A study protocol for a randomized controlled trial evaluating the impact of adding community health worker coaching calls and healthy grocery bag deliveries to a Meals on Wheels home-delivered meal program for homebound older adults in Rhode Island

Top Things to Know

Combining CHW coaching with healthy grocery deliveries addresses both nutritional and social determinants of health.

The use of CHWs to deliver motivational interviewing and goal-setting supports older adults in making sustainable dietary changes.

The study recognizes that traditional meal delivery alone may not meet all nutritional needs. By supplementing with grocery bags and nutrition education, the intervention promotes autonomy and improves access to a broader range of healthy foods.

Summary of Conclusion/Findings

This randomized controlled trial evaluates the impact of enhancing a traditional home-delivered meal program (Meals on Wheels of Rhode Island) for nutritionally at-risk, homebound older adults. Participants are randomized to receive either the standard program (five meals per week) or an enhanced version called Meals+, which includes four community health worker (CHW) coaching calls and three monthly deliveries of healthy grocery bags over 12 weeks. The primary outcome is diet quality, measured by the Dietary Screening Tool (DST), while secondary outcomes include food and nutrition security, loneliness, and health-related quality of life. The intervention is grounded in the Socio-Ecological Model and Social Cognitive Theory, aiming to address individual, interpersonal, and community-level barriers to healthy eating. The study also incorporates a robust process evaluation using the PRISM framework to assess implementation, sustainability, and participant satisfaction. Findings will inform the scalability of enhanced FIM interventions for older adults.