Ask the Experts: Creative Solutions for Local Providers by Local Providers
What are the issues concerning participation (or lack of it) in the Congregate Nutrition Program?
Older Americans Nutrition Programs serving meals at congregate sites have experienced a slow but steady decline in participation nationally (1). This trend, which is counter to what would be expected, given the growth in the overall older adult population, has challenged providers to identify and effectively address factors related to the decline.
The effectiveness of the Older Americans Nutrition Program is well documented. The 1993-1995 National Evaluation (2) showed that people who participate in the Nutrition Program benefit both in terms of enhanced nutritional intake and increased social contact. The evaluation also showed that the services are well targeted and serve a high percentage of individuals who are nutritionally at risk and who are in danger of increased incidence of chronic disease and loss of functionality.
Despite these facts, some view the decline in participation as simply an indicator of a reduction in need for congregate nutrition services. This conclusion is over simplified and fails to take into account factors regarding the diversity of the older adult population. Across the country, providers have been evaluating their programs as they seek to provide relevant, effective and attractive nutrition services. One example is a focus group study that the Chicago Suburban Area Agency on Aging, Chicago, Illinois conducted in March 2000 with the assistance of the Buehler Center on Aging at Northwestern University (3). The final report identified a wide range of issues and barriers to attendance, which many other providers would agree apply to their own program as well.
Using information from the Chicago Suburban Area Agency on Aging report, a previous Ask the Experts, Increasing Participation at Older Americans Act Title III Funded Congregate Meal Sites, explored several means of modifying and/or expanding meal service models and programming to meet the needs of participants. These innovations in program design are critical if the program is to remain vital and relevant. However, even the best designed programs will not succeed if the public is not aware of them or if an image problem makes them unattractive to the target population.
What's in a name?
Nutrition Programs operate out of senior centers, and many younger older
adults don't see themselves as "senior enough" to attend. The
name alone is often times enough to make them decide, "that's not
for me!" An image can be conveyed solely by a name. "Congregate
Meal Program," "Elderly Nutrition Program," "Senior
Lunch Program," "Senior Friendship Center, " and other
commonly used names may connote too institutional an image and can cause
potential participants to self-select themselves out of the program. Many
programs are interested in linking their meals and other services with
good health but have difficulty deciding exactly what to call the program
to highlight that connection.
How do we address the stigma of "charity" or a "program for the poor"?
Another obstacle to attendance for some older adults is the belief that participating in the Older Americans Nutrition Program reflects a need for charity. This impression exists even though there is no means testing and donations are suggested. The Chicago Suburban Area Agency on Aging study supported this finding. While low-income older adults are a primary target group, most programs realize value in attracting others from a broad socio-economic range. A study, conducted by Meals on Wheels of Shawnee and Jefferson County, Inc., found that the stigma of a welfare program was more pervasive in urban than rural areas, and that participants in rural areas were more likely to bring a friend.
Marketing Consultant comments, "There are times when I go to senior
centers and the centers look the same: dark, dirty, and smelly. This is
not a place I would want to hang around nor do the majority of the seniors
in America. Unfortunately, the staff at some of these centers thinks that
this atmosphere is acceptable. I believe that this attitude, 'be happy
with whatever you get', continues that welfare mentality." Bohse
adds, "I also know that when we do the exercise in senior centers
called 'Creating the Ideal Senior Center,' the designs that the Directors
and seniors come up with are wonderful. They are positive, outrageously
different, fun and doable. So I think it is time to put a 'New Face on
Aging' by all of us in the field."
The Congregate Nutrition Program cannot afford to be just a "meals program." Each center and their center director must know their community and be able to tap its resources. Meals on Wheels of Shawnee and Jefferson Counties, Inc. found that activities vary at centers and much of what goes on is dependent on the center manager and whether the center is directly operated by the nutrition program. Some ideas to promote interest in the program include:
Is your center and program well managed and inviting?
Often, center operations and participation are dependent on the person managing or directing the center. A center manager must involve participants in the planning and implementation of activities, programs, and the design of the facility if they are to feel ownership in the program. A center manager and a few well chosen participants can bring enthusiasm to the program and increase participant satisfaction and attendance. A prerequisite to hiring center managers at Midland Meals, Inc. is that they have an outgoing personality, a positive attitude, and a desire to be a part of the Program.
Two ideas that improved participation follow.
Does your facility need a face-lift?
By and large, most programs have been in place and operated in the same facilities for some time. As these facilities and equipment have aged, capital dollars for updates and improvements have been difficult to secure. Often times, scarce dollars are prioritized for programs and services, and the facility and equipment needs have, by necessity, fallen to a lower priority. We are forced to ask a difficult question, "Even with the best programming, would I want to come here for a meal?"
Often, a little redecorating, such as general painting and/or painting murals, wallpapering, hanging curtains, and landscaping, can go a long way toward making the facility more inviting. Effective capital campaigns have been launched in many areas, specifically for the purpose of improving the site's appearance. Many potential donors respond well to a list of specific items that are needed, such as paint and wallpaper, tables and chairs, light fixtures, landscaping materials, curtains, tablecloths, dishes, transportation vehicles, and kitchen equipment. Some successful ideas for facility improvements follow.
The Marketing Process
"Marketing is a social and managerial process by which individuals and groups obtain what they need and want through creating and exchanging products and value with others (5)." The goal of marketing is to know and understand your customer so well that your product or service "fits" or sells itself.
Karen D. Goldman, PhD, CHES (Certified Health Education Specialist), a Health Education and Social Marketing Consultant, presented at the National Association of Nutrition and Aging Services Program Conference in Nashville, June 2001. A brief summary follows to illustrate the comprehensiveness of a true marketing strategy beyond the facility fix-ups, center manager savvy, and program add-ons.
Assessing the environment
Segmenting the market
Setting goals and objectives
Developing a marketing mix
Pat Bohse, Marketing Consultant, states "Marketing has to do with everything a program does from its signage, stationery, how the staff answers the telephone, quality service, name of the center, location, etc." She says that marketing is the key to success for nutrition centers in the future. At a workshop at the National Association of Nutrition and Aging Services Program Conference in Nashville, June 2001, Ms. Bohse described the 6 Ps of marketing:
When the agency does marketing, the message must be consistent, out there all the time, and on a regular basis (at least four times a year) to be noticed. Develop media relationships with television, radio, and print personnel. Provide them with press releases, develop public service announcements, and get television and radio coverage of special events. Develop a speaker's bureau and have subject matter experts. Work with participants to be program ambassadors. The agency must go directly to the audience they want to serve and that means leaving the center (Pat Bohse).
National Marketing Initiatives
Meals On Wheels Association of America (MOWAA) is partnering with the world's largest public relations firm, Fleishman-Hillard, to implement a "Meals on Wheels Marketing Campaign." "We could not be more excited about this opportunity. Every organization needs public relations help, and we are most fortunate to be getting that help from the best in the business," said Enid Borden, MOWAA Executive Director.
For Fleishman-Hillard to get the message out to the public and to potential corporate supporters, they need to be "armed" with lots of facts and figures about the Program. A survey has been distributed to MOWAA's 800 members (December, 2001) and the answers will help Fleishman-Hillard better understand how programs work and provide them the tools needed to "persuade" corporations to partner with local programs. Information is power.
In 2002, the National Policy and Resource Center on Nutrition and Aging will conduct an Issues Panel on Marketing Older Americans Nutrition Programs. This meeting will call together experts in marketing, nutrition, and aging. The need to develop a marketing plan of action came out of the Center's Nutrition 2030 Expert Advisory Council Strategic Planning Conference (6). The "Marketing Plan," see below, illustrates that beyond local marketing needs is a national marketing prospective which can help attract older Americans to the Nutrition Program throughout the country.
Developing an effective plan for marketing and promoting the program must incorporate the cultural and ethnic diversity, differences in socio-economic background, differences in health status, food preferences, life style and activity level, the "competition," and individual values. This can be a daunting prospect. While most programs attempt to do some marketing and promotion, it is the rare program that has developed a comprehensive marketing plan with assistance from marketing experts. This is about to change.
If you are willing to share information on your program's marketing experiences with the Aging Network, please contact the Center by mail, email, or fax. This may include suggestions for program names, other marketing ideas and activities, giving the center a face-lift, comments concerning the stigma of charity and other issues, and additional resources. In addition, let the Center know of your interest in participating in the Issue Panel and/or issues to be addressed.
"Learning to Think Like A Marketer" Handbook. A manual of the Social Marketing Training Presentation for the Leadership Academy of the National Association of Nutrition and Aging Services Programs, Nashville, TN, June 7, 2001 by Karen Denard Goldman, PhD, CHES, Health Education and Social Marketing Consultant. See contact information below. The complete "Handbook" as presented at the conference is available in PDF format. http://www.fiu.edu/~nutreldr/Ask_the_Expert/Image_OACNP/Marketer.pdf
"Marketing Your Senior Center to Traditional and Non-traditional Users." Pat Bohse, President, Bohse and Associates. See contact information below.
Line®: Integrating the National Family Caregiver Support Program with
other Title III Programs. Topics include rethinking how we market services
to older adults. PowerPoint presentation from the Administration on Aging.
from the Administration on Aging Website with articles on the Senior Market,
government statistics, and Marketing Organizations and Newsletters.
The American Marketing Association website. "A comprehensive and
customizable source for all things marketing."
Compiled by Mary Podrabsky, RD and Lester Rosenzweig, MS, RD, and staff of the National Policy and Resource Center on Nutrition and Aging, Florida International University, Miami, FL. Contact: email@example.com
project is supported, in part, by a grant from the Administration on Aging,
Posted on 2/01/02