Olga Lee | Trinity College Dublin (original) (raw)

Papers by Olga Lee

International Psychogeriatrics, 2016

ABSTRACTBackground:Peer volunteers can be key to delivering effective social cognitive interventi... more ABSTRACTBackground:Peer volunteers can be key to delivering effective social cognitive interventions due to increased potential for social modeling. We consulted peer volunteers who had just taken part in an 8-week social and nutritional mealtime intervention with older adults living alone, to seek their evaluation of the intervention.Methods:Semi-structured focus groups were used with a total of 21 volunteers (17 female) and two facilitators. Thematic analysis was used to interrogate the data.Results:Six themes (16 sub-themes) are discussed. Peer volunteers described the importance of the socializing aspect of the intervention, of pairing considerations and compatibility in peer interventions, of considering the needs of the participant, of benefits to the volunteers, and of the practical considerations of conducting an intervention. Volunteers also discussed considerations for future research and services for older adults living alone.Conclusions:Volunteers found their involvement...

JMIR Research Protocols, 2015

Background: Older adults living alone are at increased risk of malnutrition as well as social iso... more Background: Older adults living alone are at increased risk of malnutrition as well as social isolation. Previous research has evaluated psychosocial interventions aimed at improving social support for older adults living alone. One meta-analysis in particular has suggested that multimodal psychosocial interventions are more effective than unimodal interventions. As such, it may be more effective to deliver an intervention which combines nutritional and social support together. Consequently, we designed the RelAte intervention, which focuses on shared mealtimes as a source of combined social and nutritional support for older adults living alone who are at risk of social isolation. Objective: The objective of the RelAte trial was to evaluate the impact of such an intervention on energy intake, anthropometric measurements, and nutritional social cognitive variables among older adults living alone in the community. Methods: There are 100 participants that will be recruited and randomized to either the treatment (n=50) or the control group. The treatment group will receive a visit from a trained peer volunteer once weekly for a period of 8 weeks. Outcomes of interest include: energy intake, social cognitive factors related to diet, abdominal circumference, body mass index, psychosocial well-being, frailty, nutritional status, and health utilities. Outcomes will be obtained at baseline, immediately postintervention (8 weeks after baseline), 12-week follow-up, and 26-week follow-up by assessors blinded to participants' randomized assignment. Results: The Relate trial is currently active. We are currently at data analysis stage. The study started in June 2013 and will run until June 2015. Conclusions: Results from this study will primarily describe the effectiveness of a shared mealtime intervention for older adults living alone in terms of their dietary well-being, physical health, and psychosocial well-being.

Background: Malnutrition impacts older Irish adults and is associated with unfavourable outcomes,... more Background: Malnutrition impacts older Irish adults and is associated with unfavourable outcomes, such as physical and cognitive decline. Older adults living alone may be particularly vulnerable. In this group, many factors, such as access to transport, mobility, health status, changes to taste an smell, metabolic changes, and medication use may impact nutrition status. We wanted to investigate whether self-reported enjoyment of food would be indicative of nutritional outcome in this population. Methods: As part of the Relate study, cross-sectional information was collected on nutritional status (using the Nestle Mini-Nutritional Assessment scale), food enjoyment (using the Food Enjoyment Scale; Vailas & Nitzke, 1998), and health status (using the Health Utilities Index; Horsman et al., 2003), among 53 adults (17 male) living alone (age range 60-91, mean age 74.4). Multiple regression analyses were performed on the data with nutritional status as the dependent variable and food enjoyment, health status, age, and gender as predictors. Results: The regression model was found to be significant [Adj. R2 = 0.145, F4,50 = 3.114, p < 0.05]. Of the predictors, only food enjoyment was found to be a significant predictor of nutritional status [β = -0.395, p < 0.01]. Conclusions: Food enjoyment, but not health status, predicts nutritional status among older adults living alone. Our findings accord with previous research which states that nutritional status can be impacted among older adults due to changes in chemosensory function as well as diminished appetite. This finding has significant implications for prevention of nutritional decline among older Irish adults, since efforts may be most beneficial in the promotion and facilitation of enjoyment of food.

Background: Older adults living independently often require cooking and nutritional support. Our ... more Background: Older adults living independently often require cooking and nutritional support. Our aim was to explore cooking and eating patterns among Irish older adults, as well as exploring the recommendations of geriatric healthcare professionals, in order to inform future design of mealtime support for older adults. Methods: User and expert consultations in the form of interviews and focus groups were held with 7 users and 25 experts from relevant professions. All data were recorded, transcribed, and analysed using content analysis by two independent researchers. Findings: Overall a need for cooking support for older adults living independently was evident. The data revealed 14 recommendations including: dyadic peer-based partnership; active, person-centred, additive, multi-componential intervention; prioritising energy intake; and the mealtime as occasion, and as an opportunity to evaluate improvement. Discussion: Implications for supporting cooking and mealtimes in a social cognitive framework are discussed. We also describe the development of our own novel peer-led intervention arising from this research, entitled “RelAte”.

International journal of geriatric psychiatry, 2015

The study demonstrated that the EQ-5D has reliability sufficient for aggregate level data and onl... more The study demonstrated that the EQ-5D has reliability sufficient for aggregate level data and only 47% of variation in one instrument was explained by another instrument. This can be given by the variability between instruments. The results demonstrated nonnormal distribution of the EQ-5D scores, and the correlation among the different items of the EQ-5D allows for confidence in the validity of the instrument. The patient's valuation of their own health state should be further investigated before the EuroQol is considered a valid instrument for policy research in this population.

British Journal of Nutrition, Oct 28, 2016

Mealtime interventions typically focus on institutionalised older adults, but we wanted to invest... more Mealtime interventions typically focus on institutionalised older adults, but we wanted to investigate whether they may also be effective among those living independently. Using a randomised controlled trial design, we assessed the effects of a novel mealtime intervention on self-efficacy, food enjoyment and energy intake. A total of 100 adults living alone aged over 60 years were randomised to the treatment or control conditions: all received a guidebook on nutrition and culinary skills. Treatment group participants received a weekly visit from a trained volunteer who prepared and shared a meal with them. Participants in the treatment group showed improvements relative to those in the control group at borderline significance (P = 0•054) for self-efficacy and at significance for food enjoyment. Significant improvements were observed in female participants in the treatment but not in the control group in energy intake (although following corrections for multiple comparisons, only the effect on food enjoyment remained significant). These findings will inform the design of future complex interventions. For this type of intervention to be successful, more focus has to be placed on making interventions more personalised, potentially according to sex. Findings are important for nutritional sciences as they indicate that, in order to improve energy intake and food enjoyment among older adults, multimodal nutritional interventions including social components may be successful.

JMIR Research Protocols, 2015

Background: Older adults living alone are at increased risk of malnutrition as well as social iso... more Background: Older adults living alone are at increased risk of malnutrition as well as social isolation. Previous research has evaluated psychosocial interventions aimed at improving social support for older adults living alone. One meta-analysis in particular has suggested that multimodal psychosocial interventions are more effective than unimodal interventions. As such, it may be more effective to deliver an intervention which combines nutritional and social support together. Consequently, we designed the RelAte intervention, which focuses on shared mealtimes as a source of combined social and nutritional support for older adults living alone who are at risk of social isolation.

International journal of geriatric psychiatry, 2015

International Psychogeriatrics, 2016

ABSTRACTBackground:Peer volunteers can be key to delivering effective social cognitive interventi... more ABSTRACTBackground:Peer volunteers can be key to delivering effective social cognitive interventions due to increased potential for social modeling. We consulted peer volunteers who had just taken part in an 8-week social and nutritional mealtime intervention with older adults living alone, to seek their evaluation of the intervention.Methods:Semi-structured focus groups were used with a total of 21 volunteers (17 female) and two facilitators. Thematic analysis was used to interrogate the data.Results:Six themes (16 sub-themes) are discussed. Peer volunteers described the importance of the socializing aspect of the intervention, of pairing considerations and compatibility in peer interventions, of considering the needs of the participant, of benefits to the volunteers, and of the practical considerations of conducting an intervention. Volunteers also discussed considerations for future research and services for older adults living alone.Conclusions:Volunteers found their involvement...

JMIR Research Protocols, 2015

Background: Older adults living alone are at increased risk of malnutrition as well as social iso... more Background: Older adults living alone are at increased risk of malnutrition as well as social isolation. Previous research has evaluated psychosocial interventions aimed at improving social support for older adults living alone. One meta-analysis in particular has suggested that multimodal psychosocial interventions are more effective than unimodal interventions. As such, it may be more effective to deliver an intervention which combines nutritional and social support together. Consequently, we designed the RelAte intervention, which focuses on shared mealtimes as a source of combined social and nutritional support for older adults living alone who are at risk of social isolation. Objective: The objective of the RelAte trial was to evaluate the impact of such an intervention on energy intake, anthropometric measurements, and nutritional social cognitive variables among older adults living alone in the community. Methods: There are 100 participants that will be recruited and randomized to either the treatment (n=50) or the control group. The treatment group will receive a visit from a trained peer volunteer once weekly for a period of 8 weeks. Outcomes of interest include: energy intake, social cognitive factors related to diet, abdominal circumference, body mass index, psychosocial well-being, frailty, nutritional status, and health utilities. Outcomes will be obtained at baseline, immediately postintervention (8 weeks after baseline), 12-week follow-up, and 26-week follow-up by assessors blinded to participants' randomized assignment. Results: The Relate trial is currently active. We are currently at data analysis stage. The study started in June 2013 and will run until June 2015. Conclusions: Results from this study will primarily describe the effectiveness of a shared mealtime intervention for older adults living alone in terms of their dietary well-being, physical health, and psychosocial well-being.

Background: Malnutrition impacts older Irish adults and is associated with unfavourable outcomes,... more Background: Malnutrition impacts older Irish adults and is associated with unfavourable outcomes, such as physical and cognitive decline. Older adults living alone may be particularly vulnerable. In this group, many factors, such as access to transport, mobility, health status, changes to taste an smell, metabolic changes, and medication use may impact nutrition status. We wanted to investigate whether self-reported enjoyment of food would be indicative of nutritional outcome in this population. Methods: As part of the Relate study, cross-sectional information was collected on nutritional status (using the Nestle Mini-Nutritional Assessment scale), food enjoyment (using the Food Enjoyment Scale; Vailas & Nitzke, 1998), and health status (using the Health Utilities Index; Horsman et al., 2003), among 53 adults (17 male) living alone (age range 60-91, mean age 74.4). Multiple regression analyses were performed on the data with nutritional status as the dependent variable and food enjoyment, health status, age, and gender as predictors. Results: The regression model was found to be significant [Adj. R2 = 0.145, F4,50 = 3.114, p < 0.05]. Of the predictors, only food enjoyment was found to be a significant predictor of nutritional status [β = -0.395, p < 0.01]. Conclusions: Food enjoyment, but not health status, predicts nutritional status among older adults living alone. Our findings accord with previous research which states that nutritional status can be impacted among older adults due to changes in chemosensory function as well as diminished appetite. This finding has significant implications for prevention of nutritional decline among older Irish adults, since efforts may be most beneficial in the promotion and facilitation of enjoyment of food.

Background: Older adults living independently often require cooking and nutritional support. Our ... more Background: Older adults living independently often require cooking and nutritional support. Our aim was to explore cooking and eating patterns among Irish older adults, as well as exploring the recommendations of geriatric healthcare professionals, in order to inform future design of mealtime support for older adults. Methods: User and expert consultations in the form of interviews and focus groups were held with 7 users and 25 experts from relevant professions. All data were recorded, transcribed, and analysed using content analysis by two independent researchers. Findings: Overall a need for cooking support for older adults living independently was evident. The data revealed 14 recommendations including: dyadic peer-based partnership; active, person-centred, additive, multi-componential intervention; prioritising energy intake; and the mealtime as occasion, and as an opportunity to evaluate improvement. Discussion: Implications for supporting cooking and mealtimes in a social cognitive framework are discussed. We also describe the development of our own novel peer-led intervention arising from this research, entitled “RelAte”.

International journal of geriatric psychiatry, 2015

The study demonstrated that the EQ-5D has reliability sufficient for aggregate level data and onl... more The study demonstrated that the EQ-5D has reliability sufficient for aggregate level data and only 47% of variation in one instrument was explained by another instrument. This can be given by the variability between instruments. The results demonstrated nonnormal distribution of the EQ-5D scores, and the correlation among the different items of the EQ-5D allows for confidence in the validity of the instrument. The patient's valuation of their own health state should be further investigated before the EuroQol is considered a valid instrument for policy research in this population.

British Journal of Nutrition, Oct 28, 2016

Mealtime interventions typically focus on institutionalised older adults, but we wanted to invest... more Mealtime interventions typically focus on institutionalised older adults, but we wanted to investigate whether they may also be effective among those living independently. Using a randomised controlled trial design, we assessed the effects of a novel mealtime intervention on self-efficacy, food enjoyment and energy intake. A total of 100 adults living alone aged over 60 years were randomised to the treatment or control conditions: all received a guidebook on nutrition and culinary skills. Treatment group participants received a weekly visit from a trained volunteer who prepared and shared a meal with them. Participants in the treatment group showed improvements relative to those in the control group at borderline significance (P = 0•054) for self-efficacy and at significance for food enjoyment. Significant improvements were observed in female participants in the treatment but not in the control group in energy intake (although following corrections for multiple comparisons, only the effect on food enjoyment remained significant). These findings will inform the design of future complex interventions. For this type of intervention to be successful, more focus has to be placed on making interventions more personalised, potentially according to sex. Findings are important for nutritional sciences as they indicate that, in order to improve energy intake and food enjoyment among older adults, multimodal nutritional interventions including social components may be successful.

JMIR Research Protocols, 2015

Background: Older adults living alone are at increased risk of malnutrition as well as social iso... more Background: Older adults living alone are at increased risk of malnutrition as well as social isolation. Previous research has evaluated psychosocial interventions aimed at improving social support for older adults living alone. One meta-analysis in particular has suggested that multimodal psychosocial interventions are more effective than unimodal interventions. As such, it may be more effective to deliver an intervention which combines nutritional and social support together. Consequently, we designed the RelAte intervention, which focuses on shared mealtimes as a source of combined social and nutritional support for older adults living alone who are at risk of social isolation.

International journal of geriatric psychiatry, 2015