Explaining the Nutritional Behaviors of Elderly Individuals Based on the PEN-3 Cultural Model: A Qualitative Study

Background : Despite the crucial role of nutrition in the health promotion and quality of life of elderly individuals, many are at risk of malnutrition. Considering the cultural and social aspects of this group's nutrition, it is essential to conduct qualitative research and select an appropriate approach. The PEN-3 model offers a cultural perspective for examining various dimensions of nutritional behaviors in elderly individuals. Objectives: The aim of this study is to explain the nutritional behaviors of the elderly based on the PEN-3 model. Methods: This qualitative study was conducted over six months in various areas of Tehran, Iran, in 2024. Data were collected through in-depth semi structured interviews using three interview guides, involving 13 elderly people (main participants), 4 caregivers, and 2 dietitians. Data analysis was conducted concurrently with data collection using the directed content analysis method based on Hsieh and Shannon's pattern, focusing on key influences on health behaviors: Perceptions, Enablers, and Nurturers. Results: Among the 169 extracted codes, the majority were assigned to perceptions and their subcategories, which include knowledge, beliefs, and attitudes. There were also fewer codes across all subcategories of enablers. However, regarding the nurtures, the codes were limited to the following subcategories: extended family and health personnel. Conclusions: The results of this study include positive and negative experiences of the elderly in the field of nutrition, as challenges and assets of the target population, which are effective in developing interventions that are more likely to be successful and reviewed. Integrating experiences in the perception domain with nutritional behavior facilitates the creation of educational content. Additionally, insights from the domains of nurturers and enablers contribute to the development of community policies.