Ageism webinars: a needs-based continuing education training for the national aging network.

To combat ageism, the National Resource Center on Nutrition and Aging (NRCNA) launched two Ageism Webinars (AWs). The study's aims were to 1) assess the effectiveness of the AWs for increasing participants' perceived familiarity (FAM) and knowledge (KNOW) and producing high behavioral intent to implement recommended action steps and quality among participants, and 2) practice equitable evaluation by ascertaining whether outcomes were fairly achieved by participants regardless of race, age, and education. A convenience sample of mostly educated non-Hispanic females with an average age of 52 years (n = 193) completed a retrospective online survey post-webinar. A retrospective Likert scale noted an overall increase in perceived FAM and KNOW (p < 0.001). However, these changes were significantly smaller (p < 0.05) among those from historically marginalized races and ethnicities. The theory of planned behavior (TPB) items predicted high intention to complete the recommended action step following the webinars. High satisfaction for webinars was reported, with 98.7% wanting to attend future NRCNA training. This study provides evidence of an effective training modality for addressing ageist perspectives, and the demonstrated differences provide insight into how to improve the AWs and the evaluation of future webinars.

Middle Age and Older Adults: Their Nutrition and Physical Activity Needs and How Best to Address Them.

This cross-sectional study assessed the nutrition and physical activity (PA) needs, practices, and programming preferences of adults ages 40+ years from seven states (n = 1,250). Respondents were mostly educated, White, food-secure, adults ages 60+ years. Many were married, suburban-residing, and interested in health programming. By self-report most respondents were "at nutritional risk" (59.3%), in "somewhat good health" (32.3%), and sedentary (49.2%). One-third reported PA intention in the next two months. Desired programs were less than four weeks and under 4 h weekly. Respondents preferred to attend self-directed online lessons (41.2%). Program format preference varied by age (P < 0.05). More respondents aged 40-49 years and 70+ years reported a preference for online group sessions compared to those aged 50 to 69 years. Respondents ages 60 to 69 years reported the highest preference for interactive apps. More older respondents (60 years and older) preferred asynchronous online lessons compared to the younger respondents (age 59 years and younger). There were significant program participation interest differences by age, race, and location (P< 0.05). These results revealed a need and preference for self-directed, online health programming for middle-aged and older adults.

Healthcare Professionals' Views and Perspectives towards Aging.

Improving care for the older population is a growing clinical need in the United States. Ageism and other attitudes of healthcare professionals can negatively impact care for older adults. This study investigated healthcare professionals' (N = 140) views towards aging and characterized a confluence of factors influencing ageism perspectives in healthcare workers using path analysis models. These models proposed relationships between aging anxiety, expectations regarding aging, age, ageism, and knowledge. Aging anxiety had a less critical role in the final model than hypothesized and influenced ageism in healthcare workers through its negative effect (ß = -0.27) on expectations regarding aging. In contrast, aging knowledge (ß = -0.23), age (ß = -0.27), and expectations regarding aging (ß = -0.48) directly and inversely influenced ageism. Increased knowledge about the aging process could lower ageism amongst healthcare professionals and improve care for older adults. The results put forth in this study help to characterize and understand healthcare workers' complex views towards the aging population they often encounter. Moreover, these results highlight the need and utility of leveraging practitioner education for combating ageism in the clinical setting.

A cross-sectional assessment of food practices, physical activity levels, and stress levels in middle age and older adults' during the COVID-19 pandemic.

Aim: This cross-sectional study examined how the COVID-19 pandemic impacted the food practices, physical activity (PA) levels, and stress levels of aging adults ages 40 years and older from seven states. It also explored to what extent the COVID-19 outcomes were affected by the social determinants of health (SDH). Subject and methods: Respondents (n = 1250) completed an online survey. Descriptive statistics were used to analyze the sociodemographic attributes and COVID-19 responses while the multiple llinear regression (MLR) test evaluated to what extent the SDH variables measured were associated with the reported COVID-19 impacts food practices, PA levels, and stress levels. Results: Respondents were mostly White (75.9%), married (58.7%), age 60 years and older (61.8%), with a high school education or higher (97.4%). Most of the respondents (85.8%) live in areas that respondents perceived as supportive of health and well-being opportunities for older adults. Nearly one-half of the respondents reported maintaining their pre-pandemic grocery shopping/food buying frequency (44.7%) and PA levels (48.1%). However, 48.6% reported being "somewhat or very stressed" due to the pandemic. Findings revealed that the COVID-19 impacts on food-buying, PA levels, and stress levels were significantly influenced by age, gender, race, education, location, community, nutritional risk, quality of life, food security, and income (p < 0.05). Conclusion: These findings provide valuable information as we continue to confront the impact the COVID-19 pandemic has had on the health and well-being of aging adults. We can use this information to inform future public health programming interventions and opportunities.

Virtual Delivery of Fresh Conversations, a SNAP-Ed Program: Participant Perceived Impact and Satisfaction.

This four-month study evaluated the virtual delivery of Fresh Conversations (FC). Participants were community-residing Iowans ages 60+ years. They were placed in one of four meeting groups based on location and participant preference: Zoom™, Adobe Connect®, group-based Zoom™ meeting, and teleconference. Participants were invited to complete a post-meeting online survey. Data analyses were completed using data from the first survey completed by each participant (n = 115). Descriptive statistics assessed response frequencies for all questions. Chi-Square and Mann-Whitney U tests assessed the differences between groups. Overall, participants were "satisfied/very satisfied" (72.1%), learned something new (85.2%), and intended to make behavior change (79.1%); no differences were detected by the group for satisfaction or reported impacts. Only 24.3% reported technical difficulties; the Adobe Connect® group reported the most difficulties (p = .004). These findings suggest virtual delivery of FC is well-received and perceived to be effective by participants.

Encore Café: An Innovative and Effective Congregate Nutrition Program.

Effective community food and nutrition programs are imperative for supporting older adults health and well-being. This three-part study examined to what extent the innovative congregate nutrition program (CNP), Encore Café, and targeted marketing campaign influenced CNP utilization, CNP program satisfaction, and overall CNP impact (e.g., nutritional risk, dietary practices, and loneliness). The Encore Café resulted in increases of 386% in meal distribution and 3,164% in CNP participants during a two-year period compared to a 20.8% reduction at traditional meal sites across the state. Total CNP satisfaction (food and dining) was high for both the Encore Café and Traditional CNP. Encore Café participants maintained their nutritional status and experienced significant reductions in emotional loneliness (p = 0.017) and dietary intake frequencies of processed meat (p = 0.027) compared to non-CNP participants. Utilizing a client-centered approach in marketing and programming for the Encore Café shows promising results for improving the utilization and effectiveness of the CNP.

Innovating the Iowa Congregate Nutrition Program: A Needs and Preference Assessment.

Participation in the Congregate Nutrition Program (CNP) is declining. This study examined CNP participation motivators, barriers, menu preferences, desired facility attributes, and educational programming to help identify strategies to increase participation. Four focus groups were held (3 = CNP participants only, n = 21; 1 = non-CNP participants, n = 11). They were audio-recorded, transcribed, and analyzed for common themes. All participants were White and food secure (93.8%). The majority were educated (75.8%), female (72.2%), and aged 71-80 years old (53.1%). CNP participation motivators were affordability, healthy meals, socialization, and location convenience. CNP participation barriers were limited awareness, the low perceived need for attending the CNP, and transportation. Ideal CNP characteristics were menu choice, variety of activities, and a welcoming ambiance. Preferred marketing strategies were print advertising and word of mouth. These findings provide insight as to how the CNP may be modified to be more appealing for the older adult population.

Perceived environmental supports for fruit and vegetable consumption among older adults in the US.

BACKGROUND: The physical and social environments surrounding food, whether perceived or observed, can influence consumers' food choices by changing food access, and affordability, or by changing settings where food-related behaviors occur. AIM: To describe older adults' perceived food environment, identify the most important sites and factors that enable healthy eating, and explore older adults' recommendations for communities to facilitate fruit and vegetable consumption. METHODS: Participants aged 60 and older from metropolitan areas in Massachusetts, Iowa, and Illinois completed a researcher-administered survey to rate the perceived environment including accessibility, availability, and affordability of fruits and vegetables, and perceived importance of factors and establishments related to fruit and vegetable consumption. Participants also suggested changes for establishments to facilitate fruit and vegetable consumption. RESULTS: The majority of the 142 participants perceived their food environment for fruits and vegetables as not difficult to access (85.2%) with good or excellent availability (90.1%). Education, marital status, and race were associated with some aspects of the perceived food environment. Perceived accessibility and supermarkets were rated as the most important factor and establishment, respectively, to facilitate fruit and vegetable consumption across all study sites. Participants proposed recommendations to address the availability, quality, accessibility and affordability of fruits and vegetables. CONCLUSION: Interventions promoting accessible, affordable, quality fruits and vegetables may improve older adult consumers' perceptions of their food environment. Communities may also use undervalued resources such as mobile markets more strategically to provide additional support for healthy eating in older adults.

Revising Diabetes Programming for Black Men and Their Families.

Type-2 diabetes has increased 160% for African American males in the United States. This two-part study's purpose was to apply social marketing theory to understand the Type-2 diabetes education needs of men in Iowa. Study One was a preference assessment of Type-2 diabetes education strategies. Four African American men participated in a series of four focus groups and indicated that they were interested in diabetes prevention programming with their families but not in having it labeled as diabetes education. Participating men would rather increase their physical activity as opposed to tracking their food intake. As a follow-up to this study, nine other African American males took part in Study Two, which used cooking demonstrations and recipe taste-testing with the men to examine their relationship to food in the context of managing their Type-2 diabetes. The findings of both studies, which provided insight into these African American men's lifestyle as related to their Type-2 diabetes, could be useful for nursing professionals who have a critical role in navigating cultural, gender, and family norms while developing care plans, offering patient education, and promoting quality of life.

Influence of Food Security Status and Anemia-Related Knowledge on Perceptions About 2 Nutritious Underutilized Foods Among Ghanaian Caregivers.

BACKGROUND: Nutritious underutilized foods (NUFs) significantly contribute to sustainable dietary diversity but are often unused for many reasons. OBJECTIVE: We assessed the influence of food security status (FSS) and anemia-related knowledge (ARK) on perceptions about Solanum torvum (turkey berry) and Rhynchophorus phoenicis Fabricius (palm weevil larvae) among Ghanaian caregivers. METHODS: A cross-sectional survey was conducted among 891 caregivers (aged 20-49 years), who have children 6 to 59 months old, from Upper Manya Krobo district (Eastern region), Kumasi metropolitan (Ashanti region), Ho municipality (Volta region), La-Nkwantanang-Madina, and Ga West municipality (Greater-Accra region), Ghana. Food security status, ARK, and perceptions about the 2 NUFs were obtained using pretested semi-structured questionnaire. Logistic regression models were used to determine effect of FSS and ARK on perception outcomes. RESULTS: Thirty-six percent of caregivers were food secure, while 13.9%, 28.4%, and 21.7%, respectively, were mildly, moderately, and severely food insecure. Most caregivers (62.0%) scored above 70% on ARK. High favorable perception was significantly lower for palm weevil larvae than that for turkey berry. Food secure caregivers were 4.5 times more likely to have poor favorable perceptions about palm weevil larvae than food insecure caregivers (P = .03). However, food secure caregivers were 2.9 times more likely to have high favorable perceptions about turkey berry than food insecure caregivers (P < .001). Caregivers' knowledge about anemia was associated with high favorable perception about turkey berry by 3.3-fold (95% confidence interval: 2-5.5, P = .001). CONCLUSIONS: Nutrition education about turkey berry and palm weevil larvae is needed to encourage their use for promoting nutrient density of complementary and household foods.

Elucidation of the AGR2 Interactome in Esophageal Adenocarcinoma Cells Identifies a Redox-Sensitive Chaperone Hub for the Quality Control of MUC-5AC.

Aims: AGR2 is a tissue-restricted member of the protein disulfide isomerase family that has attracted interest because it is highly expressed in a number of cancers, including gastroesophageal adenocarcinoma. The behavior of AGR2 was analyzed under oxidizing conditions, and an alkylation trapping and immunoprecipitation approach were developed to identify novel AGR2 interacting proteins. Results: The data show that AGR2 is induced in esophageal adenocarcinoma, where it participates in redox-responsive, disulfide-dependent complexes. AGR2 preferentially engages with MUC-5 as a primary client and is coexpressed with the acidic mucin in Barrett's esophagus and esophageal adenocarcinoma tissue. Innovation: New partner chaperones for AGR2 have been identified, including peroxiredoxin IV, ERp44, P5, ERp29, and Ero1α. AGR2 interacts with unexpected metabolic enzymes, including aldehyde dehydrogenase (ALDH)3A1, and engages in an alkylation-sensitive association with the autophagy receptor SQSTM1, suggesting a potential mechanism for the postendoplasmic reticulum targeting of AGR2 to mucin granules. Disulfide-driven AGR2 complex formation provides a framework for a limited number of client proteins to interact, rather than for the recruitment of multiple novel clients. Conclusion: The extended AGR2 interactome will facilitate the development of therapeutics to target AGR2/mucin pathways in esophageal cancer and other conditions, including chronic obstructive pulmonary disease.

Trichostatin A blocks aldosterone-induced Na+ transport and control of serum- and glucocorticoid-inducible kinase 1 in cortical collecting duct cells.

BACKGROUND AND PURPOSE: Aldosterone stimulates epithelial Na+ channel (ENaC)-dependent Na+ retention in the cortical collecting duct (CCD) of the kidney by activating mineralocorticoid receptors that promote expression of serum and glucocorticoid-inducible kinase 1 (SGK1). This response is critical to BP homeostasis. It has previously been suggested that inhibiting lysine deacetylases (KDACs) can post-transcriptionally disrupt this response by promoting acetylation of the mineralocorticoid receptor. The present study critically evaluates this hypothesis. EXPERIMENTAL APPROACH: Electrometric and molecular methods were used to define the effects of a pan-KDAC inhibitor, trichostatin A, on the responses to a physiologically relevant concentration of aldosterone (3 nM) in murine mCCDcl1 cells. KEY RESULTS: Aldosterone augmented ENaC-induced Na+ absorption and increased SGK1 activity and abundance, as expected. In the presence of trichostatin A, these responses were suppressed. Trichostatin A-induced inhibition of KDAC was confirmed by increased acetylation of histone H3, H4, and α-tubulin. Trichostatin A did not block the electrometric response to insulin, a hormone that activates SGK1 independently of increased transcription, indicating that trichostatin A has no direct effect upon the SGK1/ENaC pathway. CONCLUSIONS AND IMPLICATIONS: Inhibition of lysine de-acetylation suppresses aldosterone-dependent control over the SGK1-ENaC pathway but does not perturb post-transcriptional signalling, providing a physiological basis for the anti-hypertensive action of KDAC inhibition seen in vivo.

Position of the Academy of Nutrition and Dietetics and the Society for Nutrition Education and Behavior: Food and Nutrition Programs for Community-Residing Older Adults.

Given the increasing number and diversity of older adults and the transformation of health care services in the United States, it is the position of the Academy of Nutrition and Dietetics and the Society for Nutrition Education and Behavior that all older adults should have access to evidence-based food and nutrition programs that ensure the availability of safe and adequate food to promote optimal nutrition, health, functionality, and quality of life. Registered dietitian nutritionists and nutrition and dietetics technicians, registered, in partnership with other practitioners and nutrition educators, should be actively involved in programs that provide coordinated services between the community and health care systems that include regular monitoring and evaluation of programming outcomes. The rapidly growing older population, increased demand for integrated continuous support systems, and rising cost of health care underscore the need for these programs. Programs must include food assistance and meal programs, nutritional screening and assessment, nutrition education, medical nutrition therapy, monitoring, evaluation, and documentation of evidence-based outcomes. Coordination with long-term care services and support systems is necessary to allow older adults to remain in their homes; improve or maintain their health and manage chronic disease; better navigate transitions of care; and reduce avoidable hospital, acute, or long-term care facility admissions. Funding of these programs requires evidence of their effectiveness, especially regarding health, functionality, and health care-related outcomes of interest to individuals, caregivers, payers, and policy makers. Targeting of food and nutrition programs involves addressing unmet needs for services, particularly among those at high risk for poor nutrition. Registered dietitian nutritionists and nutrition and dietetics technicians, registered must increase programmatic efforts to measure outcomes to evaluate community-based food and nutrition services.

Position of the Academy of Nutrition and Dietetics and the Society for Nutrition Education and Behavior: Food and Nutrition Programs for Community-Residing Older Adults.

Given the increasing number and diversity of older adults and the transformation of health care services in the United States, it is the position of the Academy of Nutrition and Dietetics and the Society for Nutrition Education and Behavior that all older adults should have access to evidence-based food and nutrition programs that ensure the availability of safe and adequate food to promote optimal nutrition, health, functionality, and quality of life. Registered dietitian nutritionists and nutrition and dietetics technicians, registered, in partnership with other practitioners and nutrition educators, should be actively involved in programs that provide coordinated services between the community and health care systems that include regular monitoring and evaluation of programming outcomes. The rapidly growing older population, increased demand for integrated continuous support systems, and rising cost of health care underscore the need for these programs. Programs must include food assistance and meal programs, nutritional screening and assessment, nutrition education, medical nutrition therapy, monitoring, evaluation, and documentation of evidence-based outcomes. Coordination with long-term care services and support systems is necessary to allow older adults to remain in their homes; improve or maintain their health and manage chronic disease; better navigate transitions of care; and reduce avoidable hospital, acute, or long-term care facility admissions. Funding of these programs requires evidence of their effectiveness, especially regarding health, functionality, and health care-related outcomes of interest to individuals, caregivers, payers, and policy makers. Targeting of food and nutrition programs involves addressing unmet needs for services, particularly among those at high risk for poor nutrition. Registered dietitian nutritionists and nutrition and dietetics technicians, registered must increase programmatic efforts to measure outcomes to evaluate community-based food and nutrition services. POSITION STATEMENT: It is the position of the Academy of Nutrition and Dietetics and the Society for Nutrition Education and Behavior that older adults should have access to evidence-based food and nutrition programs that ensure the availability of safe and adequate food to promote optimal nutrition, health, functionality, and quality of life. Registered dietitian nutritionists and nutrition and dietetics technicians, registered, in partnership with other practitioners and nutrition educators, should be actively involved in programs that provide coordinated services between the community and health care systems that include regular monitoring and evaluation of programming outcomes. The rapidly growing older population, increased demand for integrated continuous support systems, and rising cost of health care underscore the need for these programs.

Gerontological education: Course and experiential differences across academic colleges.

A knowledgeable workforce is key to meeting the demands of an aging population that is expected to nearly triple by 2030 and their attitudes influence propensity to seek aging-related careers. Postsecondary education offers an opportunity to increase aging-related knowledge and facilitates intergenerational experiential-learning opportunities; however, research is lacking regarding attitudes toward aging and experiences among an academically diverse sample. To address this gap, the aims of this study were to (1) examine differences in students' attitudes toward older adults by academic college, (2) assess differences in aging-related coursework and course experiences by academic college, and (3) explore key factors associated with students' attitudes toward older adults. Online survey methodology was used with a sample of 816 undergraduate students from a single university who represented all academic colleges offering undergraduate degrees. Significant differences among students' attitudes toward older adults by academic college were noted: those enrolled in the College of Human Sciences reported better stereotype, separation, and affective attitudes. Furthermore, factors associated with students' aging-related attitudes were sex, affiliation with academic college, perception of "old," contact frequency, and desire to learn aging-related content. The authors suggest interdisciplinary and disciplinary-specific educational recommendations to improve students' attitudes toward older adults.

Fresh Conversations, a SNAP-Ed Program for Older Adults: Feedback From Program Facilitators.

OBJECTIVE: As part of a statewide Supplemental Nutrition Assistance Program-Education program evaluation, Fresh Conversations (FC) facilitators (ie, educators) provided input into a new delivery model. METHODS: The researchers interviewed 25 FC facilitators. Interviews were recorded, transcribed verbatim, and analyzed for common themes. RESULTS: Most facilitators were women with at least 1 year of FC experience. Key motivators for serving as an FC facilitator included alignment with current employment responsibilities and gerontology interest. Training was viewed as helpful, thorough, and self-explanatory. Implementation challenges included recruitment, public speaking, and time management. Nearly all stated that FC content was important and that other seniors at other congregate meal sites would be interested in FC. CONCLUSIONS AND IMPLICATIONS: Findings suggest that facilitators were pleased with FC; however, their experiences might be further improved through enhanced training. Further exploration into community food and nutrition program educators' feedback is needed to ensure these programs meet their needs as well as those of the audience.

Factors Influencing Dietary Intake Frequencies and Nutritional Risk among Community-Residing Older Adults.

Older adult (OA) dietary practices may be placing them at nutritional risk. This cross-sectional study examined the dietary intake frequencies (DIF) and nutritional risk (NR) using the Dietary Screening Tool (DST) of OA attending community-based nutrition education and physical activity programs. Most were white females aged 60-80 years. The majority (80.1%) were classified as "at NR" or "at possible NR." Participants had "low" lean protein, dairy, and processed meat DIF and "moderate" whole fruit and juice, total and whole grains, vegetables and added fats, sugars, and sweets DIF. State influenced whole fruit and juice (p ≤ .001) and vegetable (p = .021) DIF, age influenced processed meat DIF (p = .001), and gender influenced NR (p = .006), vegetable (p = .022), and processed meat (p = .033) DIF. Results indicate that OA participating in lifestyle interventions are at NR. When developing future nutrition education programs, educators should consider sociodemographic factors to promote dairy and protein-rich foods to OA at NR.

Nutritional Risk among Congregate Meal Site Participants: Benefits of a SNAP-Ed Program.

This study examined the impact of the Supplemental Nutrition Assistance Program-Education (SNAP-Ed) program Fresh Conversations (FC) on the nutritional risk (NR) of older adults (OAs). A convenience sample of OAs (207 Treatment, 148 Control) completed questionnaires comprised of validated measures to assess NR, barriers to healthy eating self-efficacy (SE), food safety behaviors (FSB), and food security (FS) at three-time points over 9 months. Participants were mostly white (92.4%), older (age 81+ years, 40.1%), widowed (52.4%), and females (75.2%). Independent t-tests identified baseline differences among groups. Analysis of covariance assessed group changes at each time point for each measure. Block regression determined which variables influence baseline NR. Baseline NR risk was significantly predicted by SE (ß = 0.21), education (ß = 0.19) and age (ß = 0.14) (p < 0.05). NR improvement was significantly higher for treatment group participants who attended four or more FC sessions than for the control group (p = .04) when controlling for the effects of gender (p = .061) and SE (p = .098).

Whole Grain Nutrition Education Program Improves Whole Grain Knowledge and Behaviors Among Community-Residing Older Adults.

U.S. older adults are not meeting the recommendation for whole grain (WG) intake. This pilot study determined the influence that a WG nutrition education program for community-residing adults aged 60 + years has on WG knowledge and behaviors. The program included WG education and discussion, participation in hands-on activities and taste testing. Participants were mostly white, females. Total grain and WG dietary intake frequencies (WG frequency; p ≤ 0.001), and "knowledge score" increased from PRE to POST (p ≤ 0.001). Participants in PowerPoint-based classes had a higher "knowledge scores" at POST (p = 0.002). Nearly all (n = 139, 88.5%) intended to eat more WG foods, with almost two-thirds (n = 93, 59.3%) reporting a "strong" intention to do so. There was a positive association between strength of intention to eat WG foods and "WG frequency" at POST (r = 0.435, p ≤ 0.001). Results suggest that this WG program is an effective strategy for improving WG knowledge and behaviors among older adults.

Community Priorities for Healthy Eating in Older Adults.

Community planners such as policymakers and health care and nutrition service providers can create an "age-friendly" environment to support healthy eating in older residents by addressing the highest priorities that enable older adults to improve their dietary intake through different food-related community settings. To identify and prioritize these factors that facilitate behavioral change (enablers) and behavioral settings important for older adult nutrition based on the social ecological model, nutrition and aging professionals (n = 30) from two rural (West Virginia, Iowa) and two urban (Massachusetts, New York) city/county regions (communities) participated in an online or live focus group discussion and completed an analytic hierarchy process survey online. Overall, the most important perceived enablers were accessibility and cost, followed by transportation and social support, but their relative importance varied by community. Participants from all communities considered congregate meal sites and food banks among the most important behavioral settings. Participants from most communities considered food stores to be important and also highlighted other settings unique to the area, such as senior housing, neighborhood, and farmers' markets. By targeting interventions to address the most notable enablers and behavioral settings specific to their community, planning groups can enhance their older residents' ability to achieve optimal nutritional health.