Measurement and Determinants of Diet Quality in Older Adults

ConditionNone Volunteer

Trial statusRecruiting

Trial phaseNot listed

Trial typeObservational

Biological sexAll

Age60+

SponsorUniversity of California, Los Angeles

About this trial

The goal of this observational study is to learn about dietary quality and barriers to healthy eating among older adults who participate in the Los Angeles County Food Rx Produce Distribution Program. The study will also evaluate whether a newer dietary assessment tool, the Global Diet Quality Questionnaire (GDQQ), performs similarly to an established dietary assessment tool, the Mediterranean Diet Scale (PREDIMED MDS), in measuring diet quality among adults aged 60 years and older.

The main questions it aims to answer are:

* Is the GDQQ associated with diet quality scores measured by the PREDIMED Mediterranean Diet Scale? * Does the GDQQ predict self-reported body mass index (BMI) as well as or better than the PREDIMED Mediterranean Diet Scale? * What barriers and facilitators influence healthy eating and participation in produce distribution programs among older adults?

Participants will:

* Complete questionnaires about their dietary habits, demographic characteristics, and food access experiences. * Complete two dietary quality assessment tools: the PREDIMED Mediterranean Diet Scale and the Global Diet Quality Questionnaire. * If randomly selected, participate in a one-time semi-structured interview to discuss healthy eating, food access, experiences with produce distribution events, and challenges to improving dietary quality.

Eligibility criteria

This trial accepts healthy volunteers

Qualifiers

Be 60 years of age or older

Be a regular attendee (i.e., more than one visit) at L.A. County Food Rx produce distribution events

Be able to communicate in English or Spanish, as these are the languages in which study materials and interviews are available

Be able to provide informed consent and complete the brief study activities These criteria reflect the study's focus on older adults at increased risk for chronic disease due to food insecurity and poor diet quality. English and Spanish were selected based on the primary languages spoken at Food Rx distribution sites and the capacity of the study team to support accurate, culturally sensitive data collection.

Disqualifiers

Are younger than 60 years old

Are first-time attendees at the produce distribution site (i.e., not familiar with program operations)

Are unable to understand or communicate in English or Spanish

Are unable to provide informed consent or complete the questionnaires or interview due to cognitive or physical limitations Language and participation history were included as exclusion criteria to ensure participant familiarity with the setting and the ability to engage meaningfully in data collection. ose who cannot provide informed consent will be excluded in accordance with ethical research protections for vulnerable adults.

Trial population

The study population will be drawn from community-dwelling older adults who participate in the Los Angeles County Food Rx Produce Distribution Program at Olive View Medical Center and affiliated produce distribution sites. Participants represent a predominantly low-income, food-insecure population residing in Los Angeles County who utilize produce prescription and food assistance services to improve access to fresh fruits and vegetables. The study population includes culturally and linguistically diverse community members, with recruitment conducted in English and Spanish through partnerships with the National Health Foundation, Food Rx program staff, volunteers, and community stakeholders.

Trial design

Design model

Ecologic or community

Time perspective

Cross-sectional

Treatments tested in this trial

Not listed

Trial groups

No trial groups listed

Trial outcomes

Primary outcomes

Global Diet Quality Questionnaire-Global Dietary Recommendations (GDQQ-GDR)

The Global Diet Quality Questionnaire (GDQQ) can be used to generate a Global Dietary Recommendations (GDR) score that ranges from 0 to 18 and is associated with meeting World Health Organization (WHO) global dietary recommendations. The GDR Score is calculated by combining indicators of dietary factors protective against noncommunicable diseases (NCD-Protect) and indicators of dietary factors that are promotive of noncommunicable disease (NCD-Risk).16 The NCD-Protect score (range 0-9) is based on consumption of nine food groups that are associated with meeting WHO recommendations on fruits, vegetables, whole grains, pulses, nuts and seeds, and fiber. The NCD-Risk Score is based on consumption of eight food groups that are negatively associated with meeting WHO recommendations on free sugar, salt, total and saturated fat, and red and processed meat.

Time frame

Participants will be asked the GDQQ surveyed once during the study period. Assessed once at enrollment during completion of baseline dietary quality questionnaires (approximately 15-20 minutes)

Secondary outcomes

Validation of GDQQ-GDR Against the PREDIMED Mediterranean Diet Scale and Self-Reported Body Mass Index

Validation of the GDQQ-GDR through (1) assessment of the correlation between GDQQ-GDR scores and PREDIMED Mediterranean Diet Scale (MDS) scores, and (2) evaluation of the ability of GDQQ-GDR scores to predict self-reported body mass index (BMI) compared with PREDIMED MDS scores. These analyses will determine whether the GDQQ performs as well as or better than the established PREDIMED MDS in this population of older adults.

Time frame

Assessed once at enrollment using data collected during completion of dietary quality questionnaires and demographic survey (approximately 15-20 minutes)

Other outcomes

Perceived Barriers to Healthy Eating

Qualitative themes related to participant-reported barriers to improving dietary quality, including food access, affordability, transportation, familiarity with produce, and other challenges identified through semi-structured interviews.

Time frame

Assessed once through series of questions during a semi-structured interview conducted for randomly selected participants following completion of dietary quality questionnaires.

Perceived Benefits and Challenges of Participation in Produce Distribution Events

Qualitative themes describing participant experiences with Food Rx produce distribution events, including perceived benefits, operational challenges, satisfaction with services, and recommendations for program improvement.

Time frame

One time at enrollment. Assessed through series of questions during a semi-structured interview conducted for randomly selected participants following completion of dietary quality questionnaires.

Knowledge and Perceptions of Dietary Quality and Chronic Disease Prevention

Qualitative assessment of participants' understanding of healthy eating, dietary quality, and the relationship between dietary patterns and chronic disease risk, derived from semi-structured interview responses.

Time frame

One time at enrollment. Assessed through series of questions during a semi-structured interview conducted for randomly selected participants following completion of dietary quality questionnaires.

Sponsors and contacts

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University of California, Los Angeles

Lead sponsor

National Institute on Aging (NIA)

Collaborator

National Center for Advancing Translational Sciences (NCATS)

Collaborator

Source ClinicalTrials.gov

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