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Implementation of the Patient Association Nutrition Checklist by the Food Train charity’s Eat Well Age Well project in the Scottish Borders

Principal Investigator

Dr Jemma Hawkins


Dr Elinor Coulman, Prof Simon Murphy


Malnutrition has been shown to affect over 1.3 million older people (over the age of 65) in the UK and this figure may be worse following the COVID-19 pandemic. Malnutrition, in the form of undernutrition (i.e. not consuming enough nutrients or food), has adverse effects on health and wellbeing outcomes, including increased risk of hospitalisation. Furthermore, the levels of malnutrition in the community are largely undetected and untreated. The Patients Association Nutrition Checklist (referred to as the “Checklist”) is a simple tool used to identify whether older adults may be at risk of under-nutrition (in need of nutritional support). The Checklist is currently being rolled out by Food Train’s Eat Well Age Well project in the Scottish Borders region.

Aims and Objectives

This project aims to find out whether using the Checklist in the community is beneficial for older people and the staff/volunteers in the community who use the Checklist. The information gathered in the project will help assist with further roll-out of the Checklist in Scotland and in the UK.

Study Design

In this project, we will work closely with organisations that are using the Checklist (in voluntary, housing and social care sectors), and the staff/ volunteers who work for them. These organisations will provide operational data about the numbers of older adults they use the Checklist with and whether they are identified as at risk of under-nutrition. We will interview up to 15 staff/ volunteers who use the Checklist and up to 15 relevant managerial staff at the organisations to explore their experiences of using the Checklist and any potential benefits/ disadvantages of using the Checklist. We will analyse evaluation forms from the training that implementers receive before using the Checklist. We will also find out whether there are data held by NHS services that might help us understand the impact of the Checklist in future, and we will also collect information about the costs involved in delivering the Checklist.

Public and Stakeholder Involvement

The project has been developed in collaboration with key stakeholders who are involved in supporting the roll-out of the Checklist including the Patients Association, the Eat Well Age Well project of the Food Train charity, NHS Borders, Scottish Borders Council, the University of Glasgow, Bournemouth University and older adult representatives. Public and practitioner involvement in the development of the project has been undertaken following a variety of methods. One-to-one consultation with public representatives, recruited from NIHR’s People in Research initiative, has ensured that all participant facing documents have been collaboratively produced with members of the public, including data collection materials and outcome measures. Ongoing and meaningful public involvement throughout the project has been guided by the public involvement representatives. This will involve collaborative decision making with the research team into project design, all participant-facing materials, project reports and dissemination materials. This will be achieved via focused public involvement meetings with public representatives, as well as membership of public involvement representatives at project management meetings, to ensure shared decision making at project management level.

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This study is funded through the NIHR Public Health Intervention Responsive Studies Team via PHIRST Insight, the Bristol and Cardiff PHIRST.