Overcoming Implementation Barriers and Enhancing the Quality of Nutritional Care in the Integrated Health Program for the Elderly: A Pilot Study in Tehran; [رفع موانع اجرایی و ارتقای کیفیت مراقبتهای تغذیهای در برنامه مراقبت های ادغامیافته سلامت سالمندان: پایلوت شهر تهران] Publisher



Veysi Z ; Rezazadeh A ; Shams L ; Jamshidi E ; Zayeri F
Source: Iranian Journal of Nutrition Sciences and Food Technology Published:2026

Abstract

Background & Objective: The Integrated Health Care Program for the elderly faces significant implementation challenges. This study aimed to identify barriers and facilitators to its execution in Tehran. Methods: This policy brief is based on a qualitative study (content analysis) through interviews with three key stakeholder groups (the elderly, key managers and policymakers, and implementers of the integrated program). Purposive and snowball sampling covered economic and geographical diversity (low, middle, and high-income areas of Tehran). Data analysis was conducted using MAXQDA software with an inductive approach (part to whole). Findings: Challenges were categorized into four main axes: 1-Environmenta: Lack of accessibility (no elevators, stairs), small spaces, and noise (infant crying). 2-Process:Improper integration of age groups (elderly sharing spaces with infants and pregnant women), overcrowding, and multiple staff in consultation rooms. 3-Resources: Absence of full-time nutritionists and insufficient supplement distribution. 4-Behavioral:Self-medication, medication forgetfulness, and poor adherence to dietary regimens. Conclusion & Policy Recommendations: To improve service quality, immediate actions should include spatial segregation of the elderly from other groups, hiring nutritionists during peak hours, and localizing nutrition education (visual packages). Long-term strategies should focus on infrastructure adaptation (installing elevators) and reforming insurance payment models. Implementing these solutions in a Tehran pilot can serve as a model for improving elderly nutritional health nationwide. © 2026, National Nutrition and Food Technology Research Institute. All rights reserved.