Bone-Health Nutrition Training for Food Service Staff in Aged Care: A Food-Based Approach to Manage Fracture Risk

Older adults living in aged care homes have the highest fracture risk, accounting for 30% of hip fractures in Australia. We increased provision of high-protein, high-calcium foods from 2 to 3.5 servings/day for 2 years in over 3300 aged-care residents and reduced fractures by 33%, hip fractures by 46% and falls by 11% compared to the 3800 residents that consumed from their regular menus. This was done by supporting food service staff to incorporate these foods into their menus. To upscale this program we have developed a Bone Health Nutrition Training Program via an on-line community of practice that aged-care food service staff can access. A community of practice enables staff within a given organisation or age care provider group to converse and share thoughts, recipes, and ideas amongst the group within a secure invitation-only platform. This is an important aspect of the training and on-going support of staff as they can securely converse within their network and share strategies and ideas within their own network as changes implemented within an organisation may have copyright or other restrictions attached to it. This project will assess the efficacy of this Training Program by measuring improved protein content of menus, and improved protein intake of residents. The project involves 16 aged care homes; half of which will be randomised to intervention (education program) with the remaining half to continue with food provision from their usual menus. Food service staff from the intervention aged care homes will undertake the Bone Health Nutrition Training Program. Food service staff at control sites will continue with their usual food provision. Menus will be assessed for nutritional quality before and after training completion. Food service staff will report on the barriers and enablers for implementing the menu changes via focus groups or interviews. A sample of at least 8 residents per aged care home will have their dietary intake recorded across two days by measuring plate waste, have their nutritional status determined using the mini nutrition assessment tool, and quality of life determined by questionnaire at baseline and after training completion and implementation of menu changes based on learnings from the Training Program (~ 2-3 months). The education will be conducted virtually. There is minimal disruption to residents’ activities with nutritional status and quality of life determined at a time that is convenient for them. Food service (e.g., timing of meal delivery) will remain unchanged. Research staff involved in data collection in aged care homes are all qualified and will be fully vaccinated and trained on infection control and processes and procedures for each aged care home.