Meal Delivery Research Articles

Feasibility of conducting qualitative research with persons living with dementia and their caregivers during a home-delivered meals pilot trial

BackgroundAmong older adults, food insecurity is associated with poor health status and health outcomes; people living with dementia (PLWD) are at increased risk for insecurity. Approaches to addressing food insecurity among homebound older adults include two modes of home-delivered meals: (1) meals delivered daily to participants’ homes by a volunteer or paid driver who socializes with the client or (2) frozen meals that are mailed to participants’ homes. Research has not examined benefits of these meals for PLWD or their caregivers nor compared the effectiveness of these two approaches in reducing food insecurity. The objective of this study was to test the processes for recruiting and engaging in qualitative research with PLWD and caregivers in an effort to understand the context, implementation, and mechanisms of impact by which relationships between meal delivery and outcomes may be achieved in preparation for a larger, follow-on study.MethodsThis is a qualitative sub-study of a pilot, multisite, two-arm pragmatic feasibility trial comparing the effect of two modes of meal delivery on nursing home placement among 243 PLWD. In this sub-study, we tested recruitment and enrollment procedures and piloted interview guides among a subset of participants and caregivers.ResultsWe recruited and conducted interviews with nine PLWD and seven caregivers. In testing the informed consent process, all participants were able to consent to be interviewed, and PLWD all demonstrated capacity to consent. We successfully used a cognitive screener to obtain scores of cognitive impairment for PLWD and observed scores indicating a broad range of function. Our interview guides successfully resulted in information about the context, implementation, and mechanisms of impact for meal delivery during the pilot.ConclusionsIn addition to establishing feasibility for the future trial, the substantive findings identified through the qualitative interviews provide an initial understanding of the contextual factors for meal delivery and the potential mechanisms of impact across meal delivery types that warrant further examination in a full-scale trial. Findings from our study provide crucial pilot data to support a follow-on trial to understand how to address food insecurity among PLWD.Name of the registryClinicalTrials.govTrial registrationNCT04850781Date of registrationApril 20, 2021, retrospectively registeredhttps://clinicaltrials.gov/ct2/show/NCT04850781

A mixed closed-open multi-depot routing and scheduling problem for homemade meal delivery incorporating drone and crowd-sourced fleet: A self-adaptive hyper-heuristic approach

A mixed closed-open multi-depot routing and scheduling problem for homemade meal delivery incorporating drone and crowd-sourced fleet: A self-adaptive hyper-heuristic approach

Optimization of route distance using k-NN algorithm for on-demand food delivery

Customers are now more able to purchase goods over the phone or the Internet, and the ability for those purchases to be delivered safely to the customer’s location is proliferating. On-request meal delivery, where customers submit their food orders online, and riders deliver them, is growing in popularity. The cutting-edge urban food application necessitates incredibly efficient and adaptable continuous delivery administrations toward quick delivery with the shortest route. However, signing up enough food parcels and training them to use such food-seeking frameworks is challenging. This article describes a publicly supported web-based food delivery system. IoT (Internet of Things) and 3G, 4G, or 5G developments can attract public riders to act as publicly sponsored riders delivering meals using shared bikes or electric vehicles. The publicly funded riders are gradually distributed among several food suppliers for food delivery. This investigation promotes an online food ordering system and uses K-Nearest Neighbor calculations to address the Traveling Salesman Problem (TSP) in directing progress. The framework also uses the Global Positioning System (GPS) on Android-compatible mobile devices and the TOM-TOM Routing API to obtain coordinates for planning purposes. To evaluate the presentation of the proposed approach, recreated limited scope and certifiable enormous scope on-request food delivery occurrences are used. Compared to the conventional methodology, the proposed strategy reduces the delay time. Each rider will receive the most direct route to the order delivery address. The delivery delay time is reduced by approximately 10–15 minutes for every order. The food supplier can determine whether an item is available to the rider; thus, the food supplier can add an order to the rider having the shortest way.

Home-delivered between-meal snacks for fragile older adults – A pilot study

BackgroundFragile home-dwelling older adults are at risk of undernutrition despite receiving meal delivery services. Weight loss is associated with increased morbidity and mortality. To promote healthy aging, home-delivered between-meal snacks (BMS) were tested in a region of Denmark. MethodsA quasi-experiment was set up with an intervention group (n=39, mean age 85.3) and a control group (n=32, mean age 80.8). The intervention group received BMS for 18 weeks corresponding to a weekly intake of 5600-9600 kJ and 40-112 g protein. The following outcomes were evaluated: weight, body mass index (BMI), body composition, and handgrip strength. ResultsThe intervention group had increased weight (mean ±SD) of 0.88 ±2.96 kg and fat mass of 1.56 ±2.55 kg but reduced muscle mass of 0.14 ±1.09 kg resulting in an increased BMI of 0.35 ±1.22 kg/m2. For comparison, the results of the control group were as follows: 0.29 ±2.56 kg, 0.27 ±3.65 kg, -0.04 ±1.76 kg, and 0.12 ±0.44 kg/m2. The between-group mean differences were not statistically significant. The intervention group had an increased right handgrip strength of 1.40 ±5.27 kg, while a decrease of 1.41 ±3.27 kg was observed for the control group resulting in a statistically significant between-group mean difference. ConclusionThis study suggests that BMS may reduce the risk of undernutrition and improve the functional status among fragile home-dwelling older adults, although the effect is minor. Nevertheless, the frequency of unplanned weight loss was lower within the intervention group even though the group constituted a more fragile population.

Abstract P222: Consuming a Vegan Diet Compared to Omnivore Diet Leads to No Significant Changes in Serum TMAO, Fasting Glucose, Insulin, or Vitamin B12: The Twins Nutrition Study (TwiNS) Randomized Controlled Trial

Introduction: Vegan diets are often encouraged for a myriad of health reasons, traditionally for control of blood lipid, cholesterol, and lipoprotein values. We proposed looking at other markers of health, including serum trimethylamine N-oxide (TMAO), fasting glucose, fasting insulin, or vitamin B12 in identical twins assigned to either a vegan or omnivore diet. Hypothesis: We hypothesized that the healthy vegan diet would lead to lower TMAO, fasting glucose, and fasting insulin (better), and lower vitamin B12 (worse) than the healthy omnivore diet. Methods: Identical twins were recruited and randomized to a healthy vegan or healthy omnivore diet. All twins consumed an omnivorous diet before enrollment. Meals were provided via a meal delivery service from baseline through week 4, with participants supplementing the delivered meals with their own diet adherent snacks. For delivered meals, both the healthy vegan and healthy omnivore diets were designed to consist of whole grains, legumes, and produce, with the main difference being omnivore diets provided ~1/3 of energy intake from animal-sourced foods. Participants prepared their own meals and snacks from weeks 5-8. Participants received nutrition education at baseline via orientation and were encouraged to choose “healthy” snacks, which for those on the vegan diet included legumes, nuts, seeds, and produce, and for those on the omnivore diet included dairy, nuts, seeds and produce. To assess compliance and intake, 24-hour dietary recalls were taken at weeks 0, 4, and 8. Clinical labs were collected at baseline, week 4, and week 8 through Stanford Medicine and analyzed both onsite and at Washington University St. Louis. Results: No significant differences between baseline and 4 or 8 weeks were seen in serum TMAO, fasting glucose, fasting insulin, or vitamin B12 between vegan and omnivorous twins (n=44). Conclusions: Vegan diets are often encouraged for their health promoting benefits; however, a healthy omnivorous diet can lead to comparable clinical lab outcomes. Funding: This study was supported by a generous donor, by the National Heart, Lung, and Blood Institute (NIH 5T32HL007034), and the Stanford Clinical and Translational Science Award (NIH UL1TR001085).

Abstract MP64: Impact of a Vegan Diet Compared to Omnivorous Diet on Blood Lipids and Weight Among Identical Twins: The Twins Nutrition Study (TwiNS) Randomized Controlled Trial

Introduction: Vegan diets, where animal- and all their by-products are excluded from the diet, have gained popularity. Growing evidence suggests potential cardiovascular benefits of vegan diets due to improvements in diet quality (i.e., higher consumption of vegetables, fruits whole grains, nuts, legumes, and seeds). Methods: The TwiNS randomized controlled trial examined the cardiometabolic impact of a healthy vegan diet compared to a healthy omnivorous diet (NCT05297825). These diets were examined in 22 pairs of identical twins, where one twin followed the vegan diet, and the other twin followed the omnivorous diet for 8 weeks. Diet specific meals were provided via a meal delivery service from baseline through week 4, and during weeks 5-8 participants prepared their own diet appropriate meals and snacks. The primary outcome was difference in LDL cholesterol from baseline to week 8. Secondary outcome measures included change in triglycerides, HDL-cholesterol and body weight. Adherence to study diets, ease/difficulty in following the diets, participant energy levels, and sense of wellbeing were also measured. A linear mixed model was used to investigate a difference in the change in primary and secondary outcomes from baseline and included a random effect for twin pair, to account for the correlation between identical twins. Results: Participants were generally healthy adults, average age 39.6 years, primarily non-Hispanic White, and had an average BMI of 26.2. On average, twins randomized to the healthy vegan diet had decreased their LDL-cholesterol more after 8 weeks compared to twins on the healthy omnivorous diet (-15.2 vs. -2.3mg/dL, 95% CI: 4.3-24.8). Participants on the healthy vegan diet also had decreased their body weight more after 8 weeks (-1.9 vs. -0.29 kg, 95% CI: 0.9-3.0). No significant differences were observed between the vegan and omnivorous diets for secondary outcomes of triglycerides or HDL-C. Conclusion: This study contributes to growing evidence that vegan diets may offer a protective cardiometabolic advantage compared to a healthy, omnivorous diet. Further analyses of the TwINS trial will examine changes to the gut microbiome (i.e., microbial diversity), inflammatory markers, and other health factors.

A Cross-Sectional Analysis of Products Marketed as Plant-Based Across the United States, United Kingdom, and Canada Using Online Nutrition Information

BackgroundThe food industry is responding to a rising demand for plant-based foods by developing and marketing an ever-wider range of vegan and vegetarian products under the banner of “plant-based.” Understanding the nutritional properties of these products is critical. ObjectivesTo assess the number, meal type, and nutritional content of products marketed as plant-based (MaPB) from the perspective of the consumer across multiple sectors in the United States, United Kingdom, and Canada. MethodsAn online search for products MaPB was performed across supermarkets, restaurants, food manufacturers, and plant-based meal delivery companies in the United Kingdom, the United States, and Canada using the terms: “vegan,” “vegetarian,” and “plant-based.” Online nutrition data were extracted, and whole meals that comprised >50% of ingredients such as fruits, vegetables, legumes, nuts, and seeds were identified. The nutritional content of dishes MaPB in restaurants was also directly compared with meat-containing dishes. ResultsFurther, 3488 unique products were identified, of which 962 were whole meals and 1137 were a replacement for the main protein component in a meal, including 771 meat alternatives. Across all sectors, 45% of whole meals had >15-g protein, 70% had <10% kcal from saturated fat; 29% had >10-g fiber per meal, and 86% had <1000 mg sodium. At restaurants, 1507 meat-containing dishes were identified and compared with 191 vegetarian and 81 vegan dishes. The meat-containing dishes were higher in protein [35.4 g (24.0–51.4)] compared with vegetarian [19.0 g (13.0–26.1)] and vegan [16.2 g (10.5–23.2) dishes (P < 0.001)]. The vegan dishes were low in saturated fat and sodium (SFA: 6.3 g ± 6.4, Sodium: 800 mg (545.0–1410.0) compared with both meat [SFA: 11.6 g ± 10.0; Sodium: 1280 mg (820.0–1952.0)] and vegetarian [SFA: 9.4 g ± 7.6; Sodium: 1011 mg (603.0–1560.0)] options (P < 0.001 for all comparisons). ConclusionsProducts MaPB tend to have lower concentrations of saturated fat and sodium than their meat-containing counterparts, but improvements are needed to optimize their nutritional composition.

Upholding dignity during a pandemic via Twitter.

Background: This article investigates how people invoked the concept of dignity on Twitter during the first year of the COVID-19 pandemic, with a secondary focus on mentions of dignity in the context of older adults and ageing. Methods: We report the results of a study that combines text analytic and interpretive methods to analyze word clusters and dignity-based themes in a cross-national sample of 1,946 original messages posted in 2020. Results: The study finds that dignity discourse on Twitter advances five major themes: (a) recognize dignity as a fundamental right, (b) uphold the dignity of essential workers, (c) preserve the dignity of at-risk populations, (d) prevent cascading disasters that exacerbate dignity's decline, and (e) attend to death, dignity, and the sanctity of life. Conclusions: Moreover, messages focusing on older adults lamented the disproportionate death toll, the terrible circumstances in long-term care homes, the added impact of suspended meal delivery services and the status of older people living below the poverty line.

Crowdsourced on-demand food delivery: An order batching and assignment algorithm

Since the early 2010s, the meal delivery business went through a veritable revolution due to online food delivery platforms. By allowing customers to quickly order from a wide range of restaurants and outsourcing currently available couriers using their vehicles (crowdsourcing), this typology of service dynamically bridges demand and supply. The main goal of online food delivery platforms consists of matching couriers to meal orders within short time intervals to provide an efficient, reliable, and sustainable service. A way to increase efficiency consists of consolidating orders into batches, such that the same courier can serve several orders in multiple pickup and drop-off routes. Since such an assignment-batching problem becomes computationally prohibitively costly in real-world scenarios characterized by a large number of customer orders as well as uncertain demand and supply, heuristic solution methods come into play. This study proposes an order batching and assignment algorithm that leverages a graph-based approach after decomposing the original problem into more tractable sub-problems employing clustering. The solution is improved by local search moves and re-optimization procedures and integrated with advanced policies to improve solutions over time. An ‘Insertion policy’ aimed at increasing batch size, and a ‘Swap policy’ aimed at identifying more efficient assignments, are implemented and compared to a ‘Myopic policy’ that does not involve any re-optimization over time. An agent-based simulation framework is developed to implement dynamic policies where couriers’ operations and movements are realistically reproduced. The performance of the developed solution approach is tested through experiments based on a real-world case study. Results show that the algorithm allows for high-quality solutions in several configurations characterized by different demand and supply patterns (e.g., density levels, couriers availability) and problem sizes.In particular, the two advanced policies investigated considerably improve the solutions.

AN ANALYSIS OF THE FACTORS THAT IMPACT THE CUSTOMERS’ SATISFACTION ON ONLINE FOOD DELIVERY SERVICES IN PETALING JAYA, SELANGOR, MALAYSIA

Gender equality in education has been an issue of interest in developing strategies for This research focuses on customer satisfaction with Malaysia's online food delivery (OFD) services. In this decade, the number of individuals who frequently purchased meals online climbed dramatically. People nowadays prefer their meals to be delivered instead of dining in a restaurant. Hence, it is crucial to understand the customers' expectations to manage a successful meal delivery business. People used to have to dine at restaurants or order takeout, but today OFD businesses provide convenience and have transformed customer behavior. This study also investigates the intrinsic and extrinsic factors influencing Malaysian's meal delivery satisfaction. Questionnaires were distributed to consumers in Petaling Jaya metropolitan area to collect and analyze data for this study. 384 respondents contributed to this study's findings, discussion, and conclusion. This study tested three independent variables that influence customers' satisfaction: hedonic motivation, price-saving orientation, and time-saving orientation. As a result, this study's three independent variables were statistically significant in satisfying customers. In conclusion, this study can be used to increase the usage of OFD services in the future. However, there are many factors to consider, as it was proven that the three independent factors positively contribute to customer satisfaction. Thus, the OFD service developers must create a solid impression that using OFD services is engaging and intriguing. Additionally, marketers must foster the idea that OFD services are integral to the user's lifestyle.&lt;p&gt; &lt;/p&gt;&lt;p&gt;&lt;strong&gt; Article visualizations:&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;&lt;img src="/-counters-/edu_01/0098/a.php" alt="Hit counter" /&gt;&lt;/p&gt;

Meals on Wheels: Promoting Food and Nutrition Security among Older Persons in Cape Town, South Africa.

Food insecurity (FI) prevails in Sub-Saharan Africa. Yet, in South Africa, although many people, including the elderly, are vulnerable to FI, little is known about the experiences of older persons (OPs) with FI and the interventions thereof. In South Africa, Meals on Wheels Community Service (MOWCS) provides readymade home meal deliveries for OPs through 209 branches across the country. Therefore, this study investigated MOWCS' role in the promotion of food security among the OPs at the Brooklyn branch, Cape Town. The study was grounded within the food security framework and focused on the availability, accessibility, utilization, and stability of food at Brooklyn MOWCS. Using qualitative research methods, 10 semi-structured interviews and one focus group discussion (N = 5) were conducted with Brooklyn MOWCS beneficiaries, in addition to three key personnel interviews conducted with staff. Data were analysed using Open Code 4.03. The findings showed Brooklyn MOWCS as a stable source of affordable and nutritious meals to OPs. The portion size satisfied hunger; occasionally, one portion sufficed for two meals. Respondents admitted the meal ingredients represented various food groups and rated them as "healthy". However, some financial challenges hindered the extension of MOWCS services to the wider community. For instance, they only had three paid employees and were overcrowded within church premises. Findings also showed race and gender disparity among respondents; 90% were White and 10% were of Mixed Ancestry, with no Black or Asian OPs represented, and only 10% were male. These outcomes are typical of the current ethnic profile of the overall Brooklyn MOWCS beneficiaries in SA. This calls, therefore, for such interventions to be extended to all South African demographic groups as an initiative to alleviate food and nutrition insecurity among all OPs.

Investigating the Role of Meal Quality and Food Look, Smell, and Taste on Perceived Health Improvement for Clients of Meals on Wheels of Central Indiana

Meals on Wheels organizations across the country have the common goal of ending hunger among the elderly, malnourished, and disabled population. Meals on Wheels of Central Indiana (MOWCI) primarily serves Marion County and the rest of the state through one of its programs. The organization offers daily hot and cold meals Monday through Friday, frozen meal deliveries, and pantry boxes. Minus the pantry boxes, meals are assembled at one of nine participating health corporations: Community Health Network, Eskenazi Health, IU Health- Methodist, Marquette, Franciscan Health, Ascension St. Vincent, and Westminster Village. MOWCI offers traditional or Medicaid subsidized hot and cold meals (for Marion County clients), Ryan’s Meals for Life (HIV/AIDS clients), and Embrace Cancer programs (low-income cancer treatment clients from Eskenazi). In this study, phone surveys were conducted investigating food quality and delivery satisfaction for daily hot and cold clients (n=149). Results were analyzed in Excel using a Chi-Square analysis of independence (alpha 0.05, 3 degrees of freedom). It was found that overall food quality and food smell, taste, and appearance were associated with perceived health improvements in a significantly significant manner with a p-value of 0.0000113 and 0.0198 respectively. There are 248 clients who as of July 7th have not been evaluated and thus, is still an active area of focus for MOWCI. A model has been created and shared with the organization that continues to allow them to collect data on future clients and input the data in order to determine what effect meals have on all of their client population as opposed to the 37.5% of clients that have been evaluated in this project. These efforts will be used in the future to aid in writing grants to allow for the expansion of current and future programs.

The Impact of the COVID-19 Pandemic on Public Interest in the Energy Labelling on Restaurant Menus.

No study has investigated the effect of the COVID-19 pandemic on the public's interest in using energy labelling on restaurant menus. This study explores the effects of the COVID-19 pandemic on the public interest in using energy labelling on restaurant menus and meal delivery applications and the impact of energy-labelling availability on food choices during the COVID-19 pandemic in Saudi Arabia. An online questionnaire was completed by 1657 participants aged ≥ 18 years. Before the COVID-19 pandemic, 32% of customers visited a restaurant 2-4 times/week. However, during the pandemic, 35% of customers visited a restaurant only once per week. There was no difference in interest in reading energy labelling or using meal delivery applications before and during the pandemic. During the COVID-19 pandemic, about 55% of restaurant customers reported that they had noticed energy labelling, with 42% of them being influenced by the energy-labelling information. Regarding energy information on food delivery applications, 40% of customers noticed energy labelling when using the applications, with 33% of them being affected by the energy labelling. Customer interest in reading about energy on restaurant menus during the pandemic did not change significantly from the level of interest before the pandemic. The interest expressed by the public in using the energy labelling was low both before and during the COVID-19 pandemic.

Consumer Insight During Covid-19: Understanding the Influence of Price Saving Benefits, Time Saving Benefits, and Food Safety Risk Perception To Consumer Intention On Online Food Delivery

Abstract. Technology has a significant impact on human existence, particularly in the phenomenon of online food delivery services. Every year, this makes online food shopping more appealing to the public. The study's goal is to compare consumers' willingness to use online meal delivery services during the Covid-19 pandemic to the new normal. The research methodology employed in the study was multivariate Structural Equation Modeling (SEM). Price savings benefits, time savings benefits, and food safety risk perceptions are all considered crucial and relevant in influencing customer intentions. The relevant data was acquired from online meal delivery customers by 299 data during the survey stage. A Google form was used to conduct the survey online. The Partial Least Square SEM approach will be utilized for the data analysis calculation stage. The findings of this investigation reveal three established hypothetical links. Data analysis revealed that Food Safety Risk Perception has a negative and significant impact on customer intentions. Customers' intentions are positively influenced by the Price Saving Benefit and the Time Saving Benefit is revealed to be the highest beta value. This study also discusses theoretical and practical contributions. Keywords: Online food delivery, price saving benefits, time saving benefits, food safety risk perceptions, consumer intention

The effect of consumption value on consumer changes behavior in usage of food delivery applica-tions in the era of society 5.0

The outbreak of the Covid-19 pandemic and the introduction of Society 5.0 by the Japanese government in 2019 have resulted in significant changes to consumer behavior. The aim of this research is to examine the impacts of consumption value on customers' behavioral shifts. Furthermore, quantitative methods were used with a sample of 344 respondents, and data analysis using the structural equation model with the Lisrel 8.72 application. The stages in the structural equation analysis of this model are: development of theoretical models, development of path diagrams, conversion of path diagrams to structural equations, selecting input matrices and types of estimates, identifying models, assessing goodness of fit criteria, and interpreting results. The results obtained showed that consumers' attitudes and habits toward utilizing meal delivery applications can be influenced by factors such as their social, conditional, emotional, epistemic, and functional values. In the use of food delivery applications, consumers are not only interested in tangible benefits, but also in less tangible benefits, such as information provided by businesses.

Food Aid and Related Challenges in Japan

In this article, the food aid in Japan was examined from the capability-based perspective. The data was obtained from in-depth interviews with 53 single mothers living in urban areas. Despite being economically disadvantaged, only 62.3% had access to food aids; of these, 52.8% used food banks, 11.3% used free or subsidised meal delivery services, and 7.5% used children canteens. Nevertheless, existing food assistance was only meant to reduce the inequality of their consequences (functioning achievements), not of their freedoms (capabilities) to eat well. To expand such capabilities, more proactive aids (such as food education and housekeeping service) are required.

Do online peer reviews stimulate diners’ continued log-in behavior: Investigating the role of emotions in the O2O meal delivery apps context

There is growing evidence that online peer reviews posted on online-to-offline (O2O) commerce platforms are a valuable source of information stimuli in consumer purchase decision-making. The research into the impact of different factors related to environmental stimuli (online peer reviews) on consumers' continued log-in behavior is under-researched in the context of O2O meal delivery apps (MDAs). Drawing on the theoretical lens of stimulus-organism-response and pleasure-arousal-dominance (PAD) models, this study examined the role of text and pictographic online review content in evoking emotions that predict continued log-in behavior on MDAs. Using a quasi-experimental setup with 134 participants from Germany, the findings reveal that the textual content of reviews positively related to pleasure and arousal, whereas the pictographic content of reviews generated pleasure and arousal. All three emotions of PAD were found to be significant predictors of the MDAs continued log-in behavior. In addition to the main effects, the results also showed the mediating effect of pleasure and arousal on continued log-in behavior. Moreover, app familiarity was found to moderate the effect of review content on emotions, implying that consumers with high app familiarity evoke fewer diners’ emotions than those with low app familiarity. In the unique Western cultural context of this MDAs setting, the findings have important theoretical and practical implications for academicians, MDAs managers and developers, and food delivery firms.

HOME-BASED EXERCISE PROGRAM WITH MEAL DELIVERY INCREASES DAILY STEP COUNT IN HOMEBOUND OLDER ADULTS

Abstract The United Nations projects adults aged 60 and older will reach 2.1 billion by 2050. With this trend, there will be an increase in older adults who are homebound, leading to more frailty with increased healthcare utilization and institutionalization. Improvements in frailty and homebound status may occur through increased physical activity, which has been shown in multiple randomized controlled trials to improve frailty. Our study aims to evaluate the effects of a home-based exercise program, administered through Meals on Wheels, on gait speed and frailty status in sixty-four homebound adults age 60 and older. All participants receive meal delivery for 12 weeks and half are randomized to receive an exercise kit with weekly exercise handouts. All participants are asked to wear an activity tracker with an additional longitudinal measure at 6 months. We now have 6 participants who have completed the study. Preliminary analysis was conducted on step count between the exercise and non-exercise group using two-sample t-tests. Average daily step count in the exercise group (n=3) was 2656 compared to 813 in the non-exercise group (n=3), p&amp;lt; 0.00001 during the first 12 weeks. The step count in the exercise group did decrease during the weeks after the intervention stopped, however they remained more active than the non-exercise group, 1112 vs 548, p&amp;lt; 0.0001. No adverse events were noted. As we continue to enroll participants, we are encouraged that the home-based exercise program with meal delivery appears to be a safe and effective way to increase physical activity in homebound older adults.

HOME-DELIVERED MEAL DELIVERIES AND FEELINGS OF SAFETY FOR OLDER AMERICANS ACT PARTICIPANTS

Abstract Home-delivered meals supported by the Older Americans Act (OAA) serve a dual purpose of improving nutritional intake and providing regular social contact for older adults. This regular contact can increase feelings of safety experienced by meal recipients. The benefits of home-delivered meal services may vary between meal recipients based on sociodemographic characteristics. Variation in home-delivered meal clients’ reports of feeling safer at home because of regular meal delivery visits was examined to support ongoing efforts to increase social engagement and equity through the delivery of OAA services. Using data from the 2019 National Survey of Older Americans Act Participants (NSOAAP) home-delivered meal module, descriptive statistics and logistic regression were conducted to identify the characteristics associated with feeling safer at home because of meal delivery visits. The majority (85%) of meal recipients report feeling safer because of meal delivery visits, and rates were especially high for rural recipients (92%), those with a high school education or less (89%),racial/ethnic minorities (94%), and those with three or more ADL limitations (90%). Logistic regression found that rural residence (OR=3.3), lower educational attainment (OR=2.0), racial/ethnic minority status (OR=4.7), living alone (OR=1.6), and having 3+ ADLs (OR=1.9) were significantly associated with higher odds of feeling safer at home because of meal delivery visits; however, age, gender, and suburban residence were not significant. Findings suggest that benefits of home-delivered meal programs are supporting the needs of traditionally disadvantaged groups and broadly increasing meal recipients’ sense of safety in their homes.

Robust meal delivery service for the elderly: a case study in Hong Kong

Service providers in a community center in Hong Kong deliver meals to community-dwelling elderly, first from a central kitchen to intermediate depots by a van and then to the homes of the elderly via walking. We propose a modified two-echelon vehicle routing model with concerns of both delivery efficiency and workload fairness among workers, incorporating important practical aspects, such as continuity of care and unique features of buildings and served elderly. Notably, we employ robust optimization to address service time uncertainties that differentiate between frail and ordinary elderly. The robust model can be transformed into a mixed integer program, for which we provide two decomposition-based approaches to accelerate computation. Through a real-data case study, we verify the effectiveness of the proposed models. We show that robust solutions can protect against service time variations and achieve better performance while incurring a small additional cost over deterministic ones. We provide insights into choosing the level of conservatism and human resource planning for practitioners.