Background and Goals
The Older Americans Act (OAA) Nutrition Program helps older Americans remain healthy and independent in their communities by providing meals and related services in a variety of community settings (including congregate facilities such as senior centers) and via home-delivery to older adults who are homebound due to illness, disability, or geographic isolation. In addition to the Title III program in states and territories, the OAA funds nutrition services for American Indians, Alaska Natives and Native Hawaiians. ACL funds services in all 50 states, the District of Columbia, and five territories through a network of 622 area agencies on aging and more than 7,000 local nutrition service providers through Title III.
Since 2017, the Administration on Aging (AoA) has funded “Innovations in Nutrition” grants that support the testing and documentation of innovative and promising practices. The goal of this program is to enhance the quality, effectiveness, and proven outcomes of nutrition services within the aging services network. Successful grants awarded under this program must have the potential for broad implementation throughout the aging services network and have demonstrated value, i.e., improvements in participant well-being, cost savings, etc. Innovations must target services to underserved older adults with greatest social and economic need, and individuals at risk for institutional placement, to permit such individuals to remain in home and community-based settings as indicated in the OAA.
It is critical that ACL work with the Aging Network (i.e., State Units on Aging, Area Agencies on Aging (AAA), and local partners) to modernize these services to drive improved health outcomes for program recipients by promoting higher service quality, and increased program efficiency through innovative service delivery models.
Grantees are undertaking a variety of innovative activities under the scope of these awards, including: developing modified meals appropriate for reduced oral/dental functions, collaborating with community health partners to increase referrals to the congregate meal sites, working with nutrition service providers to enhance the identification of, and support for older adults with elevated suicide risk or in mental health distress (ESR/MHD). and other nutrition related topics.
Beginning in 2020, grants were awarded via two funding options – Demonstration and Research. The Demonstration grants are intended to support the demonstration and documentation of innovative and promising practices that enhance the quality, effectiveness, and other proven outcomes of nutrition programs and services within the aging services network. The Research grants are intended to increase the evidenced based knowledge of OAA nutrition providers and translate the knowledge generated by this research into evidence-based models for delivering nutrition program services and programs at the community level.
For 2021, ACL awarded four community research cooperative agreements to verify the effectiveness of innovative Senior Nutrition Program practices and programs created during COVID-19. The research will positively impact senior nutrition participants by helping to transition and sustain congregate meal programs and delivering impactful nutrition education.
Four grantees were awarded a total of $1,196,381 over a three-year project period. Research projects proposed under this grant program have the potential for broad implementation throughout the aging services network.
- FY 2021 Grants
East Tennessee State University will build on successful virtual nutrition education and outreach offered locally during the COVID-19 pandemic by developing a "virtual supper club" hosted by university students and youth Nutrition Ambassadors in order to decrease food insecurity and loneliness among congregate meal participants in Northeast Tennessee. The program will enhance food resource management and connection while fostering a supportive community to decrease loneliness.
Lanakila Pacific has developed an innovative virtual congregate meal model that increases program reach by providing older adults with opportunities for social engagement and nutrition education to improve their overall health and well-being. The project goal is to show collaborative and systems level strategies, including the use of a web-based inventory of nutrition education and socialization opportunities, are effective for facilitating resource sharing that meets or exceeds program requirements, impacts policy, and creates sustainability.
University of New England will implement and evaluate an innovative, pandemic-responsive nutrition education program that addresses food security, socialization, and perceived health and well-being of residents in low-income senior housing in rural Maine. The project goals include developing a direct education intervention to reinforce messages related to eating more fruits and vegetables, increasing physical activity, and purchasing healthy foods on a budget.
$300,000 University of Texas at San Antonio will extend existing congregate meal program services through digital education and increased access. This project will remove the digital barrier for older adults so they can receive nutrition programming online with the aim of improving overall health and well-being. The project will create a culturally tailored digital nutrition intervention using community-based participatory research. It will also test the impact of a digital nutrition intervention on diet quality and food security. $296,381 Total $1,196,381
- FY 2020 Grants
FY 2020 Demonstration Grants
AgeOptions – IL: The AgeOptions project is an innovation of “Title III-C 1.5”. This project addresses a gap in the continuum of services between Title III - C1, Congregate Meals and Title III - C2, Home Delivered Meals by 1) targeting an unmet need through an alternative delivery mechanism using unique partnerships, 2) providing a new lower cost decreased overhead option of 21 meals per week 3) providing opportunities for socialization, 4) decreasing food waste; increasing consumption, and 5) targeting an ethnically, racially diverse and limited English-speaking older adults and those with chronic conditions.
Apostle Group LLC – MD: This project will develop a standardized system of statewide care delivery for adults suffering with diabetes that includes: 1) the establishment of a diabetes pathway that provides an integration and reimbursement model for AAAs, 2) technology to improve access to care, reduce social isolation and food insecurity, and 3) the development of medically tailored menu options.
Iowa Department of Aging – IA: The goal of this project is to modernize Iowa’s congregate meal program infrastructure, delivery mechanisms and outreach to increase the number of consumers and meals served. Project objectives include: 1) establishing a restaurant partnership infrastructure in the Elderbridge AAA service region, 2) developing flexible approaches to congregate meal service delivery mechanisms to target and outreach to two generations of older adults, 3) modernizing a streamlined intake process through technology use, and 4) identifying seniors who may be food insecure, socially isolated, and rural and providing nutrition education.
Kentucky State Cabinet for Health – KY: The goal of the Kentucky State Cabinet for Health project is to prepare the aging network to respond to catastrophic emergencies using strategies, actions and plans that have been tested in the aftermath of COVID-19. The project will deliver resources and tools to address social isolation and access to regular, reliable nutritious food sources.
Michigan Department of Health and Human Services – MI: The Michigan Department of Health and Human Services, Aging and Adult Services Agency, in partnership with four Area Agencies on Aging and Michigan State University Extension, will enhance nutrition programs through the three-year Boxes, Bags and Buddies project. The goal is to provide greater choices, nutrition education and social support within the existing home delivered and congregate meal programs.
New York City Department for the Aging – NY: The New York City Department for the Aging project will assume a holistic approach to address the nutritional, social and mental health needs of older New Yorkers. The project will empower seniors to manage their mental health, nutrition and health status better; encourage social connectedness and leverage technology to create efficiencies and facilitate engagement.
Open Hand Atlanta – GA: Open Hand Atlanta will modernize nutrition care for seniors participating in a pilot of tele-nutrition services. This new protocol will allow for the delivery of cost-effective nutrition education services for seniors who are at highest nutrition and food security risk. The objectives of the project include: 1) improve the health of seniors who are at highest nutritional risk by referring them for individualized Medical Nutrition (MNT) provided by an Open Hand Atlanta Registered Dietitian Nutritionist (RDN) via the tele-nutrition platform and 2) develop and evaluate monthly nutrition presentations that will be either virtual or recorded webinars via the tele-nutrition platform.
Project Open Hand - CA: The goals of Project Open Hand are to create a program where: 1) older adults who are unable to shop or attend a congregate site can maintain and sustain their ability to cook, 2) address the needs of congregate participants during and after the pandemic, 3) provide healthful culturally competent and/or medically tailored at a low cost, and 4) address social isolation through socialization, nutrition education, exercise and chronic disease self-management opportunities.
University of North Carolina at Asheville – NC: The goal of this project is to facilitate healthcare investments in Older Americans Act (OAA) services by linking cost-effective, modernized OAA nutrition and health promotion diabetes services to improved health outcomes. The project will demonstrate person-centered carbohydrate-controlled home delivered and congregate nutrition meals along with wrap-around services to clients with pre-diabetes and diabetes.
FY 2020 Research Grants Georgia State University, University Foundation Inc. – GA: The work of Georgia State University, University Foundation will equip the aging network to address social isolation, loneliness and elevated suicide risk among vulnerable older adults during COVID-19. They will leverage the skills, interest and compassion of Nutrition Services volunteers to reduce social isolation, loneliness and elevated suicidality among diverse, at-risk, homebound older adults through the novel BE WITH (Belonging and Empathy, With Intentional Targeted Helping) innovation.
Oasis Institute – MO: Oasis and Texas A&M University Center for Population and Aging will adapt Healthy Habits for Adults into a five-week virtual workshop with a meal preparation and virtual lunch called Virtual Healthy Habits (VHH). The project addresses creating partnerships between universities with aging services network organizations to test the new virtual workshop, extend the time people can safely remain in their home and enhance the quality and effectiveness of older adult nutrition programs, all through a lens of social distancing.
Grand Total for Both Demonstration and Research Grants $2,649,389
FY 2019 Grants
CHEER, Inc – DE:
Includes daily contact with volunteers delivering HDMs (home delivered meals) as an opportunity to improve the wellbeing and quality of life/care of homebound seniors ages 60+. The goal of the three-year initiative is to strengthen local coordination of care for the most medically vulnerable seniors aging in place in Sussex County, Delaware, and prevent traumatic and costly medical and life-compromising crises.
Eastern Area Agency on Aging – ME:
Establishes and tests an innovative, technology-driven nutrition enhancement and self-management program for older adults with multiple chronic diseases. The goal of this three-year project is to improve the nutritional and health status of rural adults 60 and older with multiple chronic conditions immediately following hospital discharge.
Interfaith Ministries for Greater Houston– TX:
Uses innovative technologies to enhance their Meals on Wheels program, connect seniors to vital healthcare services and provide a new framework to enhance collaborative partnerships to reduce a seniors’ reliance on in-hospital care.
LifeCare Alliance – OH:
In partnership with local fire departments and healthcare conglomerates, LifeCare Alliance will further an innovative network of referrals and information sharing for clients who frequently depend on emergency services. “Food 911: How Meals-on-Wheels Redefines Population Health” seeks to build a body of evidence supporting the positive outcomes of this holistic model with the goal of leveraging research to generate new sources of revenue.
Public Health Solutions – NY:
Adresses low income, food insecurity, and social isolation barriers by enhancing partnerships in East Harlem and creating a virtual network. The virtual network will look to ensure public housing residents and other low-income older adults are linked to nutritious food and other services to improve their food security, social connections, health outcomes, and the likelihood that they will age in place with dignity.
Texas Health and Human Services Commission – TX:
The Texas Congregate Meal Initiative will conduct research to identify causes of decline in congregate meal program participation by adults 60 and over. Based on that research, the Initiative will then provide select members of the aging network with business acumen and project development training, and the opportunity to pilot the program innovations with the support of a learning collaborative.
University of Utah – UT:
Will look to enhance collaborative community malnutrition transitions of care for recently discharged home delivered meal (HDM) recipients at risk for malnutrition through high-value nutrition care interventions.
FY 2018 Grants
Erie County Department of Senior Services – NY:
The Albany County Department for Aging (ACDFA) and Erie County Department of Senior Services (ECDSrS) will initiate a technology driven congregate dining program including a restaurant dining program to current service models.
Georgia State University Research Foundation, Inc – GA:
The Atlanta Regional Commission (Atlanta Area Agency on Aging), in partnership with affiliate nutrition service (NS) providers and Georgia State University researchers, will work to enhance the identification of, and support for older adults with elevated suicide risk or in mental health distress (ESR/MHD).
AgeOptions, Inc – IL:
The goal of this project is to decrease the prevalence of food insecurity and increase the likelihood that patients experiencing food insecurity and/or are at nutrition risk will receive and act upon referrals to community-based resources. This will be done by 1) implementing a closed- loop referral system between healthcare providers and nutrition providers; 2) increasing referrals from healthcare providers to nutrition programs; and 3) increasing patient access to and utilization of nutrition programs, benefit programs (e.g. SNAP, Medicaid, etc.), and evidence-based wellness
programs (e.g. CDSME, A Matter of Balance).
The Carter Burden Network For the Aging, Inc – NY:
The goal of the project is to reduce the level of cardiovascular risk among seniors attending senior centers by addressing highly prevalent uncontrolled high BP through introduction of an innovative multi-component intervention centered on evidence- based approaches to the delivery of nutritional services, with supporting elements of education and improved self-efficacy, designed with generalizability and broad adoption in mind.
Health and Hospital Corporation of Marion County – IN:
This project will establish an innovative frozen meal delivery program for seniors age 60 and up, and develop a website application for ordering a week’s worth of frozen meals at a time. The goal of the Meals at Home quality improvement project is
to determine the effectiveness of this innovative model for ordering and preparing food for seniors.
FY 2017 Grants
Department on Aging - Iowa:
Aimed to improve health outcomes of participants in the Linn County Innovations in Nutrition Program by promoting higher service quality. Objectives include collaborating with community health partners to increase referrals to the congregate meal sites; increasing the availability and variety of evidence-based health promotion programs at the sites; and providing chronic disease-specific nutrition education.
LiveOn - NY:
Used an existing city-wide data collection system to address oral disease and ability to eat among homebound older adults. Objectives include developing and delivering modified meals appropriate for reduced oral/dental function; and testing the utility of oral health items included in the Senior Tracking Analysis and Reporting System to identify clients in need of modified meals.
Health Promotion Council of Southeastern Pennsylvania - PA:
Used the program “Taking Charge of Diabetes” to increase knowledge about healthy eating and diabetes management. The Taking Charge program aims to help people self-manage their Type-2 diabetes to decrease their diabetes-related hospitalizations and emergency room visits.
Department of Aging - Maryland:
Introduced evidence-based practices, cost-cutting measures, innovative meal products, and efficient service delivery methods to address the epidemic of older adult malnutrition. Objectives include improving quality within the statewide delivery system by creating new medically tailored meal packages and meal delivery mechanisms for patients transitioning from hospital to home. The project also will establish an evidence-based framework for a new malnutrition education program.
University of Utah - Utah:
Developed a high-quality malnutrition home visitation pilot program for home- delivered meal recipients. Objectives include providing community-focused malnutrition training from a person- and family-centered perspective; identifying nutrition indices related to functionality, quality of life, ability to age-in-place, and hospital readmission; and creating personalized nutrition care plans.
Alliance of Area Agencies on Aging - Missouri:
Used an advanced data-card technology to improve the service, delivery, and cost-effectiveness of congregate nutrition programming for older people at high risk of malnutrition. The technology will track member participation, and offer interactive feedback, personal nutrition information, and health management advice.
For home delivered meals, the program will use in-home, artificial intelligence-enabled “smart” speakers to improve the service, delivery, and cost-effectiveness of the in-home nutrition program for older people at high risk of malnutrition. The speakers will reduce access barriers to good nutrition by opening up numerous nutrition choices. They are also highly programmable, and community partners will install code that facilitates communication and food ordering through local food pantries, all through simple voice commands by the client. Creating grocery lists, browsing and ordering food items, and arranging
for delivery to the home are examples of services. After the client communicates the food order to the pantry, the volunteer network or contract delivery service transports the food items to the home.
National Resource Center for Nutrition and Aging (NRCNA)
AoA funds the National Resource Center for Nutrition and Aging (NRCNA) to build the capacity of the aging services network to provide nutrition services for both current and future older adult populations integrated into a home- and community-based service system and provide training and technical assistance to the aging network regarding nutrition services. The purpose of the NRCNA is to modernize the provision of senior nutrition services by providing tools and resources which promote program excellence, service quality, business acumen and models for social entrepreneurship. Additionally, the NRCNA works to enhance the aging service network’s knowledge regarding the role of nutrition services in health promotion and disease prevention, and the scientific and clinical evidence that support both healthy meals and other nutrition services. To access toolkits, webinar recordings, tip sheets, learning modules, and other online resources, go to https://acl.gov/senior-nutrition.