Responses of older adults to theory-based nutrition newsletters

Objective: To evaluate the effect of a theory-based newsletter on knowledge, attitude, and behavior change in older adults. Design: Pretest-posttest, random assignment, and treatment-control design with 2 treatment groups: 1 that received newsletters only and 1 that received newsletters with follow-up telephone interviews. Control group completed pretest-posttest surveys only. Subjects/setting: Four hundred eighty men and women, aged 60 to 74 years, were recruited to participate in a homebased educational intervention using a patient list generated from a rural tertiary care hospital database, Geisinger Medical Center in Danville, Pa. Intervention: Five nutrition newsletters designed using the nutrition communication model and adult learning theory principles were mailed biweekly. Telephone interviews followed each of the 5 newsletters 10 to 14 days after distribution. Outcome measures: Nutrition knowledge and interest, food behavior related to dietary fat, and stages of change for dietary fat and fiber. Statistical analyses performed: Analysis of covariance was used to determine group differences in posttest outcome measures using pretest as covariate. Results: In addition to achieving higher scores than the control group, the treatment groups were significantly different from each other in correct and perceived nutrition knowledge at posttest. Those in the treatment group receiving telephone calls scored higher (mean change= 19.0% for correct and 20.3% for perceived) than those who received the newsletters only (mean change=12.5% for correct and 14.3% for perceived; P<.05). Treatment groups also rated their interest in nutrition higher than the control group did; there was no between-treatment difference. Treatment groups performed significantly better than the control group for dietary fiber stage of change (P<.05). Those receiving only newsletters scored significantly better than the control for the "avoid fat" food behavior (P<.05). Applications/conclusions: This study provides an example of the incorporation of a theoretical model in development and evaluation of newsletters. Home-delivered nutrition newsletters based on this model can communicate health and nutrition information to older adults. Consumers today have more opportunities than ever before to access nutrition information quickly and inexpensively. Newsletters can help dietetics professionals filter and limit what consumers must process, saving clients time and improving the accuracy of information obtained. Dietetics professionals in both clinical and community practice are uniquely positioned to provide highly focused and understandable information to consumers via a newsletter format.