The Older Adult Nutritional Ecosystem in Western Newfoundland and Examples of Community-based Nutrition Programming.

Context: Newfoundland and Labrador (NL) has an aging population (Statistics Canada, 2019) and high levels of chronic disease amongst older adults (Government of NL, 2017). Nutrition directly influences health (World Health Organization, 2015) and the nutrition of older adults living in NL is of low quality (Sarkar et al., 2015). Nutrition in NL is affected by the high cost, limited in-province production, and reliance on import via marine and truck transport for approximately 90% of consumed food (Food First NL, 2015). Objective: The aim of the research project was to explore the individual and environmental factors that influence older adult nutrition and to understand areas for potential change that can be supported by community-based organizations and nursing practice. Study Design and Analysis: Qualitative research study guided by Interpretative Description methodology (Thorne, 2016) and the theoretical perspective of the Social Ecological Model (Stokols, 1996; 2000). A community-engaged approach with community partner organizations that are directly involved in older adult nutrition. Setting: An area along the west coast of Newfoundland, the most eastern province in Canada. Population Studied: Engagement with older adults, key informants, and nurses living in western NL. Intervention/Instrument: Through review of the literature, focus groups with older adults, and individual semi-structured interviews with key informants and nurses. Outcome Measures: In-depth understanding about the individual and environmental factors that impact the nutrition of older adults. Working with community organizations to develop programming to achieve positive nutritional change. Results: A visual map of the older adult nutritional ecosystem in western NL that identifies specific individual and environmental factors that influence older adult nutrition. Individual factors that impact older adult nutrition include availability and affordability of food, time and planning, motivation, and health. Environmental factors include climate, distribution systems, finances, government policy, and social groups. A tool kit of community-based nutrition programming, including examples that were recommended by study participants and examples of programing already being implemented by community groups to positively impact older adult nutrition, highlighting the creation of an academiccommunity research collective and a new health and wellness facility with a community kitchen. [ABSTRACT FROM AUTHOR]