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Nutrition

Evaluations Report

CONTENTS

ACKNOWLEDGMENTS

I INTRODUCTION

A. OVERVIEW OF THE ELDERLY NUTRITION PROGRAM

1. Title III Nutrition Services

2. Title VI Nutrition Services

3. ENP Nutrition Requirements

B. EMERGING ISSUES IN THE ENP

1. Targeting

2. Program Impacts on Participants' Nutritional Intake and Socialization

3. Linkages with the Long-Term Care System

4. Efficient and Cost-Effective Administration and Service Delivery

5. Quality of Program Services

6. Effects of Funds Transfers

7. Appropriateness of the RDAs and the Dietary Guidelines in Program Administration

C. OBJECTIVES OF THE EVALUATION

1. Program Participation and Targeting

2. Program Impacts

3. Program Administration and Service Delivery

4. Program Funding

D. STUDY METHODS

E. STUDY LIMITATIONS

F. ORGANIZATION OF THE REPORT

II CHARACTERISTICS OF TITLE III NUTRITION PROGRAM PARTICIPANTS

A. CHARACTERISTICS OF PARTICIPANTS

Part 1 -sections 1-4 -- Part 2 sections 5-8

1. Demographic Characteristics

2. Health, Functional Ability, and Mobility

3. Food and Dietary Behaviors, Nutritional Risk, and Food Insecurity

4. Overall 24-Hour Dietary Intake

5. Program Participation Experiences

6. Receipt of Nutrition and Supportive Services

7. Participation in Other Federal, State, and Local Food and Nonfat Assistance Programs

8. Social Interactions and Activities

B. CHANGES IN PARTICIPANT CHARACTERISTICS AND SERVICE USE OVER TIME

1. Changes in the Demographic and Health Characteristics of Participants

2. Changes in Participants' Dietary Intake

3. Changes in Participation Patterns

C. THE EFFECTIVENESS OF PROGRAM TARGETING

1. Targeting Results Based Principally on Characteristics of More Frequent Users of Meals Program

2. Targeting Results Based Principally on Characteristics of All Meal Program Participants

3. Use of Program Services by Selected Priority Subgroups of Elderly

III CONTRIBUTION OF THE TITLE III NUTRITION PROGRAM
- - TO PARTICIPANTS' 24-HOUR DIETARY INTAKE AND SOCIAL CONTACTS

A. DIETARY INTAKE AND SOCIALIZATION FROM PROGRAM SOURCES

1. Participants' Dietary Intake from Program Meals

2. Social Contacts and Activities from Meal Program Sources

B. DIFFERENCES BETWEEN PARTICIPANTS AND ELIGIBLE NONPARTICIPANTS IN DIETARY INTAKES AND SOCIAL CONTACTS

1. Research Methods

2. Regression-Adjusted Mean Differences Between Participants' and Nonparticipants' 24-Hour Dietary Intakes

3. Regression-Adjusted Mean Differences Between Participants' and Nonparticipants' Number of Monthly Social Contacts and Activities

4. Conclusions

IV TITLE III PROGRAM ADMINISTRATION AND SERVICE DELIVERY

A. CHARACTERISTICS OF AGENCIES ADMINISTERING THE ENP

1. SUAs

2. AAAs

3. Nutrition Projects

4. Congregate Meal Sites

B. NUTRITION AND SUPPORTIVE SERVICES

1. Overview of Nutrition and Supportive Services Provided by the Title III Aging Network

2. Service Characteristics and Patterns at Congregate Meal Sites

3. Characteristics of Home-Delivered Meal Services

C. NUTRITIONAL EXPERTISE OF PROGRAM STAFF

1. Nutrition Credentials of SUA-Level Staff

2. Nutrition Credentials of AAA-Level Staff

3. Nutrition Credentials of Nutrition Project Staff

D. INTERAGENCY RELATIONSHIPS

1. Technical Assistance and Training

2. Monitoring and Assessment

3. AAA Monitoring of Nutrition Projects

E. RELATIONSHIPS WITH OTHER AGENCIES

1. Integration with Home and Community-Based Long-Term Care Services

2. Participation in the USDA Commodities or Cash in Lieu of Commodities Program

F. QUALITY OF PROGRAM SERVICES PROVIDED

Part 1 -sections 1-2 -- Part 2 section 3

1. Nutritional Quality of Meals Offered

2. Participants' Satisfaction with Meals and Other Program Services

3. Food Safety and Sanitation Practices

G. TARGETING OF PROGRAM SERVICES TO PRIORITY GROUPS

1. SUA Targeting Activities

2. AAA Targeting Activities

3. Nutrition Project Targeting Activities

H. WAITING LISTS

V PROGRAM FUNDING, COSTS, AND EFFICIENCY

A. COST OF TITLE III MEALS
Part 1 - section 1-2-- Part 2 - section 3-5

1. Methodology

2. Analysis of Title III Nutrition Projects Average Meal Costs

3. Costs of Meal Components by Project Characteristics

4. Regression Analysis of Title III Meal Costs

5. Projects' Perceptions of Special Meal Costs

B. PROGRAM FUNDING

1. Methodology

2. Findings on Leveraging Title III Funds

3. Participant Contributions

C. TITLE III FUNDING TRANSFERS

1. Funding Transfers Between Program Components Over Time

D. REASONS FOR FUNDING TRANSFERS AND EXPECTATIONS FOR THE FUTURE

1. Transfers from Congregate Meals to Home-Delivered Meals

2. Transfers from Congregate Meals to Supportive Services

REFERENCES

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