HOMEals: A Science-Based Clinical Decision Support System for Nutrition in IDD Group Homes

PROJECT SUMMARY/ABSTRACT People with intellectual and developmental disabilities (IDD) have been designated a health disparities population by NIH in large part due to the nutrition-related secondary conditions they experience, which contribute to increased morbidity, mortality, and healthcare expenses for this population. Despite evidence that a healthy diet can help prevent or manage many secondary conditions, dietary intake in community-dwelling adults with IDD is poor, and targeted solutions are missing. For the over 450,000 adults with IDD living in group home settings, individual and home-related complexities make healthy meal planning incredibly challenging. To address this need, Good Nutrition Ideas is developing a highly innovative Clinical Decision Support System (CDSS) to address the complex nutrition challenges within group home settings. This product will provide targeted, inclusive, evidence-based, and actionable nutrition recommendations for planning, via a universally designed technology, to people with IDD and group home staff. The CDSS web app, called HOMEals, will draw on nutrition Knowledge Bases (e.g., USDA Dietary Guidelines, MyPlate, Standards of Care) and Data Inputs on resident- and home-level needs to create tailored nutrition Recommendations for group home managers to use with their unique residents in their unique homes. The proposed HOMEals CDSS will have an immediate impact on residents’ healthy dietary intake, leading to the prevention and management of nutrition-related acute and chronic health conditions. It will provide nutrition technology support where quality, science-based options are lacking in availability, accessibility, and affordability. The long-term goal of this SBIR is to reduce nutrition-related health disparities for people with IDD, and to enhance their quality of life. In this Phase I SBIR, our Specific Aims include: (1) Demonstrating the initial feasibility and usability of the digital HOMEals CDSS, and 2) Proving the usability and acceptability of HOMEals in target end users (IDD group homes). For Aim 1, we will create an alpha version of HOMEals through an iterative design process and test the product with GNI Advisors, collecting feedback through surveys and interviews. For Aim 2, we will beta test HOMEals with eight group homes managers, obtaining feedback via the same online survey used in the alpha test, and analyze one day’s planned meals from each group home based on the CDSS Recommendations. Positive outcomes will establish that HOMEals is usable, acceptable, and valuable to end users. In Phase II, we will pilot HOMEals with group homes to assess outcomes related to dietary quality and intake, food system organization, and nutrition-related health outcomes. Using feedback from the pilot study, we will update HOMEals and begin dissemination to the 110,000+ group homes nationally.