Publication date: Jun 25, 2025
Background: Food insecurity and social isolation among older adults are pressing public health concerns that significantly impact physical and mental health outcomes. The COVID-19 pandemic exacerbated these challenges while forcing innovative adaptations to traditional congregate meal programs. Objective: This study examined the effectiveness of Kūpuna U, an alternative flexible congregate meal program comprising three models (virtual, hybrid, and traditional), in addressing food insecurity, loneliness, and self-rated health among older adults in Hawai’i. Methods: A quasi-experimental study with non-equivalent groups analyzed secondary program evaluation data. Participants (N = 270, follow-up N = 116) self-selected into virtual (grab-and-go meals + online activities), hybrid (grab-and-go meals + virtual and in-person activities), or traditional (in-person congregate meals + in-person activities) models. Food insecurity (6-item scale), loneliness (UCLA 3-item scale), and self-rated health (5-point scale) were measured at the baseline and 6-month follow-up. Results: The Virtual group showed significant improvements in food insecurity (baseline: 1. 73 to follow-up: 0. 04, p < 0. 001) and self-rated health (baseline: 2. 92 to follow-up: 3. 72, p = 0. 005). The Hybrid group demonstrated a significant increase in loneliness (baseline: 4. 25 to follow-up: 5. 00, p = 0. 024). The Traditional group showed no significant changes in any outcome measures. Analysis of variance (ANOVA) revealed significant between-group differences for food insecurity (F = 9. 047, p < 0. 001) and self-rated health (F = 5. 814, p = 0. 004) change scores. Conclusions: The Virtual model demonstrated a superior effectiveness in improving food security and self-rated health outcomes. However, self-selection bias limits causal inferences. These findings suggest that flexible, technology-enhanced nutrition programs may effectively serve older adults with mobility or transportation barriers while maintaining program benefits.
Open Access PDF
Semantics
| Type | Source | Name |
|---|---|---|
| disease | MESH | COVID-19 pandemic |
| disease | MESH | loneliness |
| disease | MESH | chronic conditions |
| disease | MESH | depression |
| disease | MESH | congestive heart failure |
| disease | MESH | cognitive decline |
| disease | MESH | obesity |
| disease | MESH | physical inactivity |
| disease | MESH | infection |
| drug | DRUGBANK | Cytidine-5′-Monophosphate |
| drug | DRUGBANK | L-Threonine |
| disease | IDO | intervention |
| disease | MESH | educational status |
| disease | MESH | Marital status |