Validity of the Australian Recommended Food Score as a diet quality index for Pre-schoolers.

BACKGROUND: Diet quality tools provide researchers with brief methods to assess the nutrient adequacy of usual dietary intake. This study describes the development and validation of a pediatric diet quality index, the Australian Recommended Food Scores for Pre-schoolers (ARFS-P), for use with children aged two to five years. METHODS: The ARFS-P was derived from a 120-item food frequency questionnaire, with eight sub-scales, and was scored from zero to 73. Linear regressions were used to estimate the relationship between diet quality score and nutrient intakes, in 142 children (mean age 4 years) in rural localities in New South Wales, Australia. RESULTS: Total ARFS-P and component scores were highly related to dietary intake of the majority of macronutrients and micronutrients including protein, ß-carotene, vitamin C, vitamin A. Total ARFS-P was also positively related to total consumption of nutrient dense foods, such as fruits and vegetables, and negatively related to total consumption of discretionary choices, such as sugar sweetened drinks and packaged snacks. CONCLUSION: ARFS-P is a valid measure that can be used to characterise nutrient intakes for children aged two to five years. Further research could assess the utility of the ARFS-P for monitoring of usual dietary intake over time or as part of clinical management.

Can Better Outdoor Environments Lead to Cost Benefits in Assisted Living Facilities Through Increased Word-of-Mouth Referrals?

OBJECTIVE: This study explores how better outdoor environments may produce cost benefits for assisted living providers by raising occupancy levels through increased resident satisfaction and word-of-mouth referrals. BACKGROUND: Older adults who spend even minimal time outdoors may reap substantial health benefits. However, many existing outdoor areas in assisted living facilities are reportedly underutilized, in part because of design issues. Providers may be more willing to improve outdoor areas if they produce cost benefits for provider organizations. METHODS: This study used data from a recent assisted living survey to assess the relationship between satisfaction with outdoor spaces, time spent outdoors, and resulting improvements in mood. A financial analysis was developed to estimate potential benefits from improved outdoor areas attributable to increased occupancy and decreased marketing costs associated with increased word-of-mouth referrals. RESULTS: Increasing resident satisfaction with outdoor areas (from approximately 29% to 96%) results in residents spending more time outdoors (increase of 1½ hours per week per resident) and improved psychological well-being (12% increase in feeling better). This greater overall satisfaction leads to 8% more residents willing to refer potential residents to their community. Because word-of-mouth referrals by current residents are a major factor in resident recruitment, improving outdoors areas leads to an estimated 4% increase in new residents, resulting in over $170,000 of increased revenue per year for a community of 100 residents. CONCLUSIONS: Improved outdoor space can provide substantial cost benefits for assisted living providers. Increasing resident well-being and satisfaction, and thereby generating additional word-of-mouth referrals, can result in higher occupancy levels. KEYWORDS: Outdoor environments, assisted living, cost benefits, resident satisfaction, occupancy levels, seniors, rental income, word-of-mouth referralPreferred Citation: Rodiek, S., Boggess, M. M., Lee, C., Booth, G. J., & Morris, A. (2013). Can better outdoor environments lead to cost benefits in assisted living facilities through increased word-of-mouth referrals? Health Environments Research & Design Journal 6(2), pp. 12-26.