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# Innovative Models

Find out how Innovations in Nutrition Programs and Services (INNU) grantees are successfully educating seniors about nutrition using innovative and promising practices.

## About INNU

The goal of the INNU program is to enhance the quality, effectiveness, and proven outcomes of nutrition services by supporting activities that can be broadly implemented throughout the aging services network.
                  - Innovations in Nutrition Programs and Services
                  - INNU Grantee Examples

## 2018 Grantees

                  - Modernizing HDMs through frozen meals and a web-based app in Indiana
                  -  **Summary:** To modernize its home-delivered meal program, Eskenazi Health’s Meals at Home looked at how frozen meals were produced, stored, and delivered. They partnered with Regenstrief Institute to develop an app for seniors to order meals, offering them a choice from 19 different frozen meal options. Seniors who were at risk of food insecurity and/or malnutrition due to their health were provided with two meals a day for 30 weeks. In a post-project assessment, more than 90% of respondents said they would like to continue receiving the frozen meals and would recommend the program.   **Resources:**                      - App Tip Sheet  (step by step directions for how to download and use the meal ordering app)
                    - Client Assessment  (survey used at beginning and end of the program)
                    - Meal Ingredients  (meal options with photos and ingredient lists)
                    - Meal Order Delivery Schedule  (guidance on when to place meal orders)
                    - Program Satisfaction Instrument  (survey used to gauge client satisfaction with ordering, delivery, and meals)
                    - Standard Operating Procedures  (procedures for recruiting new clients, processing applications, completing assessments, etc.) 
                  - Improving heart health through diet, education, and self-efficacy in New York
                  -  **Summary:** To address high blood pressure among seniors, Carter Burden Network (CBN) partnered with the Rockefeller University Center (RU) for Clinical and Translational Science and Clinical Directors Network (CDN). The project tested whether a dietary intervention at a congregate meal site ― combined with educational, social, and behavioral interventions — could lower blood pressure. The dietary intervention used was the Dietary Approaches to Stop Hypertension (DASH) diet. While the DASH diet has been proven to lower blood pressure, it had not been studied in congregate meal sites for seniors who live in community dwellings. The project showed several positive outcomes, including a decrease in blood pressure among participants, and can serve as a blueprint for senior centers nationwide.   **Resources:**                      - Appointment Card  (participant appointment reminder card)
                    - Barriers and Facilitators  (list of participant-reported barriers and facilitators to home BP monitoring)
                    - Data Collection Tools  (participant questionnaire used at months 0, 1, 3, and 6)
                    - Eating Plan Brochure  (promotional pamphlet)
                    - Food Cost Comparison  (comparison of senior center food costs with standard diet vs. DASH diet)
                    - Gap Analysis  (tool used to analyze nutritional gaps in old menu and to plan revised menu)
                    - Meal Satisfaction Results  (participant meal satisfaction ratings pre- and post-DASH implementation)
                    - Nutrition Label Comparison  (nutrition fact comparison of pastas served pre and post-DASH implementation)
                    - Omron Instructions  (step by step instructions for setting up an Omron account, using the app, and taking a BP reading)
                    - Participant Passport  (pamphlet for tracking assessment visits, education sessions, and data downloads, in English and Spanish)
                    - Participant Update Letter  (end of study information for participants, in English and Spanish)
                    - Plate Waste Data Form  (form for tracking uneaten food left on participant plates)
                    - Project Collaboration Assessment Tool  (Advisory Committee/Project Team member survey on project leadership)
                    - Recipes and Nutrition Facts  (sample meals with recipes and nutrition facts)
                    - Recruitment and Class Flyers  (study promotional materials in English and Spanish)
                    - Revised Menus  (calendar of meals served during DASH study)
                    - Smiley Face Likert Comment Cards  (scale for ranking meal satisfaction, in English and Spanish)       
                  - Increasing choice through a flexible, technology-driven meal program in New York
                  -  **Summary:** To modernize its congregate dining program, the Albany County Department for Aging and the Erie County Department of Senior Services partnered with local restaurants to give participants more flexibility in how and where they dine. Adults 60 and older could eat at any participating restaurant at a time of their choice. The study had a number of positive outcomes, including decreasing feelings of social isolation in older adults. The study also demonstrated the need for more progressive, self-driven services for older adults.  **Resources:**                      - Vendor Contract Sample  (sample contract between grantee and partner restaurant)
                    - Vendor Contract Terms and Conditions Sample  (sample statement of services for partner restaurant)
                    - Customer COVID-19 Survey  (survey on the impact of COVID-19 on participants' lives and participation in the program)
                    - Diners Guide  (guidelines, participating restaurants, and menus)
                    - Focus Group Questions  (survey of participant experiences)
                    - General Meal Requirements  (nutritional requirements restaurants must follow)
                    - Go and Dine Customer Satisfaction Survey  (survey on the impact of the program)
                    - Isolation Survey  (survey evaluating participant feelings of isolation)
                    - Participant Registration  (form for collecting participant demographics and calculating nutritional score)
                    - Tech Survey  (survey for meal providers on the effectiveness of scanners and keytags) 
                  - Supporting older adults at risk of suicide through nutrition services in Georgia
                  -  **Summary:** To enhance identification and support of older adults with elevated suicide risk or in mental health distress (ESR/MHD), the Atlanta Regional Commission (Atlanta Area Agency on Aging), in partnership with affiliate nutrition service providers and Georgia State University researchers, developed a standardized and manualized suicide intervention to be delivered by nutrition services volunteers. Through a series of related studies, they found that nutrition services volunteers and providers can develop suicide intervention skills, and when they do, use those skills as part of their job role and provide life assisting suicide interventions to the older adults they serve.  **Resources:**                      - Caregiver Tips during COVID-19  (suggestions and resources for protecting yourself and those you care for)
                    - More than a Meal: Facts, Stress, & Coping Information for HDM Volunteers during COVID-19  (guidance on how to identify signs of stress and mental health trouble or suicide risk in seniors receiving HDMs)
                    - Quick Tips for Social Distancing  (dos and don'ts for social distancing)
                    - Caring for Wellbeing of Older Adults during COVID-19  (tips for ways to connect with seniors while social distancing)
                    - Enhancing Socialization through Making Meaningful Volunteer Connections during COVID-19  (tips on building and strengthening connections with seniors)
                    - Suicide Intervention Response Inventory (SIRI 2) with Scoring  (tool for assessing a volunteer's ability to recognize appropriate responses to suicidal clients) 
                  - Increasing use of community-based resources by food-insecure seniors in Illinois
                  -  **Summary:** To decrease the prevalence of food insecurity, Age Options designed their Closed Loop Referral System project. The project aimed to increase the likelihood that patients experiencing food insecurity and/or at nutrition risk would receive and act upon referrals to community-based resources.  **Resources:**                      - Informed Consent  (provides information about the study for potential participants to review and consider before agreeing to participate)
                    - Pre-Intervention Questions  (health and wellness questions participants were asked at the beginning of the study)
                    - Post-Intervention Questions  (survey given to participants at the end of the study)
                    - Post-Intervention Referral Survey  (survey given to health care professionals at the end of the study)
                    - Participant Recruitment Brochure  (pamphlet to let people know they may be eligible for nutrition programs and services)
                    - Health Care Professional Engagement Flyer  (handout for health care professionals encouraging patient referral to nutrition programs)
                    - Health Fair Recruitment Handout  (flyer used to encourage health care professional participation in the study) 

## 2017 Grantees

                  - Offering nutrition-focused diabetes self-management in Pennsylvania
                  -  **Summary: **To address patient care beyond the clinic walls, Health Promotion Council of Southeastern Pennsylvania, Inc. offered a multi-component, home-based intervention to improve health outcomes at the patient level, and reduce health care costs at the system level, for adults 65 and older with Type 2 Diabetes.  **Resources:**                      - Summary Brief  (snapshot of project and findings)
                    - Stanford Self-Efficacy for Diabetes Survey  (survey to measure participant confidence with activities related to nutrition, health, and diabetes self-management) 
                  - Collaborating with community partners on a congregate meal delivery model in Iowa 
                  -  **Summary: **To develop an innovative, replicable service delivery model for congregate meals, the Iowa Department on Aging partnered with Heritage Area Agency on Aging to create the “Encore Café.” This café concept was designed to encourage older adults to participate in congregate meal programs. In particular, the project aimed to attract the younger subpopulation of older adults called “Baby Boomers,” who had a smaller percentage of participation in recent years.  **Resources:**                      - Summary Brief  (snapshot of project and findings)
                    - Encore Café Volunteer Orientation  (overview of the program for volunteers, including roles and responsibilities)
                    - Request for Quote  (quote request to identify food vendors for café sites)
                    - Memorandum of Understanding  (agreement outlining responsibilities and terms between the program and café sites)
                    - Senior Dining Site Policies and Procedures  (outline of expectations, procedures, and resources for the operation of café sites)
                    - Daily Site Checklist  (list of daily duties for each café site)
                    - Salad Bar Guide  (instructions and requirements for café salad bars)
                    - Nutritional Risk Survey  (survey to measure impact of the program on nutrition risk behaviors)
                    - Satisfaction Survey  (survey to measure program participant satisfaction)
                    - Awareness Survey  (survey to measure awareness of program offerings among advisory board members) 
                  - Addressing ability to eat with modified meals in NYC
                  -  **Summary: **To build the evidence needed to improve the effectiveness of home delivered meals (HDMs), Live ON NY partnered with several organizations to provide therapeutic meals modified to align with dental and oral function and promote oral health and dental care.  **Resources:**                      - Summary Brief  (snapshot of project and findings)
                    - Pre-Recruitment Scripts  (sample script for recruiting participants)
                    - Six-Item Screening Tool for Subject Recruitment  (screening tool for determining eligibility of participants)
                    - Qualitative Instrument for HDM Recipients  (survey on participants' eating ability)
                    - Survey Questionnaire for Home-Delivered Meal Recipients  (survey on participants' mouth, teeth, and dentures)
                    - Case Worker Focus Group Questionnaire and Instructions  (focus group moderator's guide)
                    - In-Depth Questionnaire for Case Managers  (interview guide)
                    - In-Depth Questionnaire for HDM Recipients  (interview guide) 
                  - Tackling malnutrition through a statewide delivery system in Maryland
                  -  **Summary: **To transform their senior nutrition program, the Maryland Department of Aging used the epidemic of older adult malnutrition as the catalyst to introduce evidence-based practices, cost-cutting measures, innovative meal products, and efficient service delivery methods to forge new health care linkages and expand service to older adults in the community.  **Resources:**                      - Summary Brief  (snapshot of project and findings)
                    - Addressing Malnutrition in Community Living Older Adults: A Toolkit for AAAs  (toolkit for setting up internal processes that prepare AAAs to address older adults with malnutrition)
                    - Expanded Food Security Screener: Home Delivered Meals Prioritization Tool  (paper screening tool, app, and instructions)
                    - Maryland Discharge Meal Program Materials  (resources to provide shelf-stable, medically-tailored meals to seniors being discharged from hospitals)
                    - Post-Discharge Meal Distribution Programs Report  (comprehensive review of meal package programs including the Maryland Discharge Meal Program)
                    - Site Visit Agenda  (sample schedule for Malnutrition Pathway site visit)
                    - Malnutrition Pathway Survey  (survey for AAAs to provide feedback on their understanding of malnutrition and the malnutrition toolkit)
                    - Malnutrition Pathway Presentation  (presentation slides) 
                  - Improving client service through advanced data-card technology in Missouri 
                  -  **Summary: **To improve service delivery and cost-effectiveness of nutrition programs for older adults at risk of malnutrition, the Mid-America Regional Council and Aging Ahead Area Agency on Aging deployed artificial intelligence-enabled speakers, Amazon Echo Show, to clients' homes to reduce access barriers to good nutrition.  **Resources:**                      - Summary Brief  (snapshot of project and findings)
                    - Intervention Manual  (manual containing all participant training and communication materials for intervention implementation) 
                  - Assessing malnutrition risk through a home visitation program in Utah
                  -  **Summary: **To demonstrate an evidence-based relationship, University of Utah School of Medicine looked at the impact of targeted nutrition home visitation assessments and care planning on the health outcomes of recently discharged home delivered meal (HDM) recipients at malnutrition risk.  **Resources:**                      - Summary Brief  (snapshot of project and findings)
                    - Home Visit Preparation with HDM Initial Malnutrition Assessment  (list of items for home visit preparation and sample malnutrition assessment) 

## Presentations

                  - Innovations in Nutrition Programs and Services Updates (Apr 2020)                     - Part 1
                    - Part 2 
                  - Innovations 101 Training Series (2019)                      - Innovations in Nutrition Grant Initiatives
                    - Launching Your Innovation Journey 

## Other Resources on Innovation

                  - Innovation: Part Discipline, Part Creativity, All Possible Summary Brief                     - Summary brief
                    - Extended brief 

## INNU Grantees

                  - 2022 INNU Conference Recap
                  - 2022 INNU New Grantee Welcome Webinar Presentation (PPT)

## Capstone Project Templates

                  - Final Capstone Project Training (video)
                  - Capstone Project Template (PDF)                      - Capstone Project Word document version 
                  - Capstone One-Pager Template (PDF)                      - One-Pager Word document version 
                  - Microsoft Word Guide to 508 Compliance for INNU Grantees

## Detailed Agenda Template

                  -  INNU Detailed Agenda Template (MS Word format) 

## Semiannual Reports

                  - Semiannual Reporting Guide

## Other Resources

                  - PowerPoint Presentation Best Practices

*Last modified on 07/12/2023*

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