Teaching community skills to formerly institutionalized adults: Eating nutrionally balanced diets

This study evaluated a community program to teach three formerly institutionalized adult males, ages 51 to 60, to eat well-balanced diets. A well-balanced diet was defined as consisting of two servings each from the meat and milk food groups and four servings each from the fruits and vegetables and breads and cereals food groups, or a total of 12 food servings each day. During baseline observations, the men averaged only 6.7 appropriate food servings per day. Instructions and self-monitoring and praise had little or no effect on the men's diets. When cash reinforcement was made contingent on the men's meeting specified daily criteria, the number of appropriate food servings eaten increased to an average of 10.5 appropriate food servings per day, an increase of 57% over baseline levels. A return to baseline conditions and follow-up observations showed continued maintenance of nearly all the treatment gains.