Video Chat During Meals to Improve Nutritional Intake in Older Adults

A research interviewer will use video chat to collect three 24-hour dietary recalls with each participant prior to starting the VideoDining sessions (pre-VideoDining). During the intervention phase, a research interviewer will use video chat to collect a 24-hour dietary recall after each VideoDining session to capture dietary intake during the VideoDining meal and subsequent day (post-VideoDining). Change in dietary intake will be calculated by comparing average caloric intake on the three pre-VideoDining recalls to the average caloric intake on the final three post-VideoDining recalls.

A research interviewer will use video chat to collect three 24-hour dietary recalls with each participant prior to starting the VideoDining sessions (pre-VideoDining). During the intervention phase, a research interviewer will use video chat to collect a 24-hour dietary recall after each VideoDining session to capture dietary intake during the VideoDining meal and subsequent day (post-VideoDining). Change in diet quality will be determined by comparing average food group equivalents and the Healthy Eating Index (HEI) on the three pre-VideoDining recalls to the average for the final three post-VideoDining recalls.

The Revised 20-item UCLA Loneliness Scale and the 6-item De Jong Giervald Loneliness Scale will be collected prior to VideoDining and at the end of the study after VideoDining. The Revised 20-item UCLA Loneliness scale measures an individual's subjective feelings of loneliness and social isolation. Each question is scored 1-4, for a total of 20 to 80 points, with 80 indicating more loneliness. The 6-item De Jong Giervald Loneliness Scale uses a 3-item loneliness scale and a 3-item emotional scale. Each item is scored 0, 1 or 2, for a possible total score of 0-6, 0 being least lonely and 6 being most lonely. Total sum scores for each scale will be calculated pre and post VideoDining and compared.

Number of people enrolled in the study as a percentage of people approached or who showed interest in the study during the recruitment time period.

Percentage of enrolled participants who do not complete the study.

Percentage of participants who complete 6 or more VideoDining sessions in 8 weeks.

Number of times participants require assistance to use video chat technology after initial training and set-up.

Quantitative data from participant and dining-partner survey responses to questions on enjoyment, comfort, nervousness, technical issues, ease, and experience of VideoDining collected after each VideoDining session.

Qualitative data from end-of-study participant interviews and dining-partner focus groups. Participant responses to open ended questions about overall experience of VideoDining, use of videochat technology, and likes and dislikes of VideoDining will be coded and analyzed.

Participant responses to a single item survey question after each VideoDining session. Participant responses to survey questions about confidence level to perform the tasks of VideoDining, collected at the end of the study.

Responses to the four questions on the Social Interaction Subscale of the Duke Social Support Index and one question about social interaction with friends and family using videochat will be collected prior to VideoDining and at the end of the study after VideoDining. The results will be compared pre and post VideoDining.

A nutrition professional will measure participant hand grip strength using the Jamar Hydraulic Hand Dynamometer at the participant's home. Measurements will be categorized using hand-grip strength cut-points for muscle weakness by gender and age (J Am Geriatr Soc. 2020 Jul;68(7):1429-1437.) and cut-points for likelihood of mobility limitation (J Am Geriatr Soc. 2010 Sep;58(9):1721-6).

A nutrition professional will administer the Strength, Assistance with Walking, Rising from a Chair, Climbing Stairs and Falls (SAR-F) survey. Outcomes of the SARC-F will be combined with calf circumference measured in question R (Calf Circumference in cm) of the MNA-FF to complete the SAR-CalF. A total sum score will be calculated, and participants categorized as at risk for sarcopenic (score 11-20) or non-sarcopenic (score 0-10). Results of the SAR-CalF will be combined with hand grip strength data and participant age and BMI to determine overall sarcopenia risk.

A nutrition professional will administer the Mini Nutritional Assessment Full Form (MNA-FF). A total sum score will be calculated and categorized as Normal nutritional status (24-30 points), At risk of Malnutrition (17-23.5 points) and Malnourished (less than 17 points).

A trained nutrition professional will assess temporal, clavicular, calf and interosseous muscle wasting following the Academy of Nutrition and Dietetics Nutrition Focused Physical Exam guidelines. Muscle mass will be categorized at each site as: adequate (no wasting noted), mild, moderate or severe wasting.

A trained nutrition professional will assess orbital and triceps subcutaneous fat wasting following the Academy of Nutrition and Dietetics Nutrition Focused Physical Exam guidelines. Subcutaneous fat will be categorized at each site as: adequate (no wasting noted), mild, moderate or severe wasting.

Participant weight will be measured using the Seca 869 Portable Scale. The participant will be weighed in their home while wearing light clothing and no shoes.

Participant height will be measured using the Seca 213 Portable Stadiometer at the participant's home.

Participant BMI will be calculated as weight in kilograms over height in meters squared using collected weight and height measurements.

Participant energy needs will be calculated using the Mifflin St. Jeor formula using the collected height, weight and age data. Participant's average daily calorie intake will be determined from the three baseline 24-hour food recalls entered into ASA24. Adequacy of energy intake will be represented as a percentage of participant calculated intake out of calculated total estimated needs.

Participant weight loss over the last 3 months will be assessed by the MNA-FF survey Question B (weight loss over the last 3 months).