Perceived barriers to optimum nutrition among congregate (sheltered) housing residents in the USA

Objective: Malnutrition, secondary to decreased food intake, is a public health problem of epidemic proportions among older adults in the United States of America (USA). Compared to community-dwelling senior citizens, congregate (sheltered) housing residents are found to be frailer, with documented deficiencies in several major and minor nutrients, and associated health complications. While studies have quantified these problems, translational research examining the perceived factors influencing their daily food habits is lacking. Design: Using a qualitative approach, this study was undertaken to further and enhance understanding of this complex, under-researched area, and to form the basis for better nutritional management of this group. Setting: Participants (n = 46) were convenience sampled from four sheltered housing settings located in the suburbs of northern New Jersey, USA. Method: Data were collected using a brief demographic questionnaire, and a focus group guide designed utilizing constructs derived from socio-ecological theory. Results: Content analysis of the transcripts identified several themes suggesting that a repertoire of individual, interpersonal, and organizational factors may serve as barriers to optimum nutritional health among residents. With an emphasis on utilizing their perspectives to explain and interpret behaviour, the qualitative approach adopted offered a perfect vehicle for shifting the focus from measuring dietary outcomes to clarifying how participants arrive at the decisions they made. Conclusion: This study is a step forward in providing the empirical foundations necessary to design a comprehensive intervention with effective strategies to motivate and encourage sheltered housing residents to make healthier food choices and improve their overall health.