The elderly nutrition program: an effective national framework for preventive nutrition interventions.
OBJECTIVE
To guide national policy, Congress mandated the 1992 research evaluation of the Elderly Nutrition Program (ENP), the nation's oldest framework for providing community- and home-based preventive nutrition and health-related services to older persons. This article summarizes key findings on the program's influence on nutritional health, the targeting and costs of its nutrition services, and the study's policy implications.


METHODS
The research included a nationally representative sample of ambulatory and homebound ENP participants And a matched sample of nonparticipants drawn from the US Health Care Financing Administration's Medicare beneficiary listings. Interviews conducted in respondents' homes considered demographic and health characteristics and assessed anthropometry and physical functioning, nutrient intake and socialization patterns, and utilization of ENP program services (participants only). Administrative and service delivery data were gathered from all levels of the ENP infrastructure.


RESULTS
The ENP program currently provides congregate and home-delivered meals and other nutrition- and health-related services to about 7% of the older population overall, including an estimated 20% of the nation's poor elders. Compared with nonparticipants, ambulatory and homebound ENP participants are better nourished (4% to 31% higher mean daily nutrient intakes; P<.001) and achieve higher levels of socialization (17% higher average monthly social contacts; P<.001). Federal spending on ENP nutrition services is efficiently leveraged by funding from other public and private sources, allowing ENP to more than double the nutrition services it provides to program participants.


CONCLUSIONS
ENP is a well-targeted, effective, and efficient federal program available to dietetics and other professionals for providing elderly persons with community-based and home-delivered nutrition and related services. The ENP infrastructure offers a potential model for preventive nutrition intervention programs in ambulatory and homebound at-risk older populations.
Millen
Barbara E
BE
Boston University School of Public Health, Mass 02118, USA.
Ohls
James C
JC
Ponza
Michael
M
McCool
Audrey C
AC
D000203:Activities of Daily Living; D000368:Aged; D002149:Energy Intake; D005260:Female; D005522:Food Services / Q000458:organization & administration* / Q000592:standards; D006299:Health Services for the Aged / Q000458:organization & administration* / Q000592:standards; D006699:Home Care Services / Q000458:organization & administration* / Q000592:standards; D006801:Humans; D007407:Interviews as Topic; D008134:Long-Term Care; D008297:Male; D006278:Medicare; D011939:Mental Recall; D009748:Nutrition Disorders / Q000517:prevention & control*; D009747:Nutritional Physiological Phenomena; D017063:Outcome Assessment, Health Care; D015397:Program Evaluation; D012951:Socialization; D014481:United States