Journal Article

Translation of a tailored nutrition and resistance exercise intervention for elderly people to a real-life setting: adaptation process and pilot study

Tieland, Michael, Leerlooijer, Joanne N., Steijns, Jan M., de Groot, Lisette CPGM, van Dongen, Ellen JI, Haveman-Nies, Annemien

2017

Overview

Background Combining increased dietary protein intake and resistance exercise training for elderly people is a promising strategy to prevent or counteract the loss of muscle mass and decrease the risk of disabilities. Using findings from controlled interventions in a real-life setting requires adaptations to the intervention and working procedures of healthcare professionals (HCPs). The aim of this study is to adapt an efficacious intervention for elderly people to a real-life setting (phase one) and test the feasibility and potential impact of this prototype intervention in practice in a pilot study (phase two). Methods The Intervention Mapping approach was used to guide the adaptation in phase one. Qualitative data were collected from the original researchers, target group, and HCPs, and information was used to decide whether and how specified intervention elements needed to be adapted. In phase two, a one-group pre-test post-test pilot study was conducted ( n  = 25 community-dwelling elderly), to elicit further improvements to the prototype intervention. The evaluation included participant questionnaires and measurements at baseline (T0) and follow-up (T1), registration forms, interviews, and focus group discussions (T1). Qualitative data for both phases were analysed using an inductive approach. Outcome measures included physical functioning, strength, body composition, and dietary intake. Change in outcomes was assessed using Wilcoxon signed-rank tests. Results The most important adaptations to the original intervention were the design of HCP training and extending the original protein supplementation with a broader nutrition programme aimed at increasing protein intake, facilitated by a dietician. Although the prototype intervention was appreciated by participants and professionals, and perceived applicable for implementation, the pilot study process evaluation resulted in further adaptations, mostly concerning recruitment, training session guidance, and the nutrition programme. Pilot study outcome measures showed significant improvements in muscle strength and functioning, but no change in lean body mass. Conclusion The combined nutrition and exercise intervention was successfully adapted to the real-life setting and seems to have included the most important effective intervention elements. After adaptation of the intervention using insights from the pilot study, a larger, controlled trial should be conducted to assess cost-effectiveness. Trial registration Trial registration number: ClinicalTrials.gov NL51834.081.14 (April 22, 2015).

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V
• Subject: Adaptation / Aged / Aging / Body Composition / Body mass / Chair Nutrition and Health over the Lifecourse / Consumer Science & Health / Dietary intake / Dietary supplements / Exercise / Exercise therapy / Exercise therapy for the aged / FBR Consumer Science & Health / Feasibility Studies / Female / Food and nutrition / Food, Health & Consumer Research / Frail Elderly / Frailty / Geriatrics / Geriatrics/Gerontology / Global Nutrition / HNE Nutrition and Health over the Lifecourse / HNE Voeding en Gezondheid in de Levenscyclus / Humans / Lean body mass / Male / Medicine / Medicine & Public Health / Muscle strength / Muscle Strength - physiology / Nutrition / nutrition and epidemiology / Nutrition Therapy / Nutritional Status / Older people / Outcome Assessment (Health Care) / Physiological aspects / Pilot Projects / Public health / Rehabilitation / Research Article / Resistance Training / Surveys and Questionnaires / VLAG / Wereldvoeding