TEXAS CONGREGATE MEAL INITIATIVE

2019-PRESENT

PROJECT DESCRIPTION

A significant portion of US adults over age 60 suffer from social isolation and food insecurity. Congregate meal programs offer social interaction with peers, nutrition services, health education, and other activities tailored to the needs of seniors, but participation in these programs has declined dramatically in recent years across Texas and the nation. In collaboration with the Texas Health and Human Services Commission and the Texas A&M Mays Business School, PPRI aided 16 community-based congregate meal providers in developing and testing low-cost innovations aimed at increasing congregate meal participation and expanding benefits to seniors. The innovations were designed to be scaled statewide and nationally, with PPRI maintaining a repertoire of resources and tools from the entire collaborative experience.

The TCMI project involved a multi-stage research process. To learn existing barriers and facilitators to serving seniors in urban and rural communities, the project first surveyed older Americans, healthcare workers, and senior-serving organizations, then conducted 29 focus groups with congregate meal providers in the state’s 28 Area Agencies on Aging (AAA) regions. Sixteen local nutrition providers were then selected to form a Learning Collaborative. Following a kick-off in a three-day virtual workshop, the pilot sites received technical assistance to learn from each other and from subject matter experts as they planned innovations in the areas of technology-based programing, wellness education, branding, and creative dining.

The pilot program components were implemented in late Fall 2021. PPRI has tracked successes and challenges, and made recommendations to stakeholders, policy makers, and researchers for broad-based dissemination. These research findings are included below. The TCMI Learning Collaborative was featured by the federal Administration for Community Living as a “best practice” example at the 2021 Conference of the National Council on Aging. Findings have been presented at key state and national conferences in 2020-2022.

APPROACH

Program and Policy Evaluation
Survey Research

Research Design and Data Analysis
Technical Assistance

RESEARCH TEAM

Nandita Chaudhuri, Ph.D. (Principal Investigator)
Kirby Goidel, Ph.D. (Co-Principal Investigator)
Paul Busch, Ph.D.
Lisa Halperin

Anthony Jackson
Zachariah Brattin
Linda Netterville
Ashleigh Williams
Laila Alvi

PILOT SITES

PILOT INNOVATIONS

Learning Collaborative Resources

Downloadable Materials

FREQUENTLY ASKED QUESTIONS

What are some project successes?

First, the mixed methods approach for the comprehensive needs assessment during the first year of the project worked very well in collecting rich qualitative and quantitative data on Texas specific facilitators and barriers for the congregate meal programs. The project used this data to inform training material for the innovation pilots in later stages.

Secondly, during years 3 and 4, using the Learning Collaborative (LC) approach to empower the pilot sites really worked well for building capacities and innovation skillsets for the 16 pilot sites through. The LC’s marketing strategies training helped the pilots increase program awareness and visibility in the pilot communities. The pilots developed superb local community partnerships too that helped enrich their project goals and enhanced their overall sustainability prospects.

Thirdly, the project helped to significantly increase resources and funding to support sustaining the pilots and/or selected pilot components. A site described, “We took $10,000 and turned it into $70,000.”

Finally, the pilots improved SDOH outcomes for clients served in the areas of general well-being, mental well-being, social connection and food security.

What has been this project’s biggest challenge?

The COVID-19 pandemic affected not only the implementation timeline of the TCMI Learning Collaborative (such as converting in-person components to virtual components) but it directly affected the pilot sites themselves. Sites had to address COVID challenges, varying public health department mandates, and stop onsite activities for extended periods of time. Besides, they re-opened at different times, causing logistical issues for pilot survey data collection, and posing challenges for the overall project design because they kept on pivoting. The sites whose innovations centered on dining model enhancements suffered the most because they could not implement their overall envisioned plans.

How did you go about finding appropriate partners?

While developing the project design, we had to carefully think about meaningful partnerships that could contribute to the success of project’s vision. Texas HHSC came to PPRI at Texas A&M University to design and implement the project and we included Texas A&M Mays Business School for their marketing acumen expertise, SNAP-Ed for their involvement with evidence-based nutrition and physical activity curriculum and linkage with the Texas food banks. Most important partnership was with the sixteen (16) selected congregate nutrition providers from an applicant pool of 37 and their respective Area Agencies on Aging. For the 16 pilot innovations, building community partnerships was key to project success and will contribute to local sustainability. They have developed effective local partnerships with food banks, local chefs, local donors, nursing schools, youth organizations, healthcare organizations, hospitals, higher-educational institutions for technology based and other activity-based curriculum. The project has been a partnership galore from all possible perspectives.

How do I get started on a similar project?

The first steps involve identifying the gaps in your local congregate programs and building a network to assist in filling those gaps. Once the gaps are identified, leverage your network of providers, researchers, and subject matter experts to work on the innovations thinking component. A congregate site must identify the resources, both existing and possible, needed for the successful planning and implementation of the innovation desired. While project staff trained and empowered the TCMI pilot sites, it was the sites themselves that developed and implemented their pilot innovations. Each of the selected sites has years (if not decades) of experience serving the older adults, and leveraging this wealth of experience is incredibly important.

Research Impact

BEST PRACTICES

Low-Cost Innovations

Site Ambience
- Reorganizing seating, paints and decor
Small Equipment
- Lower-cost items (coffee maker, smoothie machine).
- iPads, Laptops, Pedometers, BP Check Instruments
Volunteer Staffing
- 56% of all sites utilized external volunteer support
- 63% of all sites utilized older adult participant volunteers as models
Donations
- Monetary donations, sponsorships (e.g., Bingo rewards) or item donations (ex: blood pressure cuffs, Masterclass subscriptions)
- Donation or “honor system” payment to create buy-in

Community Partnerships

Businesses
- Advertising Agencies, Restaurants, Craft Stores
Civic Organizations & Special Interest Groups
- Rotary, Lions Club, AARP, Local Clubs
Other Non-Profits & Faith-based Organizations
- Food Banks & Pantries, Churches
Local Government , Healthcare & Local Schools
- Parks & Rec, Health Dept., Hospitals, Community Colleges, Culinary Schools, Local Industries

Marketing & Outreach

Community Resources
- Outreach Events, Health Fairs including COVID 19 Immunization events (San Antonio)
- Community Night-Out Events, Parades (Amigos)
Healthcare Systems
- Senior Townhall Meetings introducing New Telehealth Kiosk (Dallas)
Social Connection & Outreach: Myriad Media
- Marketing videos, flyers, posters, mailouts, telephonic contacts, virtual internet sessions, billboards, advertising on local radio stations & television
- Presentation to senior housing & other senior communities (Amigos, Waco)

Sustainability

Grants, In-Kind Support
- Equipment, facilities, technology purchase, telehealth volunteers, other external grants
Local government
- Location for the sites, monetary support, coordination assistance at local levels
Pay for Service
- Donations from seniors, Coffee for $0.50
Using Volunteers
- Curriculum from cooking, technology or craft classes as well as nutritional & health education
- Using volunteers from local educational institutions including nursing schools