani C, Busby-Whitehead J, Haines PS. Inadequate nutrient intakes among homebound elderly and their correlation with individual characteristics and health-related factors. American Journal of Clinical Nutrition, 2002;76:1535–1545.
Sharkey JR. Risk and presence of food insufficiency are associated with low nutrient intakes and multimorbidity among homebound older women who receive homedelivered meals. The Journal of Nutrition, 2003;3485–3491.
Martin CT, Kayser-Jones J, Stotts NA, Froelicher SE. Community-living elders’ views on normal and low weight. Journal of Nutrition Health and Aging. 2008;12(1):45–48.
Medicare Payment Advisory Commission. Report to the Congress: Medicare Payment Policy. Washington, DC: MedPac. Medicare Health Support, Centers for Medicare and Medicaid Services. March 2006. http://www.cms.hhs.gov/CCIP/. Accessed 09. 26.06.
National Center for Health Statistics, Health, United States, 2006 with Chartbook on Trends in the Health of Americans. 2006. Washington, DC: U. S. Government Printing Office.
Wellman NS, Kamp BF. Federal food and nutrition assistance programs for older people. Generations, 2004;28:78–83.
Drewnowski A, Shultz JM. Impact of aging on eating behaviors, food choices, nutrition, and health status. Journal of Nutrition, Health and Aging, 2001;5(2):75–79.
Payette H, Shatenstein B. Determinants of healthy eating in community-dwelling elderly people. Canadian Journal of Public Health. 2005;96 S3:S27–S31.
Falk LW, Bisogni CA, Sobal J. Food choice processes of older adults: A qualitative investigation. Journal of Nutrition Education, 1996;28(5):257–265.
Bisogni CA, Connors M, Devine CM, Sobal J. Who we are and how we eat: a qualitative study of identities in food choice. J Nutrition Education and Behavior, 2002;34(3):128–139.
Fischler C. Fischler, Food, self and identity, Social Science Information, 1988;27:275–292.
Lupton D. Food, the Body, and the Self. London: Sage. 1996.
Steptoe A, Pollard TM, Wardle J. Development of a measure of the motives underlying the selection of food: the Food Choice Questionnaire. Appetite, 1995;25:267–284.
de Almeida MD, Graca P, Afonso C, Kearney JM, Gibney, MJ. Healthy eating in European elderly: concepts, barriers, and benefits. Journal of Nutrition, Health, and Aging, 2001;5(4):217–219.
Hughes GM Bennett KM Hetherington MM. Old and alone: Barriers to healthy eating in older men living on their own. Appetite, 2004;43(3):269–276.
Schakel SF, Sievert YA, Buzzard IM. Sources of data for developing and maintaining a nutrient database. J. Am Diet Assoc, 1988;88:1268–1271.
Witschi JC. Short-term recall and recording methods. In Willett W, ed. Nutritional Epidemiology. New York: Oxford University Press; 1990:663–671.
Vailas L, Nitzke SA, Becker M, Gast J. Risk indicators for malnutrition are associated inversely with quality of life for participants in meal programs for older adults. Journal of the American Dietetic Association, 1998;98 (5):548–553.
Bickel G, Nord M, Price C, Hamilton W, Cook J. Measuring Food Security in the United States: Guide to Measuring Household Food Security, Rev. 2000. United States Department of Agriculture, Food and Nutrition Service, Office of Analysis, Nutrition, and Evaluation.
Anderson SA. Core indicators of nutritional state for difficult-to-sample populations. Journal of Nutrition, 1990;120:1557–1600.
Dietary guidelines for Americans 2005. (2005). US Department of Health and Human Services and United States Department of Agriculture. http://www.health.gov/dietaryguidelines/. Accessed 09/10/07.
Dietary Reference Intake for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids (Macronutrients). 2005. National Academy Press. http://www.nap.edu/catalog/10490.html. Accessed 07.20.06.
American Dietetic Association. Position of the American Dietetic Association: Liberalization of diet prescription improves quality of life for older adults in longterm care. Journal of the American Dietetic Association, 2005;105:1955–1965.
Schultz R, Heckhausen J, Locher JL. Adult development, control, and adaptive functioning. Journal of Social Issues, 1991;47:177–196.
Sahyoun NR, Pratt CA, Anderson A. Evaluation of nutrition education interventions for older adults: A proposed framework. Journal of the American Dietetic Association. 2004;104:58–69.
American Dietetic Association. Position of the American Dietetic Association: Nutrition across the spectrum of aging. Journal of the American Dietetic Association, 2005;105:616–633.
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Locher, J.L., Ritchie, C.S., Roth, D.L. et al. Food choice among homebound older adults: Motivations and perceived barriers. J Nutr Health Aging 13, 659–664 (2009). https://doi.org/10.1007/s12603-009-0194-7
- Food choice
- health beliefs
- health behavior
- nutrition intervention
- nutrition policy