Effect of a community-based nutrition intervention incorporating social cognitive theory constructs and transtheoretical model-based counseling among community-dwelling elderly in Korea: a quasi-experimental study.

OBJECTIVES

This study evaluated the effects of a 7-week nutrition intervention based on the personal and environmental constructs of social cognitive theory (SCT) and the transtheoretical model (TTM) on dietary behavior-related factors, dietary behavior outcomes, and stages of dietary behavior change among community-dwelling older adults.

METHODS

A quasi-experimental nonequivalent control group pretest-posttest design was conducted from May to December 2024 at seven senior facilities in Seoul and Gyeonggi, Korea. Older adults aged ≥ 65 years were assigned by facility to either an intervention group (n = 66; four facilities) or a control group (n = 65; three facilities). The intervention group completed a 7-week program consisting of baseline assessment, five weekly group education sessions, individualized nutrition counseling, and post-intervention assessment. The control group received one general nutrition education session. Outcomes included dietary knowledge, outcome expectations, value expectations, self-efficacy, environmental factors (food accessibility and household food availability and social support), dietary behavior outcomes assessed using the Nutrition Quotient for the Elderly (NQ-E), and stage of change. Program effects were analyzed using ANCOVA adjusted for age, family composition, education, baseline dietary knowledge, and value expectations.

RESULTS

Compared with the control group, the intervention group demonstrated significantly greater improvements in dietary knowledge (P < 0.001), outcome expectations (P = 0.018), self-efficacy (P < 0.001), environmental factors (P < 0.001), and NQ-E total score (P = 0.011). No significant between-group difference was observed for value expectations. The proportion of participants in the action stage increased from 9.1% to 93.9% in the intervention group, and post-intervention stage distribution differed significantly between groups (P < 0.001). Program satisfaction was high (4.69 ± 0.41).

CONCLUSION

A 7-week nutrition intervention incorporating SCT-based personal and environmental constructs and TTM-based stage-matched counseling improved dietary behavior-related factors, dietary behavior outcomes, and stage distribution among community-dwelling older adults.