Evidence map›Paper›PMID 34758733›Full record

ArticleBMC family practice2021

Optimising an intervention to support home-living older adults at risk of malnutrition: a qualitative study.

Liz Payne, Daniela Ghio, Elisabeth Grey, Joanna Slodkowska-Barabasz, Philine Harris, Michelle Sutcliffe, Sue Green, Helen C Roberts, Caroline Childs, Sian Robinson and 11 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC family practice, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.0field-weighted citation impact, top 25% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 13 citations in OpenAlex.

  1. Barriers and facilitators in the implementation of nutrition interventions to prevent or treat malnutrition in older adults: A scoping review.Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition · 2025
    Article
  2. Article
  3. Article
  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

21 authors at 8 institutions in 1 country.

Liz PayneSchool of Psychology, University of Southampton, Southampton, UK. E.A.Payne@soton.ac.uk.
Daniela GhioPrimary Care Population Sciences and Medical Education, University of Southampton, Southampton, UK.
Elisabeth GreyDepartment for Health, University of Bath, Bath, UK.
Joanna Slodkowska-BarabaszSchool of Psychology, University of Southampton, Southampton, UK.
Philine HarrisSchool of Psychology, University of Southampton, Southampton, UK.
Michelle SutcliffeDietetics Department, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
Sue GreenDepartment for Nursing Science, Bournemouth University, Poole, UK.
Helen C RobertsAcademic Geriatric Medicine, Faculty of Medicine, University of Southampton, Southampton, UK.
Caroline ChildsHuman Development and Health, University of Southampton, Southampton, UK.
Sian RobinsonAGE Research Group, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK.
Bernard GudginPublic and Patient Involvement, University of Southampton, Southampton, UK.
Pam HollowayPublic and Patient Involvement, University of Southampton, Southampton, UK.
Jo KellyPrimary Care Population Sciences and Medical Education, University of Southampton, Southampton, UK.
Kathy WallisWessex Academic Health Science Network, Southampton, UK.
Oliver DeanFaculty of Medicine, University of Southampton, Southampton, UK.
Paul AveyardNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Paramjit GillWarwick Medical School, University of Warwick, Coventry, UK.
Mike StroudClinical Nutrition, University of Southampton, Southampton, UK.
Paul LittlePrimary Care Population Sciences and Medical Education, University of Southampton, Southampton, UK.
Lucy YardleySchool of Psychology, University of Southampton, Southampton, UK.
Leanne MorrisonSchool of Psychology, University of Southampton, Southampton, UK.
University of Southampton · GBBournemouth University · GBNIHR Newcastle Biomedical Research Centre · GBUniversity Hospital Southampton NHS Foundation Trust · GBUniversity of Bath · GBUniversity of Oxford · GBUniversity of Warwick · GBWessex Academic Health Science Network (United Kingdom) · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn the UK, about 14% of community-dwelling adults aged 65 and over are estimated to be at risk of malnutrition. Screening older adults in primary care and treating those at risk may help to reduce malnutrition risk, reduce the resulting need for healthcare use and improve quality of life. Interventions are needed to raise older adults' risk awareness, offer relevant and meaningful strategies to address risk and support general practices to deliver treatment and support.

methodsUsing the Person-based Approach and input from Patient and Public Involvement representatives, we developed the 'Eat well, feel well, stay well' intervention. The intervention was optimised using qualitative data from think aloud and semi-structured process evaluation interviews with 23 and 18 older adults respectively. Positive and negative comments were extracted to inform rapid iterative modifications to support engagement with the intervention. Data were then analysed thematically and final adjustments made, to optimise the meaningfulness of the intervention for the target population.

resultsParticipants' comments were generally positive. This paper focuses predominantly on participants' negative reactions, to illustrate the changes needed to ensure that intervention materials were optimally relevant and meaningful to older adults. Key factors that undermined engagement included: resistance to the recommended nutritional intake among those with reduced appetite or eating difficulties, particularly frequent eating and high energy options; reluctance to gain weight; and a perception that advice did not align with participants' specific personal preferences and eating difficulties. We addressed these issues by adjusting the communication of eating goals to be more closely aligned with older adults' beliefs about good nutrition, and acceptable and feasible eating patterns. We also adjusted the suggested tips and strategies to fit better with older adults' everyday activities, values and beliefs.

conclusionsUsing iterative qualitative methods facilitated the identification of key behavioural and contextual elements that supported engagement, and issues that undermined older adults' engagement with intervention content. This informed crucial revisions to the intervention content that enabled us to maximise the meaningfulness, relevance and feasibility of the key messages and suggested strategies to address malnutrition risk, and therefore optimise engagement with the intervention and the behavioural advice it provided.

Indexed as

MalnutritionQuality of LifeAgedCommunicationHumansIndependent LivingQualitative ResearchAgeing; primary health careDietary supplementsEating patternsGeneral practiceHealth services for the agedIndependent livingIntervention planningMalnutritionPerson-based approach

Identifiers

PMID34758733
PMCPMC8580738
OpenAlexW3214042686

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.