Food activities and identity maintenance in old age: a systematic review and meta-synthesis

Figures & data

Table 1. Quantitative assessment parameters (Annear et al., 2014, p. 596).

	Assessment score
Assessment parameters	0	1	2	3
Research design	NR/IN	Cross-sectional/quasi-experimental design	Longitudinal	Randomised controlled trial
Reliability and validity of measures	NR/IN	Reliability and validity of some measures ascertained	NA	Pilot testing/prior verification of all measures
Sample size and representativeness	NR/IN	Small sample size	Sample size > 500 (power requirements not reported)	Representative sample (power requirements reported)
Response rate	NR/IN	<60%	60%–79%	>80%
Appropriateness of statistical analysis	NR/IN	Generally appropriate but some inconsistencies	NA	All hypotheses and objectives adequately addressed
Control of potential confounders	NR/IN	NA	NA	Potential confounders included in the analysis

Notes: NR: not reported. IN: inappropriate in the context of the study.

Table 2. Qualitative assessment parameters (Annear et al., 2014, p. 596).

	Assessment score
Assessment parameters	0	1	2	3
Research design	NR/IN	NA	NA	Appropriate to the aims of the study
Sampling and recruitment strategy	NR/IN	NA	NA	Appropriate to the aims of the study
Theoretical framework use	NR/IN	NA	NA	Theoretical framework for methods or design present
Evidence of reflexivity	NR/IN	NA	NA	Preconceptions or meta-positions are addressed
Rigour of data analysis	NR/IN	NA	NA	Well-documented and systematic process
Validation of findings	NR/IN	NA	NA	Triangulation and verification of results

Notes: NR: not reported. IN: inappropriate in the context of the study.

Figure 1. Search strategy results.

Table 3. The relationship between food activities and identity maintenance–qualitative evidence.

Authors	Research design/data collection	Sampling	Theoretical framework	Data analysis	Evidence of reflexivity	Validation of findings	Score
Maintenance of women's gendered ethnic identities
Beoku-Betts (1995)	Ethnographic: Semi-structured interviews	N = 22 Women Age: 35–75 USA (Gullah)	Black feminist studies Afro-centric values system	Qualitative inductive narrative analysis	Meta-position as Black feminist scholar made explicit	Triangulation of data sources	15
	Journal/field observations
Hocking, Wright-St. Clair, and Bunrayong (2002)	Qualitative: Focus groups	N = 49 Women Age = >60–65 Thai (n = 33) New Zealand (n = 16)	No	Interpretive analysis narrative approach	No	Triangulation of researchers (data analysis)	12
Wright-St Clair et al. (2005)	Qualitative: Focus groups	N = 16 Women Age > 65 New Zealand	No	Interpretive analysis	No	Triangulation of researchers (data analysis)	12
O’Sullivan et al. (2008)	Qualitative: Focus groups	N = 20 Women Age: 65–93 Canada	Symbolic interactionism	Interpretive analysis narrative approach	Yes	Member checking Peer review Field notes Immersion Participant observation	18
D’Sylva and Beagan (2011)	Qualitative: In-depth interviews	N = 13 Women Age: 26–70 Canada (Goan)	NR	Inductive qualitative analysis	Explicit position of both researchers in relation to study	Theoretical saturation Field notes	15
Janowski (2012)	Food-centred life history methodology: Lightly structured interviews	N = 7 Women Age: Born 1913–1938 UK (Polish)	NR	NR	Explicit position of researchers in relation to study	NR	9
Maintenance of ethnic identities
Hadjiyanni and Helle (2009)	In-depth interviews	N = 13 Age: 36–68 Gender: NR USA (Ojibwe)	NR	NR	Design perspective	Research/field observations House plans Photographs	9
Maintenance of community identities
Griffith (2003)	Semi-structured interviews	N = 25 Age: 50–91 Gender: Women (n = 20) Men (n = 5) USA	Symbolic interactionism	Comparative pattern analysis	NR	No	12
Scarpello et al. (2009)	Semi-structured interviews	N = 29 interviews Age: 18–65+ Gender: Women (n = 22) Men (n = 7) UK	No	Interpretative phenomenological approach	No	Theoretical Saturation Triangulation of researchers	9

Table 4. The relationship between food activities and identity maintenance–quantitative evidence.

Authors	Research design	Reliability and validity of measures	Sample size and representativeness	Response rate	Appropriateness of statistical analysis	Control of potential confounders	Score
Cantarero et al. (2013)	Mixed methods. Quantitative phase included cross-sectional participant sample	NR	N = 816 Simple random sampling	NR (0)	Inappropriate tests used for type of data	NR	3
Schnettler et al. (2012)	Cross sectional	Measures pilot tested and reliability reported	N = 400 (1)	NR	Appropriate and hypotheses tested	Included in analysis	11

Table 5. Qualitative evidence of a threat to the relationship between food Activities and identity maintenance.

Authors	Research design/data collection	Sampling	Theoretical framework	Data analysis	Evidence of reflexivity	Validation of findings	Score
Changes in food choice as a threat to food activities and identity
Bisogni et al. (2002)	Grounded theory: Focus groups In-depth interviews Theoretical samplint	N = 17 Age: 25–89 Gender: Women (n = 9), Men (n = 8) USA (White)	Constructionist	Constant comparison	Yes	Theoretical saturation	18
Diabetes as a threat to food activities and identity
Broom and Whittaker (2004)	Discourse and Narrative Analysis	N = 119 Age: 20–90 Gender: Women (n = 60) Men (n = 59) Australia	NR	Thematic analysis – poorly described	No	Diabetes support group Focus group with general practitioners	9
Peel et al. (2005)	Qualitative: Longitudinal over six months	N = 40 Age: 21–77 Gender: Women (n = 19) Men (n = 21) Scottish (White)	Discursive Health Psychology	Thematic discourse analysis	NR	No	12
Kohinor et al. (2011)	Qualitative Semi-structured interviews	N = 32 Age: 36 to 70 years Gender: Women (n = 20) Men (n = 12) Netherlands (Surinamese)	Grounded theory principles (no evidence of application)	Coding matrix	No	Triangulation of researchers	12
Mathew et al. (2012)	Qualitative: Secondary analysis focus groups (n = 5) and Individual interviews (n = 9)	N = 35 Mean age = 57 years Gender: Women (51.4) Men (48.6%) Canada	No	Thematic analysis	Authors had variety of expertise – reduced risk of bias in analysis	Independent coding by three authors	15
Coeliac disease as a threat to food activities and identity
Rose and Howard (2014)	Grounded theory: Written narratives in a survey	N = 130 Age: 19–78 Gender: Women (67%), Men (33%) UK	Narrative psychology No clear theoretical approach to identity	Grounded theory methods (Charmaz, 2006) Described in detail	No	Theoretical saturation Triangulation of researchers	15
Cancer as a threat to food activities and identity
Locher et al. (2010)	Grounded theory: Semi-structured in-depth interviews	N = 30 patients N = 21 carers Patient age = 68–90 Gender: Women (n = 17) Men (n = 13) USA	Constructivist Not evident in analysis	Claim Glaser and Strauss, but not evident in results	No	Theoretical saturation – unlikely given participant sample	3
Valentine (1999)	Qualitative: Case studies	N = 7 Age: NR Gender: NR Nationality: British (Yorkshire)	Somers (1994) conceptualisation of identity in narrative	Data analysis methods not clear	No	Substantial detail of each case study	12
Frailty as a threat to food activities and identity
Moss et al. (2007)	Qualitative: Ethnographic Interviews	N = 15 Age: > 75 Gender: Men USA	No	Draw on many methods of qualitative data analysis. Do not describe own methods in detail	Theoretical position of the authors in relation to food literature is made explicit	Coding by one author Discussion of analysis in weekly meetings. No data triangulation	6
Dementia as a threat to food activities and identity
Atta-Konadu et al. (2011)	Grounded theory: Longitudinal over three years	N = 9 dyads Age: 58–88 (T1) Wives with dementia and their husbands Canadian (white)	Grounded theory Symbolic interactionism Role theory	Constant comparison	Theoretical position of the authors in relation to food literature is made explicit	Coding by one author but discussion of analysis in weekly meetings. Longitudinal design	18

Table 6. Quantitative evidence of a threat to the relationship between food activities and identity maintenance.

Authors	Research design	Reliability and validity of measures	Sample size and representativeness	Response rate	Statistical analysis	Control of potential confounders	Score
Bradbury et al. (2008)	Cross sectional	Measures verified using Chronbach alpha	Representative but power calculation not reported	131/153 (85%)	Appropriate and hypotheses tested	Included in analysis	14

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