title: Effects of a dietary self-management programme for community-dwelling older adults: a quasi-experimental design.
abstract: BACKGROUND
  Nutritional health plays a crucial role in determining successful ageing and differs by different living area. Although nutritional interventions have long been advocated, little research has directly assessed the effectiveness of nutritional interventions on community-dwelling older adults in urban and rural areas and compared intervention effects on these two populations.
  
  
  OBJECTIVE
  To examine the effectiveness of a 12-week dietary self-management programme for salt-, fluid-, fat- and cholesterol-intake behaviours of community-dwelling older adults and to compare these effects in rural- and urban-dwelling older adults.
  
  
  METHODS
  For this quasi-experimental two-group study, older adults (≥65 years old) were recruited from two randomly selected public health centres in a rural north-eastern county and a northern city of Taiwan from January through December 2011. Outcomes included nutritional status, nutritional self-efficacy and health locus of control. Data were collected at baseline and 12 weeks later. To compare changes in outcome variables over time between the control (usual care) and intervention (nutritional programme) groups and between the urban- and rural-dwelling participants in the experimental group, we used generalised estimating equation analysis.
  
  
  RESULTS
  Of the 129 participants, 120 completed this study (58 in the intervention group and 62 in the control group). After 12 weeks, the intervention group had significantly better nutritional status and higher internal health locus of control than the control group. Moreover, older rural participants who received the intervention tended towards higher nutritional self-efficacy and internal health locus of control than their urban counterparts.
  
  
  CONCLUSIONS
  Our research findings support the positive effect of our nutritional self-management programme for community-dwelling older adults. The knowledge gained from this study can help stakeholders recognise the need for healthcare policy to establish effective strategies and sustainable intervention programmes for this population, especially those living in rural areas.
authors.affiliation: School of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan.
authors.forename: Su-Hui
authors.initials: SH
authors.lastname: Chen
authors.affiliation: School of Nursing, National Quemoy University, Taiwan.
authors.forename: Yu-Ping
authors.initials: YP
authors.lastname: Huang
authors.affiliation: School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Jung-Hua
authors.initials: JH
authors.lastname: Shao
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004032:Diet; D005260:Female; D006801:Humans; D008297:Male; D009752:Nutritional Status; D012648:Self Care; D013624:Taiwan
keywords: dietary self-management; health locus of control; nutritional status; older adults; rural-urban; self-efficacy