Process evaluation of bringing nutrition screening to seniors in Canada (BNSS).

Although nutrition risk is prevalent in Canadian older adults, the process of screening must be considered before nationwide programs can be recommended. A process evaluation of the Bringing Nutrition Screening to Seniors in Canada demonstration project was completed. Through the use of the 15-item Seniors in the Community: Risk Evaluation for Eating and Nutrition (SCREEN(c)) questionnaire, risk was identified in convenience samples of 1,196 community-living older adults recruited from five Canadian communities. All at-risk participants were offered referrals to community resources. Telephone follow-up of at-risk participants occurred after screening. Telephone interviews with screening administrators and older adults revealed screening benefits and challenges. Nutrition risk occurred in 38.9% of the sample. Most participants found screening helpful. Among the at-risk group (n=465), 39% accepted referrals for additional services. Older adults provided several reasons for refusing referrals, including denial of risk. Dietitian services were an identified gap, as were prevention-level resources. Nutrition risk is prevalent and older adults can benefit from screening. Training, ongoing support, and prioritization (policy, time, and money) are needed for sustainable screening programs. Before implementation of a nationwide screening program, sufficient and appropriate community resources are required, as is a national strategy for screening older adults.