Improving Diet Quality of Community-Dwelling Seniors Using a Community-Based Participatory Approach

This is a single-arm trial and so all participants will be in the intervention arm.

The intervention is a food literacy workshop comprising 4 sessions held once every 2 weeks, up to 3 hours each. The main workshop themes are: 1) Practical ways to prepare simple and healthy meals; and 2) Basic nutrition knowledge related to the meals prepared, such as their nutrient components, links to chronic conditions and short/long-term health effects. These sessions include hands-on food preparation, tasting sessions, talks, group discussions and/or question and answer. Hands-on food preparation will focus on 'no-equipment' or 'light cooking' recipes. Food tasting involves everyday ingredients such as fruits, vegetables, proteins, nuts, seeds, spices, grains, and condiments. Group discussions will be facilitated by a study team member and will revolve around the specific themes of the workshop delivered on that day.

A questionnaire that captures all foods consumed by the individual respondent during a 24-hour reference period and classifies foods into their corresponding GDQS food groups. The overall GDQS score sums up points across food groups, totaling a possible range of 0-49. Higher scores denote better diet quality.

Knowledge regarding health eating self-rated on a 5-point Likert scale. Higher scores denote better self-rated knowledge

Self-selected factors influencing food choice and frequency of snacking behavior.

A quiz that assesses the participant's nutrition literacy.

A scenario-based assessment that tests the participant's food literacy across 4 domains: Planning, Selection, Preparation, and Eating. Each correct answer will be given one score, totaling a possible range of 0-4.

Subjective sleep quality is rated from 0 (very bad) to 3 (very good). Sleep duration is rated from < 5 hours (severe sleep deprivation) to > 7 hours (standard healthy recommendations).

Three domains (feelings of Stomach discomfort, Energy, and Mood) self-rated on a 0-10 VAS. Higher scores denote less stomach discomfort, better energy or better mood.

Weight (kg) divided by the square of height (m), a measure of obesity and overweightness.

Participants are timed as they rose from a chair, walked 3-metres to-and-fro, and sat back down on the chair. A measure of physical function and performance.

A 3-item questionnaire that assesses an individual's subjective feelings of loneliness and social isolation. Higher scores denote more loneliness. A score of 6-9 out of 9 indicated loneliness

A 6-item validated instrument designed to measures the size, closeness, and frequency of a person's social interactions with family and friends. Possible range of scores is from 0 to 30. A score of <12 out of 30 indicated poor social network score, or at risk of social isolation.

A health-related quality of life questionnaire based on five dimensions (mobility, self-care, usual activities, pain/discomfort, and anxiety/depression) across five levels. An index score will be computed based on specific country's value set, where max score is 1.000 (perfect health) and min score could be a negative value (health state that is "worse than dead"). Based on the official Singapore EQ-5D-5L value set, the index scores range from 1.000 down to -0.851. Visual-analogue scale score ranges from 0 to 100, with higher scores denoting better self-rated health.

Overall satisfaction with intervention program rated on a 5-point Likert scale. Higher point denotes better satisfaction.

Confidence in delivering health and nutrition-related messages, rated on 5-point Likert scale.

An adapted validated scale to measure participant's trust in the trainers. Each item is scored on a 4-point Likert scale. Scores are calculated as a mean of non-missing items, with possible range of score from 1.0 to 4.0. Higher scores denote higher trust.