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Essential Connections: How improved referrals from hospital to community meal provision can impact malnutrition outcomes in older adultsStudy Overview

The CONNECT study will test a new model of care that leverages registered dietitian nutritionists as the essential connection between clinical and community settings. This program will utilize the Academy of Nutrition and Dietetics Health Informatics Infrastructure (ANDHII) to facilitate referral of patients from the hospital to Title III C1 or C2 meal provision organizations, allowing for continuous RDN-provided nutrition care for older adults. The CONNECT study seeks to improve food security, nutrition status, and quality of life for clients with malnutrition.

This project is supported by the Administration for Community Living (ACL), U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $3.99 million with 75% funded by ACL/HHS and 25% funded by the Academy of Nutrition and Dietetics. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by ACL/HHS, or the U.S. Government.

Now Recruiting

Recruitment is underway for 8 locations, each with an acute care hospital and a Title III-C1 or C2 funded meal provision organization who will function as a pair. The Academy will assist with forming these pairs. Pairs will collect data for 5 periods. Each period will last 7 months long. Data collection in total is 35 months, or ~3 years. Researchers in the clinical setting will enroll ~7 patients per month (28 patients per period), totaling 140 patients over the entire study. Contact us with questions or to learn more about enrollment.

Who Can Participate?

Clinical Site

  • Use EPIC as your EHR
  • Meet the study’s technical requirements to allow for transfer of data to ANDHII from EHR

Community Site

  • Be a meal provision service that provides Title III-C1 or Title III-C2 nutrition services (i.e. receive some amount of funding from AAA to provide these services)

Clinical and Community Site

  • Complete data use agreement and site agreement with the Academy
  • Agree to 5-year time commitment
  • Rely on the IRB of Record (WCG IRB)
  • Agree to a key contact staff person of the organization that will facilitate practical execution of study and provide facility wide baseline data

There is an emphasis on recruiting sites who serve individuals who are Black, Latino, Indigenous and Native Americans and individuals living in rural areas of the country.

Why Participate?

The aging population is growing exponentially with more individuals living longer, healthier, and more independently. Within the United States, most older adults live in the community, but as individuals age, admission to an acute care hospital becomes more prevalent. Poorly managed chronic conditions, functional impairments, food insecurity and social determinants of health can leave older persons vulnerable to malnutrition during a hospitalization. Malnutrition in hospitalized older adults can decrease quality of life, increase risk of mortality, and increase health care costs, and severe malnutrition predicts worse outcomes including more frequent readmissions and emergency room visits. While hospitalized older adults may receive nutrition care during an admission, within the United States, continuity of nutrition care between the hospital and home is poor.

A transitional model such as that being tested in the CONNECT study, that provides coordinated post-discharge nutrition care by a Registered Dietitian Nutritionist (RDN) by following patients from the hospital to home could improve dietary intake and health outcomes for older adults. Good nutrition and socialization provided by meal provision organizations can help older adults stay out of the hospital and contribute to healthy, independent living and improved quality of life. Your organization’s participation could help determine whether continuous RDN-provided nutrition care from the inpatient to the community setting can improve health outcomes for older adults with malnutrition.

To support this research, participating hospitals and community meal provision organizations will be provided with financial and administrative support. The study budget will financially support a 0.5 FTE RDN position to complete clinical research activities and up to a 0.25 FTE RDN position in the community setting. Additionally, hospitals are eligible to receive up to a $5,000 honorarium.

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