Educating limited resource older adults for better choices to lower risk of food insecurity

United States (U.S.) national and North Carolina state data on older adult food insecurity in combination with associated poor nutrition-related health outcomes point to a critical need for interventions to improve their food security. Nearly 8% of North Carolinians aged 60 and older and 11% of those aged 50-59 are food insecure, placing North Carolina in the top ten states in the U.S. for food insecurity for both age groups. Therefore, the Better Choices intervention was designed to educate limited-income older adults in ways to manage their meager resources to purchase more and healthier foods. The purpose of this study was to determine the effectiveness of the Better Choices intervention in improving the knowledge, attitude, and behavior of participants concerning their food money resource management. Older adults (n=453) with ages ranging from 59 to over 90 years participated in 8 weeks of educational programming delivered by educators in 15 participating North Carolina counties. In a cross-over program design participating counties were randomly assigned to two groups, to create a control for the food money resource management treatment. A three-points-in-time survey supported longitudinal measurement. Independent samples t-tests showed no significant differences between groups at baseline. Paired sample t-test results show the intervention was effective with statistically significant improvement of participants' knowledge regarding preparing a healthy meal on a budget, beans as a low-cost alternative to meat, and the use of unit pricing to compare products to identify the best value. Participant-developed action plans reflected planned behavior change. Study results show this group of older adults were capable of and willing to adopt new behaviors for a healthier lifestyle. While not a representative sample, the broad applicability of adult learning and planned behavior theories underpinning the program lead us to conclude that the methods and theories applied in this intervention should be of use to educators and practitioners serving limited-resource older adult populations.