Background: Frailty often results from deteriorating muscle strength and decreased physical function in older adults. Frailty includes not only physical components, but also psychological and social aspects. Previous research has shown that exercise programs, especially resistance exercises combined with nutritional care, can reduce frailty. Objectives: This study aimed to develop a Frailty Prevention Care Management Program that prevents frailty and improves physical activity and nutrition compared to usual care for community-dwelling older adults. Methods: A quasi-experimental and single-blinded trial with a non-equivalent control group using a before-after design will be performed involving Frailty Prevention Care Management Program interventions, taking place both at the communities. Participants will be divided into two different intervention groups and two control groups. All groups will be assessed three times: at baseline, immediately after the intervention, and 3 months post intervention. A total of 72 community-dwelling older adults are recruited. This intervention includes an exercise program (design TRX program) and nutritional education. The control group will not receive any specific exercise training. The primary outcome shall comprise the effect of the Frailty Prevention Care Management Program on frailty using the Taiwanese version of the Tilburg frailty indicator. Secondary outcomes include the effect of physical activity using the Senior Fitness Test and nutrition measures using the Mini Nutritional Assessment-Short Form. A generalized estimating equation is constructed to analyze the effects of the intervention. Conclusions: This trial will provide vital information to guide interventions to improve outcomes (frailty, physical activity, and nutrition) and inform the integration of nutrition and TRX exercises in community-dwelling older adults.

Background: Swallowing difficulties (dysphagia) are highly prevalent among older adults and significantly contribute to malnutrition, dehydration, and poor health outcomes. Healthcare aides (HCAs), as frontline caregivers in long-term care, play a pivotal role in supporting residents’ nutritional intake. However, validated tools to evaluate their competencies in nutrition-related eating support are lacking. Methods: A cross-sectional study was conducted to develop and validate a competency-based questionnaire assessing healthcare aides’ knowledge, attitudes, and behaviors toward nutrition-focused eating support. Core domains, including oral function care, safe feeding practices, food texture modification, and nutrition safety, were identified through a systematic literature review and refined using a two-round modified Delphi process involving 26 experts. A 47-item questionnaire was then administered to 202 HCAs in Taiwan. Psychometric testing included item analysis, KR-20, Cronbach’s α, confirmatory factor analysis (CFA), composite reliability (CR), and average variance extracted (AVE). Results: The final instrument demonstrated strong content validity. The knowledge domain achieved acceptable reliability (KR-20 = 0.61), while the attitude and behavior domains showed excellent internal consistency (Cronbach’s α = 0.98). CFA confirmed good structural validity (χ²/df = 3.86, CFI = 0.93). CR and AVE values further supported construct validity. Conclusions: This nutrition-centered questionnaire is a valid and reliable tool to assess HCAs’ competencies in providing eating support. It offers a foundation for identifying training needs and designing educational programs aimed at preventing malnutrition and enhancing person-centered mealtime care in long-term care facilities.