EAL

H/A: Foodborne Illness (2009)

Citation:

Study Design:

Class:

- Click here for explanation of classification scheme.

Quality Rating:

Research Purpose:

The purpose of this report in describing characteristics of these programs is to provide information that may:

Define the diversity in client populations whose needs may increasingly need to be met through expansion and diversification of client services
Present the opportunity to recognize shared interests and develop collaborative approaches to human services policy with regard to HIV infection and AIDS
Corroborate CDC-reported trends in HIV-infection and incidence of AIDS in the United States population
Provide baseline data for use in further research.

Inclusion Criteria:

All known existing home-delivered meals programs for persons with HIV and AIDS currently providing services in their respective regions.

Exclusion Criteria:

None specifically mentioned.

Description of Study Protocol:

Recruitment: Data for this study was obtained from 15 of the 17 known home-delivered meals programs for individuals with HIV and AIDS in the United States through an original, cross-sectional survey instrument conducted by telephone interview between March 1994 and May 1994. Names of programs obtained from Community Servings (Boston, MA) and God's Love We Deliver (New York, NY).

Design: Cross-sectional descriptive study

Statistical Analysis: Frequencies reported.

Data Collection Summary:

Timing of Measurements

Original, cross-sectional survey instrument conducted by telephone interview between March 1994 and May 1994.

Dependent Variables

Service
Organizational (personnel)
Client population characteristics.

Independent Variables

Home-delivered meals programs.

Description of Actual Data Sample:

Initial N: 15 of the 17 known home-delivered meals programs for individuals with HIV and AIDS in the United States

Attrition (final N): 15

Age: Not applicable

Ethnicity: Not applicable

Location: United States.

Summary of Results:

Program Name	Number of Home-Delivered Meals per Day	Number of Home-Delivered Meals per Week
Caring Cuisine, AIDS Project NH	500	3,500
Chicken Soup Brigade	--	800
Community Servings	200	1,000
Cure AIDS Now	600	4,200
Food and Friends	1,050	6,300
Food for Friends	450	2,250
Food Outreach, Inc	--	--
God's Love We Deliver	130	650
Metropolitan AIDS Neighborhood Nutrition Alliance (MANNA)	1,400	7,280
Moveable Feast	330	1,980
Open Arms of Minnesota	85	510
Open Hand Chicago	900	4,500
Open Hand	1,800	12,600
Project Angel Food	520	3,600
Project Angel Heart	100	600

Other Findings

Results from this study show an increase in the number of minority populations who participate in these programs (36% African-American and 12% Hispanic vs. 51% Caucasian), as well as women (17.2%) and children (7%).

Geographic location was an important determinant for program eligibility.

The number of meals served weekly varied greatly, from 510 to 12,600 per week.

Other significant services included nutrition counseling, newsletters and holiday-basket programs.

Enhancing service-delivery systems was one of the more prevalent "high-priority" concerns cited, especially with regard to food quality and safety.

Food safety and quality control are issues of great concern and were addressed by all respondents.

All programs commit to providing some form of orientation for their new volunteers and employees to ensure appropriate concern for the person with HIV/AIDS and his/her family, food quality control and safe delivery of the meals.

Author Conclusion:

These results show that these programs are catering increasingly to minority populations, women and children, and that they are expanding their services to meet the growing needs of their client populations. These findings suggest that there is a greater need for meals and other home-based services for people living with HIV and AIDS.

Funding Source:

Reviewer Comments:

Statistical analysis not sophisticated. Survey instrument not shown to be valid or reliable.

Quality Criteria Checklist: Primary Research
Relevance Questions
	1.	Would implementing the studied intervention or procedure (if found successful) result in improved outcomes for the patients/clients/population group? (Not Applicable for some epidemiological studies)	N/A
	2.	Did the authors study an outcome (dependent variable) or topic that the patients/clients/population group would care about?	Yes
	3.	Is the focus of the intervention or procedure (independent variable) or topic of study a common issue of concern to dieteticspractice?	Yes
	4.	Is the intervention or procedure feasible? (NA for some epidemiological studies)	N/A

Validity Questions
1.	Was the research question clearly stated?		Yes
	1.1.	Was (were) the specific intervention(s) or procedure(s) [independent variable(s)] identified?	Yes
	1.2.	Was (were) the outcome(s) [dependent variable(s)] clearly indicated?	Yes
	1.3.	Were the target population and setting specified?	Yes
2.	Was the selection of study subjects/patients free from bias?		Yes
	2.1.	Were inclusion/exclusion criteria specified (e.g., risk, point in disease progression, diagnostic or prognosis criteria), and with sufficient detail and without omitting criteria critical to the study?	Yes
	2.2.	Were criteria applied equally to all study groups?	Yes
	2.3.	Were health, demographics, and other characteristics of subjects described?	Yes
	2.4.	Were the subjects/patients a representative sample of the relevant population?	Yes
3.	Were study groups comparable?		N/A
	3.1.	Was the method of assigning subjects/patients to groups described and unbiased? (Method of randomization identified if RCT)	N/A
	3.2.	Were distribution of disease status, prognostic factors, and other factors (e.g., demographics) similar across study groups at baseline?	N/A
	3.3.	Were concurrent controls or comparisons used? (Concurrent preferred over historical control or comparison groups.)	N/A
	3.4.	If cohort study or cross-sectional study, were groups comparable on important confounding factors and/or were preexisting differences accounted for by using appropriate adjustments in statistical analysis?	N/A
	3.5.	If case control study, were potential confounding factors comparable for cases and controls? (If case series or trial with subjects serving as own control, this criterion is not applicable.)	N/A
	3.6.	If diagnostic test, was there an independent blind comparison with an appropriate reference standard (e.g., "gold standard")?	N/A
4.	Was method of handling withdrawals described?		Yes
	4.1.	Were follow-up methods described and the same for all groups?	Yes
	4.2.	Was the number, characteristics of withdrawals (i.e., dropouts, lost to follow up, attrition rate) and/or response rate (cross-sectional studies) described for each group? (Follow up goal for a strong study is 80%.)	Yes
	4.3.	Were all enrolled subjects/patients (in the original sample) accounted for?	Yes
	4.4.	Were reasons for withdrawals similar across groups?	N/A
	4.5.	If diagnostic test, was decision to perform reference test not dependent on results of test under study?	N/A
5.	Was blinding used to prevent introduction of bias?		N/A
	5.1.	In intervention study, were subjects, clinicians/practitioners, and investigators blinded to treatment group, as appropriate?	N/A
	5.2.	Were data collectors blinded for outcomes assessment? (If outcome is measured using an objective test, such as a lab value, this criterion is assumed to be met.)	N/A
	5.3.	In cohort study or cross-sectional study, were measurements of outcomes and risk factors blinded?	N/A
	5.4.	In case control study, was case definition explicit and case ascertainment not influenced by exposure status?	N/A
	5.5.	In diagnostic study, were test results blinded to patient history and other test results?	N/A
6.	Were intervention/therapeutic regimens/exposure factor or procedure and any comparison(s) described in detail? Were interveningfactors described?		Yes
	6.1.	In RCT or other intervention trial, were protocols described for all regimens studied?	N/A
	6.2.	In observational study, were interventions, study settings, and clinicians/provider described?	Yes
	6.3.	Was the intensity and duration of the intervention or exposure factor sufficient to produce a meaningful effect?	N/A
	6.4.	Was the amount of exposure and, if relevant, subject/patient compliance measured?	N/A
	6.5.	Were co-interventions (e.g., ancillary treatments, other therapies) described?	N/A
	6.6.	Were extra or unplanned treatments described?	N/A
	6.7.	Was the information for 6.4, 6.5, and 6.6 assessed the same way for all groups?	N/A
	6.8.	In diagnostic study, were details of test administration and replication sufficient?	N/A
7.	Were outcomes clearly defined and the measurements valid and reliable?		???
	7.1.	Were primary and secondary endpoints described and relevant to the question?	Yes
	7.2.	Were nutrition measures appropriate to question and outcomes of concern?	Yes
	7.3.	Was the period of follow-up long enough for important outcome(s) to occur?	Yes
	7.4.	Were the observations and measurements based on standard, valid, and reliable data collection instruments/tests/procedures?	???
	7.5.	Was the measurement of effect at an appropriate level of precision?	???
	7.6.	Were other factors accounted for (measured) that could affect outcomes?	???
	7.7.	Were the measurements conducted consistently across groups?	N/A
8.	Was the statistical analysis appropriate for the study design and type of outcome indicators?		???
	8.1.	Were statistical analyses adequately described and the results reported appropriately?	???
	8.2.	Were correct statistical tests used and assumptions of test not violated?	???
	8.3.	Were statistics reported with levels of significance and/or confidence intervals?	No
	8.4.	Was "intent to treat" analysis of outcomes done (and as appropriate, was there an analysis of outcomes for those maximally exposed or a dose-response analysis)?	N/A
	8.5.	Were adequate adjustments made for effects of confounding factors that might have affected the outcomes (e.g., multivariate analyses)?	N/A
	8.6.	Was clinical significance as well as statistical significance reported?	No
	8.7.	If negative findings, was a power calculation reported to address type 2 error?	N/A
9.	Are conclusions supported by results with biases and limitations taken into consideration?		Yes
	9.1.	Is there a discussion of findings?	Yes
	9.2.	Are biases and study limitations identified and discussed?	Yes
10.	Is bias due to study's funding or sponsorship unlikely?		Yes
	10.1.	Were sources of funding and investigators' affiliations described?	Yes
	10.2.	Was the study free from apparent conflict of interest?	Yes