Feeding Assistance for Eating

(JBH Trial)

Recruiting in Burlington (>99 mi)

Overseen By Ahmadi, PhD

Age: 65+

Sex: Any

Trial Phase: Academic

Sponsor: Joseph Brant Hospital

Disqualifiers: NPO status, Enteral feeding, Palliative, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Approved in 1 Jurisdiction This treatment is already approved in other countries

Compensation: Varies

Number of Visits: 1

Duration: 6 days

80 Participants Needed

Trial Summary

What is the purpose of this trial?

This research study will determine the impact of the Eating Matters Program on the nutritional status of elderly patients at Joseph Brant Hospital. The Eating Matters Program at Joseph Brant Hospital is a volunteer-based feeding assistance program that aims to improve patients' nutritional intake by providing assistance during mealtimes. As research on the impact of such programs on food intake is limited in Canada, this study will explore how the Eating Matters Program influences protein and energy intake of patients at Joseph Brant Hospital. Further, this study will explore if the hypothesized increase in protein and energy intake with the initiation of the Eating Matters Program is correlated with a decreased risk of malnutrition.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What data supports the effectiveness of the treatment Feeding Assistance, Eating Matters Program, Volunteer-based Feeding Assistance?

Research shows that volunteer-based feeding assistance can improve dietary intake in elderly patients, as seen in a study where protein intake increased when volunteers helped during meals. Additionally, mealtime assistance by volunteers has been found to promote food intake in hospital settings. ^{1 2 3 4 5}

Is feeding assistance generally safe for humans?

Feeding assistance programs, like those involving trained volunteers in long-term care facilities, have been shown to improve safety during meals by providing better training and supervision, which helps prevent issues like choking and aspiration (food or liquid entering the airway). ^{3 6 7 8 9}

How is the Feeding Assistance treatment different from other treatments for eating difficulties?

The Feeding Assistance treatment, also known as the Eating Matters Program, is unique because it involves volunteer-based support to help individuals with eating difficulties, focusing on personalized assistance rather than medication or dietary supplements. This approach emphasizes human interaction and support, which can be particularly beneficial for those who need encouragement and guidance during meals. ^{9 10 11 12 13}

Research Team

Latifa Ahmadi, PhD

Principal Investigator

Western University

Eligibility Criteria

This trial is for patients aged 65 or older admitted to Medicine and Rehabilitation units at Joseph Brant Hospital, expected to stay for 10-14 days. They should need help with eating, have a moderate to high risk of malnutrition (SGA score B or C), and be able to consent themselves or through a Power of Attorney.

Inclusion Criteria

Patients able to provide consent or have a Power of Attorney to do so on their behalf

I am 65 or older and will be in the hospital for 10-14 days for rehab.

I need help with eating due to my nutrition assessment.

Exclusion Criteria

Patients that are NPO status (nothing by mouth)

I need tube or IV feeding.

Palliative care patients

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Baseline Data Collection

Baseline food intake data is gathered during a 2-day period for both Study Group A and Control Group B.

2 days

1 visit (in-person)

Treatment

Feeding assistance is provided to participants in Study Group A, and food intake is recorded for a total of 6 days.

6 days

Follow-up

Participants are monitored for changes in dietary intake, weight, handgrip strength, and C-reactive protein levels.

2 weeks

Feedback and Assessment

Feedback on the Eating Matters Program is collected, and assessments such as Subjective Global Assessment and Hand Grip Strength are conducted.

19 days

Treatment Details

Interventions

• Feeding Assistance

Trial Overview The study is testing the Eating Matters Program, which uses volunteers to assist elderly patients during meals. The goal is to see if this assistance increases protein and energy intake, potentially reducing the risk of malnutrition among these patients.

Participant Groups

Group I: Study Group A Experimental Treatment 1 Intervention

Study group A will include patients from the medical unit on 6S100 in addition to the Rehab units on 6N400/500. Participants in Study Group A will be receiving mealtime assistance from volunteers via the Eating Matters Program.

Group II: Control Group B Active Control 1 Intervention

Control Group B will include participants from the Rehab Unit on 4N400 and the Medical unit on 6S200.

Feeding Assistance is already approved in Canada for the following indications:

Approved in Canada as Eating Matters Program for:

• Nutritional support for elderly patients
• Prevention of malnutrition

Who Is Running the Clinical Trial?

Joseph Brant Hospital

Lead Sponsor

Trials

4

Recruited

210+

Western University

Collaborator

Trials

31

Recruited

129,000+

Compass Group Canada

Collaborator

Trials

1

Recruited

80+

Findings from Research

The FoodforCare (FfC) meal service significantly improved protein and energy intake among hospitalized patients, with mean daily protein intake increasing from 59% to 79% of requirements on day 1 and from 59% to 73% on day 4 compared to the traditional meal service.

Patient satisfaction with the FfC service was maintained or slightly improved, particularly regarding the appearance and smell of meals, indicating that enhancing meal services can positively impact dietary intake without compromising patient experience.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A novel in-hospital meal service improves protein and energy intake. Dijxhoorn, DN., van den Berg, MGA., Kievit, W., et al.[2019]

A pilot study involving 9 elderly patients (average age 89) showed that trained volunteers significantly increased protein intake during lunch by an average of 10.1 grams when compared to weekends without volunteer assistance (p<0.05).

Volunteers not only improved dietary intake but also provided more social interaction and encouragement for patients to eat, suggesting that their presence could enhance nutritional care in hospitals, especially as the elderly population grows.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A volunteer feeding assistance program can improve dietary intakes of elderly patients--a pilot study. Walton, K., Williams, P., Bracks, J., et al.[2013]

Trained dining companions can significantly enhance the mealtime experience for hospitalized patients by providing assistance and promoting social interaction, which may help mitigate the risks of malnutrition.

These volunteers not only help patients eat safely but also serve as a communication link to nurses, ensuring that any issues are promptly reported and addressed.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Mealtime help. Sander, R.[2019]

A scoping review of 35 studies highlights that individualized dietary treatments can significantly improve food intake and other positive health outcomes for hospitalized patients suffering from malnutrition.

While foodservice strategies that encourage patient choice show promise, and mealtime assistance can enhance food intake, more research is needed to effectively implement and evaluate these 'food first' approaches in acute care settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Dietary, food service, and mealtime interventions to promote food intake in acute care adult patients. Cheung, G., Pizzola, L., Keller, H.[2016]

The FNS Patient Advocate program significantly improved post-discharge patient satisfaction ratings for various food and nutrition service attributes, with 73% of patients recalling their interaction and reporting high satisfaction (mean score of 5.8 on a 7-point scale).

Patients who had previously rated their satisfaction as 3 or lower showed marked improvements in satisfaction regarding special diet explanations, food temperature, food quality, server courtesy, and likelihood of receiving ordered foods after interacting with the Patient Advocate.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Timely resolution of patient concerns improves post-discharge satisfaction. Barsamian, AM., Gregoire, M., Sowa, D., et al.[2015]

The updated meal pattern requirements for the Child and Adult Care Food Program emphasize serving more whole grains, a greater variety of vegetables and fruits, and reducing added sugars and solid fats, aligning with the Dietary Guidelines for Americans.

These changes, which are the first major revision since 1968, aim to promote healthier eating habits in young children and improve the overall wellness of adult participants, supporting breastfeeding mothers and enhancing consistency with other nutrition programs.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Child and Adult Care Food Program: Meal Pattern Revisions Related to the Healthy, Hunger-Free Kids Act of 2010. Final rule. [2016]

A formalized training program for volunteers at Coler Memorial Hospital significantly improved the quality of meal assistance for residents in long-term care, enhancing their socialization and communication during meals.

The program also emphasized safety, addressing the risks associated with swallowing disorders and aspiration, ensuring that volunteers were better prepared to assist residents effectively.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Volunteer participation in feeding residents: training and supervision in a long-term care facility. Lipner, HS., Bosler, J., Giles, G.[2019]

The feeding assistance intervention significantly increased daily caloric intake and helped residents maintain or gain weight over 24 weeks, while the control group lost weight.

Providing feeding assistance required more staff time than usual care, but delivering snacks between meals was more time-efficient and could be a practical option for nursing homes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Prevention of unintentional weight loss in nursing home residents: a controlled trial of feeding assistance. Simmons, SF., Keeler, E., Zhuo, X., et al.[2022]

The Food for Peace Act has evolved over 60 years from focusing on the quantity of food aid to emphasizing the quality of food assistance, particularly for vulnerable groups, impacting over 3 billion people in 150 countries.

Current discussions are centered on the use of fortified blended foods, especially the role of dairy ingredients, to prevent and treat malnutrition in the first 1000 days of life, with ongoing trials to gather more evidence on their effectiveness.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Delivering Improved Nutrition: Dairy Ingredients in Food Aid Products. Schlossman, N.[2016]

In a study analyzing 36.4 million pounds of food distributed by the Oregon Food Bank, 66% of the food was categorized as nutritious according to MyPyramid guidelines, indicating a significant focus on improving the nutritional quality of emergency food supplies.

The distribution of MyPyramid Days revealed that while grains, meat/beans, and vegetables were well-represented, fruits and milk were less frequently distributed, highlighting areas for potential improvement in food resource development to enhance overall nutrition for recipients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Nutritional quality of emergency foods. Hoisington, A., Manore, MM., Raab, C.[2018]

The report highlights significant issues in U.S. emergency food aid programs, including problems with the quantity and quality of food contributions, which may hinder meeting the nutritional needs of disaster victims.

It emphasizes the need for better integration of nutrition science in food aid formulation and suggests that non-nutritional priorities, such as agricultural market linkages, often overshadow the nutritional requirements of recipients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Foods provided through U.S. Government Emergency Food Aid Programs: policies and customs governing their formulation, selection and distribution. Marchione, TJ.[2018]

A volunteer dietitian successfully revised the hospital diet manual in Liberia to better align with local food customs, which is crucial for improving dietary practices in the community.

The dietitian also provided valuable education to healthcare professionals on nutrition and specific dietary needs for malnourished children, particularly focusing on the evaluation of a kwashiorkor treatment formula.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Volunteer experience of an American dietitian in Liberia, West Africa. Fairfull, CB.[2016]

The FoodMate® program, an 8-week nutrition education initiative, was well-received by participants and led to long-term improvements in their cooking skills, dietary habits, and overall life satisfaction over a follow-up period of up to 2 years.

Participants reported enhanced confidence in cooking and trying new foods, indicating that such programs can effectively promote healthy eating and food independence among individuals facing food insecurity.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

An evaluation of SecondBite&#174; 's FoodMate&#174; , a nutrition education and skill-building program aimed at reducing food insecurity. Stephens, LD., Smith, G., Olstad, DL., et al.[2021]

References

1. England pubmed.ncbi.nlm.nih.gov

A novel in-hospital meal service improves protein and energy intake. [2019]

2. England pubmed.ncbi.nlm.nih.gov

A volunteer feeding assistance program can improve dietary intakes of elderly patients--a pilot study. [2013]

3. England pubmed.ncbi.nlm.nih.gov

Mealtime help. [2019]

4. United States pubmed.ncbi.nlm.nih.gov

Dietary, food service, and mealtime interventions to promote food intake in acute care adult patients. [2016]

5. United States pubmed.ncbi.nlm.nih.gov

Timely resolution of patient concerns improves post-discharge satisfaction. [2015]

6. United States pubmed.ncbi.nlm.nih.gov

Child and Adult Care Food Program: Meal Pattern Revisions Related to the Healthy, Hunger-Free Kids Act of 2010. Final rule. [2016]

7. United States pubmed.ncbi.nlm.nih.gov

Volunteer participation in feeding residents: training and supervision in a long-term care facility. [2019]

8. United States pubmed.ncbi.nlm.nih.gov

Prevention of unintentional weight loss in nursing home residents: a controlled trial of feeding assistance. [2022]

9. United States pubmed.ncbi.nlm.nih.gov

Delivering Improved Nutrition: Dairy Ingredients in Food Aid Products. [2016]

10. United States pubmed.ncbi.nlm.nih.gov

Nutritional quality of emergency foods. [2018]

11. United States pubmed.ncbi.nlm.nih.gov

Foods provided through U.S. Government Emergency Food Aid Programs: policies and customs governing their formulation, selection and distribution. [2018]

12. United States pubmed.ncbi.nlm.nih.gov

Volunteer experience of an American dietitian in Liberia, West Africa. [2016]

13. Australia pubmed.ncbi.nlm.nih.gov

An evaluation of SecondBite&#174; 's FoodMate&#174; , a nutrition education and skill-building program aimed at reducing food insecurity. [2021]