University of Kentucky UKnowledge Theses and Dissertations--Communication Communication 2020 ENCOURAGING HEALTHY EATING AMONG OLDER ADULTS USING THE TRANSTHEORETICAL MODEL: AN EVALUATION OF A PILOT INTERVENTION Lauren Brinkman Roberson University of Kentucky, [email protected] Digital Object Identifier: https://doi.org/10.13023/etd.2020.314 Right click to open a feedback form in a new tab to let us know how this document benefits ou.y Recommended Citation Roberson, Lauren Brinkman, "ENCOURAGING HEALTHY EATING AMONG OLDER ADULTS USING THE TRANSTHEORETICAL MODEL: AN EVALUATION OF A PILOT INTERVENTION" (2020). Theses and Dissertations--Communication. 93. https://uknowledge.uky.edu/comm_etds/93 This Doctoral Dissertation is brought to you for free and open access by the Communication at UKnowledge. It has been accepted for inclusion in Theses and Dissertations--Communication by an authorized administrator of UKnowledge. For more information, please contact [email protected]. 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Lauren Brinkman Roberson, Student Dr. Kimberly Parker, Major Professor Dr. Anthony Limperos, Director of Graduate Studies ENCOURAGING HEALTHY EATING AMONG OLDER ADULTS USING THE TRANSTHEORETICAL MODEL: AN EVALUATION OF A PILOT INTERVENTION __________________________________________ DISSERTATION __________________________________________ A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy in the College of Communication and Information at the University of Kentucky By Lauren Brinkman Roberson Lexington, KY Co-Directors: Dr. Kimberly Parker, Associate Professor of Integrated Strategic Communication and Dr. Bobi Ivanov, Professor of Integrated Strategic Communication Lexington, Kentucky Copyright © Lauren Brinkman Roberson 2020 ABSTRACT OF DISSERTATION ENCOURAGING HEALTHY EATING AMONG OLDER ADULTS USING THE TRANSTHEORETICAL MODEL: AN EVALUATION OF A PILOT INTERVENTION Older adults, defined as those age 60 and above, are at an increased risk for many health-related complications that are directly related to nutrition (Centers for Disease Control and Prevention, 2015). This study highlights the lack of nutrition education material developed for older adults in Kentucky. Such material has great potential to influence the health of older adults (Chernoff, 2001). This study evaluated an intervention developed, by means of formative research, to teach older adults nutrition basics. Both direct and indirect measures related to stages of change for healthy eating behaviors were collected six weeks pre-intervention and then immediately post- intervention. Grocery store receipts (behavioral measure), Pfizer’s (2011) “Newest Vital Sign (NVS)” tool (cognitive measure), a modified version of Andres et al. (2011) S- Weight and P-Weight questionnaire (attitudinal measure) and focus groups with staff, caretakers, and administrators working with older adults, served as tools for data collection. In addition, participants were interviewed, either one-on-one or in a focus group setting after the conclusion of the intervention. The goal was to assess general feedback with regards to intervention implementation and areas for improvement. While none of the quantitative data achieved statistical significance, qualitative data showed promise with regards to the intervention having a positive effect on participants. Specifically, the intervention had a positive impact on nutrition behavior, knowledge, and attitudes. Older adults indicated increased knowledge in relation to reading a nutrition facts label and judging appropriate portion size. In addition, participants indicated behavior change via decreased calorie intake due to portion size awareness, intentional food choice, and decreased grocery spending. Likewise, participants conveyed positive attitudes towards eating healthy, preparing food at home, and monitoring their caloric intake. While the intervention was influenced by the novel COVID-19, results offer many theoretical and practical implications; both of which are discussed. KEYWORDS: Nutrition Education, Older Adults, Malnutrition, Transtheoretical Model, Evaluation Lauren Brinkman Roberson ___________________________________________ July 21st, 2020 ___________________________________________ Date ENCOURAGING HEALTHY EATING AMONG OLDER ADULTS USING THE TRANSTHEORETICAL MODEL: AN EVALUATION OF A PILOT INTERVENTION By Lauren Brinkman Roberson Dr. Kimberly A. Parker _______________________________________ Co-Director of Dissertation _______________________________________Dr. Bobi Ivanov Co-Director of Dissertation Dr. Anthony Limperos _______________________________________ Director of Graduate Studies July 21st, 2020 _______________________________________ DEDICATION Few people can honestly say that they have found their calling. That special niche where they fit. I am both grateful and blessed to have been given the opportunity to find mine. I am forever grateful. I am happy. I am confident. I am home in academia doing research and teaching with potential to impart change. Thank you, Dr. Kimberly Parker and Dr. Bobi Ivanov for giving me that chance. I dedicate this work to you as a token of my appreciation. Thank you both! ACKNOWLEDGEMENTS This dissertation could not have been completed without the guidance and support of many people. I would first like to thank Dr. Kimberly Parker. The amount of time, love, and energy that you invested in me, helping me to reach my true potential, has not gone unnoticed. I am so fortunate to have you in my life, both as a mentor and a friend. I look forward to our future journey, in scholarship and in life. I would like to second this moment of gratitude by thanking Dr. Bobi Ivanov, my dissertation co-chair, for believing in me and enabling me to pursue my research interests. Your guidance, encouragement, and expertise are both inspiring and invaluable. Thank you for helping me to accomplish my greatest achievement thus far in life – finding myself. In addition to my dissertation co-chairs, I would like to extend my appreciation for my dissertation committee. First, I would like to thank Dr. Beth Barnes for her ingenuity and guidance in data collection. Her experience in community-based participatory research is empowering. I have learned a great deal about the intricacies of field work as a result. Thank you! Second, I would like to thank Dr. Tina Studts for her direction in terms of measurement and evaluation design. I am honored that I was able to take a methods class with you. The emphasis that you place on developing and using rigorous instruments will stick with me forever. I appreciate your generosity in sharing your wisdom and your kind heart and support throughout this journey. Thank you! Lastly, I would like to thank Dr. Martha Biddle for her willingness to serve as an outside examiner on my committee. Your time and expertise are greatly appreciated as well, thank you! iii In keeping with the theme of gratitude, I would like to express my appreciation and thanks to the Graduate Program in Communication within the College of Communication and Information at the University of Kentucky. This program is second to none. Every faculty member, staff member, and administrator that I have had the pleasure to interact with has been extraordinarily, kind, helpful, and genuine. The plethora of experience that our college represents is phenomenal. I am both lucky and honored to have had the opportunity to study under such amazing people! Specifically, I would like to thank the following: Ms. Laure Ziembroski-Smith, Dr. Anthony Limperos, Dr. Nancy Harrington, Dr. Donald Helme, Dr. Allison Gordon, Dr. Kevin Real, and Dr. Renee Kaufman. Laure, from day one your warmth was infectious. Your encouragement and positive attitude really helped me to stay focused and succeed when writing my qualifying exams. Thank you! Dr. Limperos, you are the best professor. I am so thankful to have been able to take two classes with you. Your down-to-earth nature and ability to connect content with