Digital Nutrition Intervention for Older Adults

December 15, 2025 updated by: Sarah Ullevig, The University of Texas at San Antonio

A Technological Intervention to Improve Nutrition Among Older Adult Congregate Meal Participants During COVID-19

The "digital divide" or gap in technological access and knowledge, for older adults has worsened during the COVID-19 pandemic, leading to disruptions in services like congregate meal programs funded by the Older Americans Act. Seven San Antonio congregate meal sites remained partially open biweekly to distribute meals but no longer offer in-person nutrition education, physical activity classes, and social activities. The proposed project will test the efficacy of digital nutrition intervention with at-risk older adults who attend congregate meal center in areas of high poverty and digital exclusion.

The study is uses a stepped-wedge cluster clinical trial. Key community partners with the Department of Health Services Senior Services Division and Older Adult Technology Services (OATS) will participate in the planning phase, research design, and implementation of the study.

The study aims are:

  1. To test the impact of a technology-based intervention on the primary outcomes of food security and diet quality;
  2. To determine the effect of the intervention on secondary outcomes of technology knowledge and usage, physical activity, and social isolation and loneliness;
  3. To examine the long-term impact and sustainability of technology use on food security, diet quality, physical activity, and social isolation.

If successful, the impact of this program could be applied throughout the national OATS network and to similar CMPs to bridge the digital divide beyond the COVID-19 pandemic

Study Overview

Status

Active, not recruiting

Conditions

Intervention / Treatment

Detailed Description

This project will target community-dwelling older adults who are "congregate meal" program (CMP) participants living in areas at-risk of the digital divide. The CMP is funded by the Older Americans Act and serves over 2000 San Antonio older adults who live 33% below the poverty level and 18% considered at high nutritional risk. During the pandemic, seven San Antonio sites in areas with high poverty and digital exclusion remain partially open biweekly to distribute meals but did not hold in-person nutrition education, physical activity classes, and social activities. The proposed project extends existing congregate meal programming infrastructure and partnerships with Older Adults Technology Services (OATS), a national leader in creating health service programs focusing on older adults. The goal of the proposed study is to remove the digital barrier to receiving essential, evidence-based nutrition programming online, utilizing OATS' five-week technology "Essential Series," which has successfully educated thousands of older adults nationwide by providing support for technology and internet connectivity.

This proposed nutrition intervention will enrolled congregate meal participants using a stepped-wedge cluster design with two cohorts to allow for sequential intervention enrollment with simultaneous control and intervention data collection timepoints. Key community partners within Department of Health Services Senior Services Division and OATS will participate in the planning phase, research design, and implementation of the study. Feedback from congregate meal participants in focus groups will guide the development of the intervention.

The 20-week intervention will include 5 weeks technology training, including internet access and devices, followed by 15 weeks of a culturally tailored nutrition intervention via online sessions. The study will recruit 440 older adult from seven at-risk congregate meal sites. Data will be collected at baseline (T0), during the online intervention (T1), after the online intervention (T2) and 6 months post-intervention (T3).

The successful outcome of our study will be impactful because of the potential broader application of this program throughout the national OATS network and to similar CMPs to bridge the digital divide through and beyond the COVID-19 pandemic.

Study Type

Interventional

Enrollment (Actual)

369

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • United States
    • Texas
      • San Antonio, Texas, United States, 78249
        • University of Texas at San Antonio

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

60 years to 120 years (Adult, Older Adult)

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • 60 years of age
  • Inadequate or no working technology device (computer, smart-phone, tablet), no or poor internet connectivity at home, or lack of knowledge and usage of technology
  • Food insecurity or low diet quality

Exclusion Criteria:

  • Blind
  • Terminal disease or illness
  • Diagnosis of dementia or Alzheimer's disease
  • Unable to read or write in English or Spanish

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Supportive Care
  • Allocation: Randomized
  • Interventional Model: Sequential Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Cohort 1
Cohort 1 will start the intervention directly after randomization.
Behavioral: Technology intervention
Older Adult Technology Services (OATS) 5-week technology intervention
Behavioral: Digital Nutrition Intervention
15-week nutrition intervention delivered completely online
Active Comparator: Cohort 2
Cohort 2 will serve as the control while cohort 1 is in the intervention stage. Cohort 2 will start the intervention after cohort 1 concludes the intervention.
Behavioral: Technology intervention
Older Adult Technology Services (OATS) 5-week technology intervention
Behavioral: Digital Nutrition Intervention
15-week nutrition intervention delivered completely online

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Diet Quality as measured by the Healthy Eating Index
Time Frame: Change in diet quality from baseline to 3 and 6 months
Two non-consecutive 24-hour dietary recalls will be collected and the Healthy Index will be calculated to determine diet quality.
Change in diet quality from baseline to 3 and 6 months

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Food Security
Time Frame: Change in food security from baseline to 3 and 6 months
Food security measured by the USDA's US Adult Food Security Survey Module
Change in food security from baseline to 3 and 6 months
Physical Activity
Time Frame: Change in physical activity from baseline to 3 and 6 months
Physical activity measured by the Physical Activity Scale for the Elderly (PASE)
Change in physical activity from baseline to 3 and 6 months
Technology Use and Access
Time Frame: Change in technology use and access from baseline to 3 and 6 months
Technology use questionnaire from the National Health & Aging Trends Study
Change in technology use and access from baseline to 3 and 6 months
Attitudes Towards Technology
Time Frame: Change in attitudes towards technology from baseline to 3 and 6 months
Adapted from Attitudes Towards Computers Questionnaire (ATCQ)
Change in attitudes towards technology from baseline to 3 and 6 months
Social Isolation
Time Frame: Change in social isolation from baseline to 3 and 6 months
Social isolation measured by The Social Disconnectedness Scale and the Perceived Isolation Scale
Change in social isolation from baseline to 3 and 6 months
Loneliness
Time Frame: Change in loneliness from baseline to 3 and 6 months
Loneliness assessed by the 3-item UCAL Loneliness Scale
Change in loneliness from baseline to 3 and 6 months
Malnutrition
Time Frame: Change in malnutrition from baseline to 3 and 6 months
Malnutrition measured by the Mini Nutrition Assessment Short-Form
Change in malnutrition from baseline to 3 and 6 months

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

The University of Texas at San Antonio

Collaborators

National Institute of Nursing Research (NINR)
Older Adult Technology Services
City of San Antonio Department of Human Services
Agile Analytics, LLC

Investigators

  • Principal Investigator: Sarah L Ullevig, PhD, University of Texas at San Antonio

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Helpful Links

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

June 1, 2022

Primary Completion (Actual)

September 30, 2024

Study Completion (Estimated)

January 30, 2026

Study Registration Dates

First Submitted

January 19, 2022

First Submitted That Met QC Criteria

February 1, 2022

First Posted (Actual)

February 2, 2022

Study Record Updates

Last Update Posted (Estimated)

December 16, 2025

Last Update Submitted That Met QC Criteria

December 15, 2025

Last Verified

December 1, 2025

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 20-21-241
  • 1R01NR020303-01 (U.S. NIH Grant/Contract)

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

IPD Plan Description

All IPD collected will be shared

IPD Sharing Time Frame

Data will become available after primary and secondary outcome measures has been analyzed and published.

IPD Sharing Access Criteria

Data will be made available for research educational purposes.

IPD Sharing Supporting Information Type

  • STUDY_PROTOCOL
  • SAP
  • ICF

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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