Project Summary

This research project is in progress. PCORI will post the research findings on this page within 90 days after the results are final.

What is the research about?

In the United States, millions of older adults don’t have enough food to stay healthy and active, which is known as food insecurity. Older adults who have a disability or a low income or who live in rural areas are at increased risk for food insecurity. Even when older adults have money for food, they may not have transportation to go buy food or the ability to prepare it. One way to help older adults stay healthy enough to remain in their homes is to deliver meals to them.

In this study, the research team is comparing two ways to deliver meals to older adults. The first way is in-person meal delivery. A second, lower cost way is shipping frozen meals to older adults’ homes. The team wants to know how well each type of meal delivery helps older adults to stay healthy and remain in their homes.

Who can this research help?

Results may help community organizations and meal delivery programs when considering ways to deliver meals to older adults. Results may also help older adults and their families to choose the type of meal delivery that works best for them.

What is the research team doing?

The research team is enrolling 2,300 older adults who are on the waiting list for six Meals on Wheels programs in Florida, Texas, California, and South Carolina. The team is assigning adults by chance to one of two groups. In the first group, a volunteer or paid driver delivers meals in person five days a week. The delivery person talks to the adults to check on their safety and well-being. In the second group, adults get 10 frozen meals shipped to their homes every two weeks.

The research team is looking at Medicare claims to see if adults have a hospital stay or move to a nursing home three and six months after they start receiving meals. The team is also surveying adults prior to receiving meals and again three months later to learn about their:

  • Access to food
  • Feelings of loneliness
  • Quality of life
  • Diet
  • Satisfaction with the meals
  • Preference for home delivery versus shipped meals

Older adults who are receiving meals, family members, health insurers, dieticians, and Meals on Wheels drivers are helping to plan and conduct this study.

Research methods at a glance

Design Element Description
Design Randomized controlled trial
Population 2,300 adults ages 66 and older who are on a waiting list for six Meals on Wheels programs in Florida, Texas, California, and South Carolina
  • Daily home-delivered meals with wellness check and socialization
  • Frozen meals shipped every two weeks

Primary: 6-month ratio of number of days in an institutional setting (ratio of days spent in an institutional setting [i.e., acute care hospital, psychiatric hospital, long-term care hospital, nursing home, and skilled nursing facility] to number of days alive)

Secondary: 3-month ratio of days in an institutional setting, food insecurity, perceived isolation/loneliness, health-related quality of life

*Patient-Centered Economic Outcomes Funding Supplement 
This study received supplemental funding to build on existing PCORI-funded comparative clinical effectiveness research (CER) studies to improve the understanding of appropriate costs and other economic burdens that are meaningful and inclusive to patients, caregivers and other stakeholders.

Project Information

Kali Thomas, PhD
Brown University School of Public Health
Evaluating The Effectiveness of Mode of Meal Delivery on the Ability of Homebound Older Adults to Remain in the Community

Key Dates

July 2021
January 2026


Award Type
Health Conditions Health Conditions These are the broad terms we use to categorize our funded research studies; specific diseases or conditions are included within the appropriate larger category. Note: not all of our funded projects focus on a single disease or condition; some touch on multiple diseases or conditions, research methods, or broader health system interventions. Such projects won’t be listed by a primary disease/condition and so won’t appear if you use this filter tool to find them. View Glossary
Populations Populations PCORI is interested in research that seeks to better understand how different clinical and health system options work for different people. These populations are frequently studied in our portfolio or identified as being of interest by our stakeholders. View Glossary
Intervention Strategy Intervention Strategies PCORI funds comparative clinical effectiveness research (CER) studies that compare two or more options or approaches to health care, or that compare different ways of delivering or receiving care. View Glossary
State State The state where the project originates, or where the primary institution or organization is located. View Glossary
Last updated: January 24, 2024