Core functions and forms in home-delivered meal programs: a stakeholder-driven approach to identifying essential...

Area of Science:

• Gerontology
• Public Health
• Implementation Science

Background:

• The aging population requires specialized programs, with home-delivered meals crucial for nutrition and social support.
• Variations in local meal program implementation hinder understanding of their impact on older adults.
• This study uses the core functions and forms framework to identify replicable essential practices in meal programs.

Purpose of the Study:

• To identify and prioritize essential practices (forms) in home-delivered meal programs.
• To understand how specific program practices influence health outcomes for older adults.
• To provide a foundation for evaluating and improving home-delivered meal program effectiveness.

Main Methods:

• A pragmatic randomized effectiveness trial comparing two home-delivered meal models.
• Data collection involved nine meal programs across the U.S. using site visits, surveys, and listening sessions.
• A modified e-Delphi process with stakeholders identified essential program forms based on core functions from the Older Americans Act.

Main Results:

• Three core functions were identified: reducing hunger/malnutrition, providing socialization, and promoting health/well-being.
• Out of 103 identified program forms, 25 were deemed essential for achieving core functions.
• Essential practices included dietary customization, emergency meal provision, and client-directed interactions.

Conclusions:

• Standardizing core functions and essential forms provides a framework for evaluating home-delivered meal programs.
• Findings support national improvements by balancing standardized practices with local needs.
• This study models the characterization of complex interventions in community settings, advancing implementation science.