Dissertation
Can daily meal plan nutritional quality be improved for homeless shelter residents within budgetary limits?
Doctor of Health Science (D.H.Sc.), Drexel University
May 2019
DOI:
https://doi.org/10.17918/00011583
Abstract
Background: Philadelphia is among the top ten cities in the United States with the highest poverty rates. Housing and feeding the homeless or marginalized population continues to be a difficulty in our city. Residents of homeless and emergency shelters in Philadelphia exhibit a high rate of metabolic illness (kidney disease and diabetes), making medically appropriate meal provisions necessary but costly. As a general rule, homeless shelters spend an equal amount on breakfast, lunch, and dinner. Objective: The primary hypothesis is that if nutrient dense recipes are used for meal plans, and spending is increased on dinner and decreased on breakfast and lunch, while maintaining the same overall daily amount allocated per person per day, Healthy Eating Index 2015 (HEI2015) scores will be increased. Methods: Meal plans were developed for shelter residents (Project HOME) suffering from chronic kidney disease and diabetes, based on nutritional parameters for these disease states. Pre-modified recipes in use at the homeless shelter were analyzed and compared to post-modified recipes. HEI 2015 scores were generated and averaged for two weeks of pre-modified and post-modified meal plans based on nutritional analysis using Automated Self-Administered Tool (ASA24), A dietary assessment tool by the National Institute of Health and National Cancer Institute. Statistical Analysis System (SAS) was used to generate weekly average HEI scores for pre and post- modified meal plans. Results: The Total HEI-2015 Mean score for one week of pre-modified meal plans was 44.15, with a minimum of 31.38 and maximum of 53.18. The Total HEI-2015 Mean score for one week of post-modified meal plans was 76.44, with a minimum of 56.83 and maximum of 86.80. The percent increase between pre-modified meal plans and post-modified meal plans is 73.18%. HEI-2015 average score for pre-modified meal plans for week 2 is 45.36, with a minimum of 27.18 and maximum of 56.19. HEI average score for post-modified meal plans is 70.14 with minimum score of 61.02 and maximum score of 79.68. The percent increase between pre and post-modified meal plans for week 2 is 54.6%. Daily HEI was statistically significantly improved (t (13) = -8.410, p = .000, two-tailed). In both weeks, HEI score was improved, while maintaining total food cost per day at $4.00/person/day, with higher food cost allocated on dinner than on either breakfast or lunch. Conclusion: By reallocating funds to specifically spend more on dinner, Healthy Eating Index (HEI) scores, which measure how closely diet conforms to Dietary Guidelines for Americans, were improved, and medically appropriate nutrition needs better addressed, thus improving the health of individual residents.
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Details
- Title
- Can daily meal plan nutritional quality be improved for homeless shelter residents within budgetary limits?
- Creators
- Rosemary Trout
- Contributors
- Sinclair A. Smith (Advisor) - Drexel University, Health Sciences
- Awarding Institution
- Drexel University
- Degree Awarded
- Doctor of Health Science (D.H.Sc.)
- Publisher
- Drexel University
- Number of pages
- 92 pages
- Resource Type
- Dissertation
- Academic Unit
- College of Nursing and Health Professions; Drexel University; Health Sciences
- Other Identifier
- 991022234044704721