Abstract
IMPORTANCE: The Older Americans Act Nutrition Program is essential to supporting older adults and their ability to maintain their quality of life. Despite this, such services are underfunded and are at risk of further cuts. OBJECTIVE: To characterize the benefits of home-delivered meals programs as reported by older adult recipients. DESIGN, SETTING, AND PARTICIPANTS: This qualitative study is a substudy within a randomized clinical trial, Deliver-EE, which evaluates the comparative effectiveness of 2 modes of meal delivery. Participants were randomized to 1 of 2 study groups: daily-delivered meals or frozen, bulk-shipped meals. Between August 2022 and March 2024, in-depth, semistructured telephone interviews with older adults receiving home-delivered meals were conducted. Interviews were conducted with participants living in California, Florida, North Carolina, South Carolina, and Texas. The interview guide was designed in collaboration with 2 advisory panels. The guide covered the quality and impact of meals. EXPOSURE: Receipt of home-delivered meals. MAIN OUTCOMES AND MEASURES: The primary outcome was to examine the benefits of home-delivered meals programs. Interview transcripts were analyzed using modified grounded theory and thematic analysis. RESULTS: According to interviews with 54 participants (mean [SD] age, 75.9 [6.8] years; 30 female [55.6%]), home-delivered meals met the stated goals of the Older Americans Act Nutrition Program (to reduce hunger, food insecurity, and malnutrition; to promote socialization; and to promote the health and well-being of older adults). Participants said that home-delivered meals provided much-needed nutritional stability and that they had positive interactions with delivery drivers. Meals also relieved their stress, including by eliminating their need to cook for themselves, which can be physically taxing. In addition, participants said home-delivered meals improved the health, well-being, and finances of their caregivers. CONCLUSIONS AND RELEVANCE: The findings of this qualitative study of home-delivered nutrition services for older adults suggest that home-delivered meals programs achieved their intended outcomes and yielded meaningful benefits beyond their stated purpose that remain to be quantified. The findings also support funding the Older Americans Act Nutrition Program.