Lee Jenny Jinyoung, Sultana Nargis, Nishita Christy
Thompson School of Social Work & Public Health, University of Hawai'i at Mānoa, 1960 East-West Road, Biomed C-105A, Honolulu, HI 96822, USA.
Nutrients. 2025 Jun 25;17(13):2106. doi: 10.3390/nu17132106.
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. : 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. A quasi-experimental study with non-equivalent groups analyzed secondary program evaluation data. Participants ( = 270, follow-up = 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. The Virtual group showed significant improvements in food insecurity (baseline: 1.73 to follow-up: 0.04, < 0.001) and self-rated health (baseline: 2.92 to follow-up: 3.72, = 0.005). The Hybrid group demonstrated a significant increase in loneliness (baseline: 4.25 to follow-up: 5.00, = 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, < 0.001) and self-rated health (F = 5.814, = 0.004) change scores. 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.
老年人的粮食不安全和社会孤立是紧迫的公共卫生问题，会对身心健康结果产生重大影响。新冠疫情加剧了这些挑战，同时迫使人们对传统的集体用餐计划进行创新性调整。本研究考察了名为“Kūpuna U”的另一种灵活的集体用餐计划的有效性，该计划包括三种模式（虚拟模式、混合模式和传统模式），旨在解决夏威夷老年人的粮食不安全、孤独感和自评健康问题。一项采用非等效组的准实验研究分析了二级项目评估数据。参与者（n = 270，随访n = 116）自行选择进入虚拟模式（即取餐即走餐食 + 线上活动）、混合模式（即取餐即走餐食 + 虚拟和面对面活动）或传统模式（即面对面集体用餐 + 面对面活动）。在基线和6个月随访时测量粮食不安全（6项量表）、孤独感（加州大学洛杉矶分校3项量表）和自评健康（5分量表）。虚拟模式组在粮食不安全方面有显著改善（基线：1.73，随访：0.04，p < 0.001），在自评健康方面也有显著改善（基线：2.92，随访：3.72，p = 0.005）。混合模式组的孤独感显著增加（基线：4.25，随访：5.00，p = 0.024）。传统模式组在任何结果指标上均无显著变化。方差分析（ANOVA）显示，粮食不安全（F = 9.047，p < 0.001）和自评健康（F = 5.814，p = 0.004）变化分数在组间存在显著差异。虚拟模式在改善粮食安全和自评健康结果方面显示出更高的有效性。然而，自我选择偏差限制了因果推断。这些发现表明，灵活的、技术增强型的营养计划可能有效地服务于有行动或交通障碍的老年人，同时保持计划的益处。
