Abstract
BackgroundThe limited or uncertain access to adequate food in elderly people includes not only economic restrictions but also inability of food utilization due to functional or cognitive impairment, health problems, and illiteracy.ObjectiveThe aim of this work is to present the protocol of the randomized controlled trial Saúde.Come Senior, an educational and motivational television (TV)-based intervention to promote healthy lifestyles and decrease food insecurity in elderly people.MethodsA randomized controlled study will be conducted in subjects aged 60 years and older with food insecurity, identified at 17 primary care centers in the Lisboa e Vale do Tejo health region in Lisbon, Portugal. The primary outcome will be the changes in participants’ food insecurity score (evaluated by the Household Food Insecurity Scale) at 3 months. Change in other outcomes will be assessed (dietary habits, nutritional status, physical activity, health status, and clinical outcomes). Subjects will be followed over 6 months; the intervention will last 3 months. Data collection will be performed at 3 different time points (baseline, end of intervention at 3 months, and follow-up at 6 months). The intervention is based on an interactive TV app with an educational and motivational program specifically developed for the elderly that has weekly themes and includes daily content in video format: (1) nutrition and diet tips for healthy eating, (2) healthy, easy to cook and low-cost recipes, and (3) physical exercise programs. Furthermore, brief reminders on health behaviors will also be broadcasted through the TV app. The total duration of the study will be 6 months. The intervention is considered to be effective and meaningful if 50% of the individuals in the experimental group have a decrease of 1 point in the food insecurity score, all the remaining being unchanged. We expect to include and randomize 282 (141 experimental and 141 control) elderly with food insecurity. We will recruit a total of 1,128 subjects considering that 50% of the target individuals are food insecure (based on INFOFAMÍLIA Survey) (567) and about 50% of those will adhere to the study (282).ResultsThe randomized controlled trial with the 12-week home-based intervention with a comprehensive program on healthy eating and physical activity delivery is planned to start recruiting participants at the end of 2017.ConclusionsThis study will assess the efficacy of this innovative tool (Saúde.Come Senior) for disseminating relevant health information, modifying behaviors, and decreasing food insecurity in an easy, low-cost, and massive way.
Highlights
The world is facing a situation without precedent: soon there will be more older people than children and more people at extreme old ages than ever before [1]
The impact of an economic crisis may be acute for older people, mainly for those who are physically vulnerable, living in poverty, or dependent on private pensions, leading to adverse lifestyles and health outcomes
Elderly people with food insecurity report reduced quality, variety, or desirability of diet which leads to higher morbidity through decompensated chronic noncommunicable diseases, low muscle strength with less mobility, higher mortality, and higher health care costs [4,5]
Summary
The world is facing a situation without precedent: soon there will be more older people than children and more people at extreme old ages than ever before [1]. Portugal has a high proportion of elderly persons and is one of the European countries with the lowest birth rate [2]. As both the proportion of older people and the length of life increase throughout the world, some key questions arise. The impact of an economic crisis may be acute for older people, mainly for those who are physically vulnerable, living in poverty, or dependent on private pensions, leading to adverse lifestyles and health outcomes. The limited or uncertain access to adequate food in elderly people includes economic restrictions and inability of food utilization due to functional or cognitive impairment, health problems, and illiteracy
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