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Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet]. York (UK): Centre for Reviews and Dissemination (UK); 1995-.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet].

Group nutrition education classes for older adults

M Meck Higgins and M Clarke Barkley.

Review published: 2004.

CRD summary

This review concluded that there was little consistent comparative research with which to assess the effects of group nutrition education classes for older adults. Confidence in these conclusions is restricted by limitations in the review methodology.

Authors' objectives

To describe the interventions, participants and outcomes of studies using group nutrition education classes for older adults.


AgeLine, AGRICOLA, Biological Abstracts, CHID Online, CRIS, ERIC, HealthSTAR, HNRIMS, MEDLINE Express, PsycINFO and PubMed were searched from 1993 to 2003 for relevant English language publications; the search terms were reported in a related article (see Other Publications of Related Interest). Recent issues of selected journals were handsearched for further relevant evidence.

Study selection

Study designs of evaluations included in the review

The authors did not state any inclusion criteria relating to the study design. Both controlled and uncontrolled studies were among those selected for the review.

Specific interventions included in the review

Studies evaluating group classes that included and described nutrition education as a substantial component were eligible for inclusion. The classes had to be offered as a series of sessions. The specific intervention strategies included lectures/discussions, videotapes, recipes, exercise, goal-setting, take-home activities, handouts, food/cooking demonstrations, taste testing and written personal plans. Three studies explicitly indicated that elements of a stated behavioral change theory had been incorporated into the intervention. The theories and models used were Health Belief, Social Action, Social Learning, Socio-Ecological and Transtheoretical (Stages of Change). The classes ranged from 8 to 24 weeks in duration.

Participants included in the review

Studies reporting separately on adults aged at least 50 years living independently in the USA were eligible for inclusion. Where reported, the included participants were aged from 55 to 91 years.

Outcomes assessed in the review

The authors did not state any inclusion criteria relating to the outcomes. The included studies measured a variety of outcomes relating to knowledge, attitudes or beliefs, behaviours and physiologic measures.

How were decisions on the relevance of primary studies made?

The authors did not state how the papers were selected for the review, or how many reviewers performed the selection.

Assessment of study quality

Aspects of study quality were discussed, but it was unclear whether a formal validity assessment was undertaken.

Data extraction

The authors did not state how the data were extracted for the review, or how many reviewers performed the data extraction. Data on key study characteristics and results were extracted.

Methods of synthesis

How were the studies combined?

The studies were combined in a narrative; six studies included comparison groups.

How were differences between studies investigated?

Differences between the included studies were apparent from the data extraction tables presented in the review article. The studies were grouped and discussed according to the interventions, participants and outcomes being investigated.

Results of the review

Nine studies (n=1,429) were included in the review.

The nine included studies were heterogeneous in terms of the interventions, particiants, study designs and outcomes evaluated. No consistent patterns were detected among the reported outcomes (e.g. knowledge, attitude, behaviour and physiologic characteristics).

Authors' conclusions

Little comparative research has been conducted to determine whether group nutrition classes for older adults are the most appropriate educational approaches to use to teach healthy nutrition practices to this age group. The inconsistent effects observed made it difficult to form any conclusive recommendations about the effectiveness of these interventions.

CRD commentary

The review question was broadly defined in terms of the interventions and participants of interest. Several electronic databases and journals were searched for relevant publications. However, no attempt was made to identify unpublished evidence and only English language studies published from 1993 were included, suggesting that relevant studies might have been missed. Aspects of study quality were discussed in the review, but it was unclear whether the validity of the studies was assessed using any formal processes. It was also unclear whether attempts were made to minimise error and bias in the review methods.

The authors' narrative synthesis largely provided a description of the studies rather than integrating the data, but this was not surprising given that their primary aim was to describe the studies rather than assess the effects of the interventions. Overall, the authors' lack of any clear recommendations for practice seem appropriate given the heterogeneity of the included evidence, although these conclusions should be interpreted in the light of the limitations highlighted.

Implications of the review for practice and research

Practice: The authors did not state any implications for practice.

Research: The authors recommended that researchers conduct studies to explore all aspects of older adult group education. They stated that published research describing advantages and disadvantages of group classes versus other educational interventions versus combination approaches is needed. They added that reports of these studies should include detailed descriptions of the theory-based educational and behavioural strategies selected by the partners in the planning team, the sessions provided, and the topics taught and their instructors; a complete description of the older adult participants and control or comparison groups; and the evaluation and follow-up methods used.

Bibliographic details

Meck Higgins M, Clarke Barkley M. Group nutrition education classes for older adults. Journal of Nutrition for the Elderly 2004; 23(4): 67-98. [PubMed: 15149942]

Other publications of related interest

Higgins MM, Clarke Barkley M. Important nutrition education issues and recommendations related to a review of the literature on older adults. J Nutr Elder 2003;22:65-78.

Indexing Status

Subject indexing assigned by NLM


Aged; Aged, 80 and over; Aging /psychology; Female; Follow-Up Studies; Health Knowledge, Attitudes, Practice; Health Promotion /methods; Humans; Male; Middle Aged; Needs Assessment; Nutritional Sciences /education; Outcome Assessment (Health Care)



Database entry date


Record Status

This is a critical abstract of a systematic review that meets the criteria for inclusion on DARE. Each critical abstract contains a brief summary of the review methods, results and conclusions followed by a detailed critical assessment on the reliability of the review and the conclusions drawn.

CRD has determined that this article meets the DARE scientific quality criteria for a systematic review.

Copyright © 2014 University of York.

PMID: 15149942

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