Digital nutrition intervention in Older Americans Act programs impacts knowledge and desire to participate in virtual programming.

Objective: The Older Americans Act of the United States is a federal law providing funding for meals and nutrition education, primarily for adults aged ≥ 60 years, to help them live independently. Nutrition education has traditionally been delivered in-person, but an evolving population has prompted a need to utilize digital programming to expand reach. The Georgians Receiving Insightful Telenutrition Services (GRITS) study was a 20-month program to provide group education and individual medical nutrition therapy (MNT) to adults using phone and online video conferencing. The objective of this study was to develop a virtual program for group and individual settings and to evaluate its effect on nutrition knowledge, confidence, and health behaviors, as well as overall feasibility and acceptability of delivering education in a virtual format. Method: Implementation and evaluation occurred from 2020-2023 within senior centers across four regions in the state of Georgia, USA. Group education and individual MNT sessions were led by a Registered Dietitian Nutritionist (RDN). Group education was delivered as standardized 30-min lessons over Zoom for 12-20 months, with length of time varying by site. Individual MNT was completed primarily over the phone and Zoom, with session duration of approximately 30-60 minutes for initial sessions and 15-30 minutes for follow-up sessions. Outcome measures were collected in both groups at baseline and post-intervention using short- and long-term qualitative surveys to assess program effects and acceptability of the program. Senior center staff also completed post-intervention qualitative surveys and focus groups to evaluate feasibility of program implementation. The program structure and evaluation were guided by RE-AIM framework for creating sustainable, generalizable interventions. Mixed-effects regression models were used to examine effects of the program. Results: In group education, a total of 22 centers completed at least 12 group sessions serving 5,012 duplicated clients. Participants who completed knowledge surveys showed a modest 1.6% improvement in knowledge scores at post-session compared to pre-session (95% CI: 0.4, 2.9; Conclusion: Results from this study suggest virtual nutrition education in group and individual settings was acceptable, feasible, and showed preliminary effects on knowledge and behavior among a subset of Older Americans Act clients. Future directions include long-term evaluation of virtual methods to deliver nutrition education to better serve community-dwelling older adults in ways that are sustainable, efficient, and effective for long-term health.