Study protocol for a randomized, parallel-group trial to compare the effectiveness of registered dietitian and occupational therapy services on fall risk among home-delivered meal recipients

Top Things to Know

This trial directly tests whether meals alone are insufficient and whether combining food provision with nutrition counseling (RDN) and functional/home safety support (OT) leads to better outcomes.

This study advances FIM beyond nutrient adequacy toward preventing costly, downstream health events.

If effective, the combined meals + RDN + OT model could support reimbursement and policy changes that recognize food‑based interventions as platforms for delivering preventive, interdisciplinary care to high‑risk older adults.

Summary of Conclusion/Findings

This article presents a study protocol for a large randomized controlled trial designed to test whether adding registered dietitian nutritionist (RDN) and/or occupational therapy (OT) services to home‑delivered meal programs can reduce fall risk among community‑dwelling older adults. The trial will enroll 608 households and compare four models: meals alone, meals plus RDN services, meals plus OT services, and meals plus both RDN and OT services. The primary outcome is perceived fall risk, measured using the Short Falls Efficacy Scale–International, with secondary outcomes including risk of malnutrition, dietary intake, health care utilization, and quality of life. The protocol is grounded in evidence linking malnutrition, functional decline, and unsafe home environments to elevated fall risk among home‑delivered meal recipients. While results are not yet available, the study is designed to generate causal evidence on whether integrating clinical nutrition and functional services enhances the health and safety impact of meal delivery alone. Overall, the protocol positions home‑delivered meals as a foundational intervention that may be substantially strengthened through targeted, interdisciplinary care.