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Volume 108, Issue 5, Pages 785-792 (May 2008)


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An Integrated Model to Measure Service Management and Physical Constraints' Effect on Food Consumption in Assisted-Living Facilities

Hui-Chun Huang, PhDCorresponding Author Informationemail address, Carol W. Shanklin, PhD, RD

Accepted 9 October 2007.

Abstract 

Objective

The United States is experiencing remarkable growth in the elderly population, which provides both opportunities and challenges for assisted-living facilities. The objective of this study was to explore how service management influences residents' actual food consumption in assisted-living facilities. Physical factors influencing residents' service evaluation and food consumption also were investigated.

Design

A total of 394 questionnaires were distributed to assisted-living residents in seven randomly selected facilities. The questionnaire was developed based on an in-depth literature review and pilot study. Residents' perceived quality evaluations, satisfaction, and physical constraints were measured. Residents' actual food consumption was measured using a plate waste technique.

Subjects

A total of 118 residents in five facilities completed both questionnaires and food consumption assessments.

Statistical analysis

Descriptive, multivariate analyses and structural equation modeling techniques were employed.

Major findings

Service management, including food and service quality and customer satisfaction, was found to significantly influence residents' food consumption. Physical constraints associated with aging, including a decline in health status, chewing problems, sensory loss, and functional disability, also significantly influenced residents' food consumption. A significant relationship was found between physical constraints and customer satisfaction.

Conclusions

Foodservice that provides good food and service quality increases customer satisfaction and affects residents' actual food consumption. Physical constraints also influence residents' food consumption directly, or indirectly through satisfaction. The findings suggest that food and nutrition professionals in assisted-living should consider the physical profiles of their residents to enhance residents' satisfaction and nutrient intake. Recommendations for exploring residents' perspectives are discussed.

Corresponding Author InformationAddress correspondence to: Hui-chun Huang, PhD, Department of Restaurant and Institutional Management, Shih Chien University, No. 70, Ta-Chih St, Taipei, Taiwan ROC.

PII: S0002-8223(08)00184-3

doi:10.1016/j.jada.2008.02.025


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