Mountain Empire Older Citizens

Employing Technology to Promote Healthy Behaviors Among Seniors in Southwest Virginia

The Project

Mountain Empire Older Citizens (MEOC), a regional aging and public transit provider, is expanding access to nutrition, exercise, and health care services for older adults in three counties. Through in-person and telehealth platforms, MEOC will provide nutrition counseling, exercise programs, cancer education, and telehealth navigation to improve health outcomes. A registered dietitian and telehealth navigator will support these efforts, ensuring that older individuals receive personalized health guidance and access to care.

Work to be Conducted:

Expand Telehealth Access – Train MEOC staff to serve as telehealth navigators, establish a permanent telehealth kiosk, and deploy two mobile platforms to bring health care services to underserved areas.
Enhance Health Education – Offer cancer prevention workshops, chronic disease education, and telehealth support for follow-up care.
Improve Nutrition Services – Hire a registered dietitian to provide group education and individual counseling, targeting those at high nutritional risk.
Promote Fall Prevention & Wellness – Deliver at least 50 Bingocize sessions, combining exercise and health education to improve balance and mobility.

Goals to be Achieved:

Increase Telehealth Utilization – Provide health care access through telehealth for a set number of older adults, tracking patient engagement and outcomes.
Expand Health Outreach – Reach at least 100 individuals with cancer prevention and screening resources.
Improve Nutrition & Wellness – Deliver nutritional counseling, group education, and distribute monthly health newsletters.
Strengthen Community Support – Engage participants through exercise and health education programs to promote independence and well-being.

Healthy Appalachia Institute Next Steps:

As this program unfolds, we aim to better understand how leveraging telehealth and community-based programs might improve health care access, nutrition, and wellness for older adults in the region. By integrating technology with hands-on support, we wish to learn more and in what ways this approach could enhance health literacy and preventive care among older adults.

We invite you to revisit this page as this project

is updated and as the evaluation

of the project continues

Evidence from Across Appalachia

Embedding Lifestyle Interventions into Cancer Care via Telehealth

This article outlines the advantages and challenges of using telehealth to integrate lifestyle interventions into cancer care, particularly relevant for older adults in rural areas.

Advancing Telehealth In Rural Appalachia

The report highlights telehealth’s potential to improve health care access in rural Appalachia but identifies barriers like broadband gaps, digital literacy, and unclear reimbursement policies. Addressing these challenges requires policy reforms, infrastructure investment, and community engagement.

Project Updates

Aug 2025 – Oct 2025

Telehealth Training & Implementation – MEOC continued to strengthen its telehealth capacity this quarter by training congregate site managers on the referral process for tele–behavioral health sessions and the use of Myio-Valant, the telehealth platform used by Healing Waters Counseling. Telehealth nutrition counseling remained available to all prior participants, and information about these services was printed on every nutrition education flyer. Fifty-four older adults received telehealth-based nutrition counseling (57 total sessions), and MEOC also partnered with The Brain Clinic/Healing Waters Counseling to deliver tele–behavioral health therapy to congregate participants.

Health & Nutrition Education – The Understanding Cancer series concluded in July, ultimately reaching 140 individuals with cancer prevention, screening, and resource information via Zoom, both live and recorded. MEOC supported 40 Bingocize sessions with 63 older adults. General medical education sessions across the grant period reached 224 participants with information on chronic respiratory disease, diabetes, cancer, and cognitive decline, reinforcing MEOC’s emphasis on preventive health.

Nutrition Services & Outreach – All clients receiving nutrition counseling via telehealth were screened using the NSI before and at least one month after their session. While NSI scores themselves remained relatively stable, post-counseling surveys showed meaningful behavioral change: most participants reported trying to limit salt and sugar, increase fruit and vegetable intake, drink more water, and use nutrition labels to guide food choices. Between March and late September, the registered dietitian completed 57 teleconferences and 16 telephone-based individual counseling sessions with congregate clients and members of the general public. Quarterly group nutrition education sessions in February, May, and August drew approximately 130 participants each, and monthly nutrition newsletters on topics such as garden-fresh meals, protein, and fiber were distributed to an unduplicated total of 578 home-delivered meal clients and 150 congregate clients. Nearly all surveyed home-delivered meal recipients reported that the newsletter's content was beneficial, particularly information on food safety, label reading, and the MyPlate method.

Supplemental Award – With an additional $20,000 supplemental award, MEOC significantly expanded mental health and dementia education and caregiver support for older adults and their families. Three behavioral health education sessions for congregate participants, led by Kelley Kinder of The Brain Clinic, addressed mental health awareness, recognizing anxiety and depression in seniors, and distinguishing dementia from normal aging, with participants demonstrating at least a 10% improvement in knowledge and awareness. A dedicated Alzheimer’s/Dementia Caregiver Education Day reached 76 caregivers with training on dementia care strategies, cognitive assessment, coping skills, and available resources, and each attendee received a reminder clock, memory picture phone, and a copy of The Complete Guide to Alzheimer’s Proofing Your Home, along with VDARS materials and local support group information.

May 2025 – July 2025

Telehealth Training & Implementation – This quarter, MEOC made significant progress in expanding telehealth access and building staff capacity. Nutrition and congregate site staff received training on iPads, Zoom, and health-related peripherals, guided by UVA’s Anthony Nappi, Kristen Rutherford, and MEOC’s telehealth champion, Robin Woodard. Robin also visited all seven Connections Senior Centers to deliver telehealth nutrition counseling and provide on-the-ground training, resulting in 23 documented encounters. The stationary telehealth kiosk was phased out in favor of three mobile telehealth platforms, all of which are now fully operational and available for client use. Bingocize programming continued, with post-surveys collected at the Norton and Jonesville sites, and new classes launched at Laurels Assisted Living in July.

Health & Nutrition Education – MEOC advanced its health education initiatives by delivering programs both virtually and in person. The Understanding Cancer workshop reached four congregate sites via Zoom in July, complete with pre- and post-tests. Ballad Health also contributed to medical education, with a July 9th session led by Dr. Laurie Archbald Pannone on cognitive decline in aging, which was recorded for broader distribution. Nutrition education was provided by RDN Maggie Adams to all congregate sites in May, engaging approximately 150 participants. Monthly newsletters with topics such as “Taking Small Steps to Healthy Eating,” “Good Fats, Bad Fats,” and “Summer Food Safety” were distributed across meal programs, ensuring consistent outreach to clients.

Nutrition Services & Outreach – Nutrition services were further strengthened this quarter through targeted screenings and outreach. Newly enrolled clients completed the Nutritional Screening Instrument (NSI), with those identified at risk receiving follow-up phone calls offering telehealth counseling. Twenty-three nutrition counseling sessions were documented, and flyers promoting the availability of registered dietitian services were widely distributed to local churches, community groups, businesses, and municipal offices. Additionally, group nutrition education reached broad audiences through Zoom and in-person sessions.

February 2025 – April 2025

Telehealth Training & Implementation – MEOC made substantial progress establishing telehealth access points by setting up all stationary and mobile equipment and completing 15 nutrition counseling sessions via telehealth, 13 at congregate sites, and two at their main office. Staff across congregate meal sites were trained to use Zoom for both telehealth visits and health education programming, with additional training planned for those needing further support. Despite challenges in forming partnerships with outside providers, MEOC continues to explore collaborations with PACE, Frontier Health, and Healing Waters Counseling Services. Their telehealth champion has facilitated a strong foundation for digital navigation, with site managers now confidently supporting clients during virtual sessions.

Health & Nutrition Education – MEOC launched several health education initiatives this quarter. Medical professionals contributed to chronic disease education: Dr. Shivana Ramphall delivered a live Zoom session on chronic respiratory disease, and Dr. Shraddha Lohani shared educational slides on diabetes to be used later in the year. The “Understanding Cancer” workshop is scheduled for July 2025, with pre- and post-test tools prepared. Additionally, MEOC delivered monthly newsletters featuring health and nutrition tips, distributing 370 flyers to home-delivered meal clients and 130 to congregate site participants each month. Special Bingocize nutrition flyers were also provided at multiple sites, totaling over 500 flyers across Norton and Jonesville locations.

Nutrition Services & Outreach – A part-time Registered Dietitian (RDN) was hired and has been active in providing services. Nutrition education was presented via Zoom to all congregate sites in February, and 10 participants completed post-counseling NSI surveys. Clients identified as nutritionally at-risk through NSI or UAI screening were offered individualized counseling via telehealth or phone. Outreach efforts expanded significantly, with flyers promoting RDN-led education sessions distributed across dozens of community organizations and churches. The Bingocize program collected all pretests this quarter, with posttests scheduled for May. MEOC’s coordinated approach is ensuring nutrition services are both accessible and well-promoted throughout the region.

November 2024 – January 2025

Telehealth Training & Implementation – MEOC staff received telehealth training, including a Best Practices Webinar and an Interprofessional Telehealth Training Program. The initiative was introduced at the Connections Senior Center Christmas Party, where informational flyers were distributed, and a pre-survey was completed. Telehealth equipment was received, set up, and inventoried. High-risk clients were contacted and offered services, and a spreadsheet was developed to document encounters. The initiative was also promoted on social media.

Health & Nutrition Education – An Understanding Cancer workshop was scheduled for Summer 2025 and was planned to be broadcast live via Zoom to four congregate sites, with three sites accessing recordings. Pre- and post-tests were set to be administered. Ballad Health residents presented educational topics on chronic respiratory disease, diabetes, and cancer to the Connections Senior Centers via Zoom in February and March as part of their Nutrition Department rotation. Lastly, an opportunity with the Virginia Insurance Counseling and Assistance Program (VICAP) was also planned to be offered via Zoom.

Nutrition Services & Outreach – A part-time registered dietitian was hired, and nutrition education was scheduled quarterly. High-risk clients identified through the NSI screening process were contacted, and the first telehealth nutrition counseling session took place on February 27th. The Bingocize program was set to launch in March, with pre-and post-tests conducted before and after sessions. Monthly nutrition newsletters continued to be distributed, reaching approximately 800 home-delivered meal clients and 300 congregate site participants throughout December and January.