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Deliver-EE: Bewertung der Auswirkungen der Essenslieferung

26. Oktober 2026 aktualisiert von: Brown University

Deliver-EE: Bewertung der Auswirkungen der Essensausgabe auf die Fähigkeit heimgebundener älterer Erwachsener, in der Gemeinschaft zu bleiben, durch eine pragmatische, zweiarmige, randomisierte vergleichende Wirksamkeitsstudie

This study will randomly assign 2,300 older adults on waiting lists at fourteen Meals on Wheels programs in Florida, Illinois, Maryland, Tennessee, Texas, North Carolina, South Carolina, and California into two groups who will receive: (a) daily delivery of meals, five days a week or (b) a shipment of 10 frozen meals, every two weeks. Researchers will examine participants' Medicare claims to understand if differences in healthcare utilization occur between the two groups within six months after they start receiving meals. Researchers will also ask participants questions prior to receiving meals, and again at three months, to understand how meals impact their ability to obtain food, their feelings of loneliness, and their overall quality of life. The primary study outcome will be the ratio of days spent in institutional settings (i.e., hospital, nursing home) in the six months after participants begin receiving meals. The secondary outcomes include the ratio of days spent in institutional settings in the three months after participants begin receiving meals, food insecurity, subjective isolation/loneliness, and health-related quality of life. The team will also examine differences in dietary intake between the two groups as an exploratory outcome.

Studienübersicht

Status

Aktiv, nicht rekrutierend

Bedingungen

Intervention / Behandlung

Detaillierte Beschreibung

Background and Significance: Food insecurity among older adults is a critical public health issue with implications for families, the healthcare system, and society. In 2017, an estimated 5.5 million older adults (7.7%) in the United States were food insecure. Among older adults, food insecurity is associated with poor health status and outcomes and accounts for an estimated $130 billion annually in medical expenses. As a result, healthcare entities (e.g., payers, integrated systems, providers) are increasingly interested in addressing food insecurity, among other social risk factors, through non-medical services such as home-delivered meals to older patients and enrollees. Home-delivered meals, long provided through a network of community-based organizations funded through the Older Americans Act, state dollars, and charitable contributions, promote food security, socialization, and independence among older adults. While meals have traditionally been provided daily to clients' homes by a volunteer or paid driver, mailed frozen meals have emerged in recent years as a lower cost alternative. However, there is limited evidence about what mode of delivery is most effective in promoting community independence, reducing healthcare utilization, and improving patients' quality of life, as well as how these outcomes may vary as a function of patients' preferences for how meals are delivered to them.

Study Aims: The long-term goal of this research is to generate evidence to guide patient, family, meal programs, and healthcare entities' decision-making about which mode of meal delivery is best for promoting important, patient-centered outcomes. This will be accomplished through three specific aims: 1) To evaluate the effectiveness of receiving daily-delivered meals with a safety check and socialization versus frozen, drop-shipped meals on food insecure, homebound older adults' ability to remain in the community; 2) To understand food insecure, homebound older adults' preferences for mode of meal delivery and the effect of receiving a meal that is concordant with their preference on their ability to remain in the community; and 3) To measure and quantify secondary outcomes prioritized by stakeholders related to these different modes of meal delivery.

Study Description: This is a two-arm pragmatic, randomized controlled trial that will compare participants' health outcomes between two conventional approaches for delivering meals to food insecure, homebound older adults at fourteen diverse Meals on Wheels America member programs in Florida, Illinois, Maryland, Tennessee, Texas, California, North Carolina, and South Carolina. The comparators are the two main modes of meal delivery used in everyday practice: daily-delivered meals and drop-shipped, frozen meals. A total of 2300 food insecure, homebound older adults (ages 66+) on waiting lists at these programs will be enrolled in the study; 1150 older adults will receive meals delivered five days per week, with socialization and a wellness check by a volunteer or paid driver, and 1150 will receive a box of 10 frozen meals that will be mailed to participants every two weeks. The primary outcome will be the ratio of days that a participant is in an institutional setting (i.e., hospital, nursing home) in the six months following the start of meal delivery and will be derived from data from the Centers for Medicare and Medicaid Services; secondary outcomes include the ratio of days in institutional settings in the three months following the start of meal delivery, food insecurity, loneliness, and quality of life. Secondary outcomes will be derived from Centers for Medicare and Medicaid Services' data and surveys with participants. Self-reported dietary intake will be included as an exploratory outcome. To examine heterogeneity of treatment effects, the investigators will test for interactions between the two types of meals and participants' preferences for meals, as well as clients' living arrangements. This research will be the first to prospectively evaluate the comparative effectiveness of the two predominant meal delivery options in partnership with a variety of stakeholders. The knowledge generated from this research will be of tremendous value to healthcare payers, health systems, providers, community-based organizations, patients, and their families, because it will identify the mode of meal delivery that best meets older, homebound, and food insecure patients' needs and promotes community independence

Studientyp

Interventionell

Einschreibung (Tatsächlich)

2300

Phase

  • Unzutreffend

Kontakte und Standorte

Dieser Abschnitt enthält die Kontaktdaten derjenigen, die die Studie durchführen, und Informationen darüber, wo diese Studie durchgeführt wird.

Studienorte

    • California
      • San Diego, California, Vereinigte Staaten, 92110
        • Meals on Wheels San Diego County
    • Florida
      • Clearwater, Florida, Vereinigte Staaten, 33762
        • Neighborly Care Network
      • Jacksonville, Florida, Vereinigte Staaten, 32210
        • Aging True
    • Illinois
      • Evanston, Illinois, Vereinigte Staaten, 60201
        • Meals on Wheels Northeastern Illinois
    • Maryland
      • Baltimore, Maryland, Vereinigte Staaten, 21224
        • Meals on Wheels of Central Maryland
    • North Carolina
      • Durham, North Carolina, Vereinigte Staaten, 27703
        • Meals On Wheels Durham
      • Greensboro, North Carolina, Vereinigte Staaten, 27408
        • Senior Resources of Guilford
    • South Carolina
      • Anderson, South Carolina, Vereinigte Staaten, 29624
        • Meals On Wheels - Anderson
      • Columbia, South Carolina, Vereinigte Staaten, 29205
        • Senior Resources Inc
    • Tennessee
      • Memphis, Tennessee, Vereinigte Staaten, 38126
        • Metropolitan Inter-Faith Association (MIFA)
    • Texas
      • Dallas, Texas, Vereinigte Staaten, 75247
        • Visiting Nurse Association of Texas
      • Houston, Texas, Vereinigte Staaten, 77090
        • Northwest Assistance Ministries
      • Mission, Texas, Vereinigte Staaten, 78572
        • Amigos Del Valle, Inc
      • San Antonio, Texas, Vereinigte Staaten, 78229
        • Meals on Wheels San Antonio

Teilnahmekriterien

Forscher suchen nach Personen, die einer bestimmten Beschreibung entsprechen, die als Auswahlkriterien bezeichnet werden. Einige Beispiele für diese Kriterien sind der allgemeine Gesundheitszustand einer Person oder frühere Behandlungen.

Zulassungskriterien

Studienberechtigtes Alter

66 Jahre und älter (Älterer Erwachsener)

Akzeptiert gesunde Freiwillige

Ja

Studienberechtigte Geschlechter

Alle

Beschreibung

Inclusion Criteria:

  • Age 66+
  • On program waiting list
  • Must reside in program's daily service area
  • Must be able to eat a general diet with no dietary restrictions

Exclusion Criteria:

  • Primary language is not English or Spanish
  • Has end stage renal disease/requires specialized renal diet
  • Unable to participate in a phone survey/interview (e.g., difficulty hearing, lack of comprehension of study purpose, does not have working phone)

Studienplan

Dieser Abschnitt enthält Einzelheiten zum Studienplan, einschließlich des Studiendesigns und der Messung der Studieninhalte.

Wie ist die Studie aufgebaut?

Designdetails

  • Hauptzweck: Unterstützende Pflege
  • Zuteilung: Zufällig
  • Interventionsmodell: Parallele Zuordnung
  • Maskierung: Single

Waffen und Interventionen

Teilnehmergruppe / Arm
Intervention / Behandlung
Aktiver Komparator: Daily home delivered meals

A lunch-time meal delivered to participants' homes five days per week with wellness check and socialization.

In-home delivery with opportunity for driver observation and interaction

Prepared meals compliant with Older Americans Act nutrition programs guidelines

Experimental: Frozen, Drop-shipped Meals

Ten frozen meals that are mailed to participants every two weeks.

Prepared meals compliant with Older Americans Act nutrition programs guidelines

Was misst die Studie?

Primäre Ergebnismessungen

Ergebnis Maßnahme
Maßnahmenbeschreibung
Zeitfenster
6-Month Ratio of Days in Institutional Settings
Zeitfenster: 6 months

Ratio between the number of days that are spent in an institutional setting (i.e., acute care hospital, psychiatric hospital, long-term care hospital, nursing home, or skilled nursing facility) and the number of days alive in the six months following receipt of meals

6 months

Sekundäre Ergebnismessungen

Ergebnis Maßnahme
Maßnahmenbeschreibung
Zeitfenster
3-Month Ratio of Days in Institutional Settings
Zeitfenster: 3 months

Defined similarly to the primary outcome, but assesses the immediate (3-month) impact of meals on days spent in institutional settings

3 months
Food Insecurity
Zeitfenster: 3 months

U.S. Household Food Security Survey Module: Six-Item Short Form; Minimum value (0) indicates high food insecurity; Maximum value (6) indicates very low food insecurity

3 months
Subjective Isolation/Loneliness
Zeitfenster: 3 months

University of California, Los Angeles 3-Item Loneliness Scale; Minimum value (3) indicates low feelings of loneliness; Maximum value (9) indicates high feelings of loneliness

3 months
Health-Related Quality of Life
Zeitfenster: 3 months

The Centers for Disease Control and Prevention's Health-Related Quality of Life 4-question core modules, called the "Healthy Days Measures"; The unhealthy days index is calculated by summing the number of physically and mentally unhealthy days, capped at 30 total days.

3 months

Mitarbeiter und Ermittler

Hier finden Sie Personen und Organisationen, die an dieser Studie beteiligt sind.

Sponsor

Mitarbeiter

Ermittler

  • Hauptermittler: Kali S. Thomas, PhD, Johns Hopkins University School of Nursing
  • Studienleiter: Kimberly P. Bernard, PhD, Brown University School of Public Health

Publikationen und hilfreiche Links

Die Bereitstellung dieser Publikationen erfolgt freiwillig durch die für die Eingabe von Informationen über die Studie verantwortliche Person. Diese können sich auf alles beziehen, was mit dem Studium zu tun hat.

Studienaufzeichnungsdaten

Diese Daten verfolgen den Fortschritt der Übermittlung von Studienaufzeichnungen und zusammenfassenden Ergebnissen an ClinicalTrials.gov. Studienaufzeichnungen und gemeldete Ergebnisse werden von der National Library of Medicine (NLM) überprüft, um sicherzustellen, dass sie bestimmten Qualitätskontrollstandards entsprechen, bevor sie auf der öffentlichen Website veröffentlicht werden.

Haupttermine studieren

Studienbeginn (Tatsächlich)

1. Mai 2022

Primärer Abschluss (Geschätzt)

1. August 2027

Studienabschluss (Geschätzt)

1. März 2028

Studienanmeldedaten

Zuerst eingereicht

27. April 2022

Zuerst eingereicht, das die QC-Kriterien erfüllt hat

27. April 2022

Zuerst gepostet (Tatsächlich)

2. Mai 2022

Studienaufzeichnungsaktualisierungen

Letztes Update gepostet (Tatsächlich)

28. Oktober 2026

Letztes eingereichtes Update, das die QC-Kriterien erfüllt

26. Oktober 2026

Zuletzt verifiziert

1. September 2026

Mehr Informationen

Begriffe im Zusammenhang mit dieser Studie

Andere Studien-ID-Nummern

  • 2022003287
  • IHS-2020C3-21201 (Andere Zuschuss-/Finanzierungsnummer: Patient-Centered Outcomes Research Institute)

Plan für individuelle Teilnehmerdaten (IPD)

Planen Sie, individuelle Teilnehmerdaten (IPD) zu teilen?

NEIN

Arzneimittel- und Geräteinformationen, Studienunterlagen

Studiert ein von der US-amerikanischen FDA reguliertes Arzneimittelprodukt

Nein

Studiert ein von der US-amerikanischen FDA reguliertes Geräteprodukt

Nein

Diese Informationen wurden ohne Änderungen direkt von der Website clinicaltrials.gov abgerufen. Wenn Sie Ihre Studiendaten ändern, entfernen oder aktualisieren möchten, wenden Sie sich bitte an register@clinicaltrials.gov. Sobald eine Änderung auf clinicaltrials.gov implementiert wird, wird diese automatisch auch auf unserer Website aktualisiert .