Examining the Relationship Between Home-Delivered Healthy Meals to Seniors and Social Connectedness: A Mixed Methods Study

Mean Change in Adult Food Security Score

时间窗: Baseline up to week 12

Food security status will be assessed using the United States Adult Food Security Survey Module- a 10-item measure that assesses a person's ability to access food. Questions include topics such as having enough food in the house, running out of food due to lack of money, skipping meals, and reducing portion sizes. Scoring range is from 0-10. A higher score represents a lower food security status. Assessed at baseline, week 6, and week 12.

Median Change of Adult Food Security Score

时间窗: Baseline up to week 12

Food security status will be assessed using the United States Adult Food Security Survey Module- a 10-item measure that assesses a person's ability to access food. Questions include topics such as having enough food in the house, running out of food due to lack of money, skipping meals, and reducing portion sizes. Scoring range is from 0-10. A higher score represents a lower food security status. Assessed at baseline, week 6, and week 12.

Mean Change in Food Frequency Assessment- Usage of 1% Milk, Skim Milk, and/or Low-fat Yogurt Per Day

时间窗: Baseline up to week 12

Usage of 1% milk, skim milk, and/or low-fat yogurt per day will be assessed using question 5 of a food frequency assessment adapted from the 17-item National Cancer Institute fruit and vegetable screener and the National Health and Nutrition Examination Survey (NHANES) Dietary Screener ("How often do you use 1% milk, skim milk, and/or low-fat yogurt?"). Scoring range is from 0-4. A higher score represents a greater usage of 1% milk, skim milk, and/or low-fat yogurt. Assessed at baseline, week 6, and week 12.

Mean Change in Food Frequency Assessment- Consumption of Greater Than 1 Kind of Vegetable Per Day

时间窗: Baseline up to week 12

Frequency of consumption of greater than 1 kind of vegetable per day will be assessed using question 7 of a food frequency assessment adapted from the 17-item National Cancer Institute fruit and vegetable screener and the National Health and Nutrition Examination Survey (NHANES) Dietary Screener ("How often do you eat more than one kind of vegetable each day (carrots, corn, green beans, etc.)"). Scoring range is from 0-4. A higher score represents a greater frequency of consuming more than one vegetable per day. Assessed at baseline, week 6, and week 12.

Median Change in Food Frequency Assessment- Consumption of Greater Than 1 Kind of Vegetable Per Day (Baseline to Week 6)

时间窗: Baseline up to week 12

Frequency of consumption of greater than 1 kind of vegetable per day will be assessed using question 7 of a food frequency assessment adapted from the 17-item National Cancer Institute fruit and vegetable screener and the National Health and Nutrition Examination Survey (NHANES) Dietary Screener ("How often do you eat more than one kind of vegetable each day (carrots, corn, green beans, etc.)"). Scoring range is from 0-4. A higher score represents a greater frequency of consuming more than one vegetable per day. Assessed at baseline, week 6, and week 12.

Mean Change in Food Frequency Assessment- Healthy Food Option Consideration

时间窗: Baseline up to week 12

How often someone considers healthy food choices when deciding what to eat will be assessed using question 8 of a food frequency assessment adapted from the 17-item National Cancer Institute fruit and vegetable screener and the National Health and Nutrition Examination Survey (NHANES) Dietary Screener ("When deciding what to eat, how often do you think about healthy food choices?"). Scoring range is from 0-4. A higher score represents a greater frequency considering healthy food choices when deciding what to eat. Assessed at baseline, week 6, and week 12.

Mean Change in Food Frequency Assessment- Fruit Eaten Per Day

时间窗: Baseline up to week 12

Total cups of fruit eaten per day will be assessed using question 1 of a food frequency assessment adapted from the 17-item National Cancer Institute fruit and vegetable screener and the National Health and Nutrition Examination Survey (NHANES) Dietary Screener ("On average, how many total cups (use your fist as a measure of a cup) of fruit do you eat each day? Count all that you eat whether in a combination dish or by itself"). Scoring range is categorical, with the following answer choices: 0; ½; 1; 1 ½ ; 2; 2 ½; 3; 3 ½; 4 or more. A higher score represents a greater amount of fruit consumed. Assessed at baseline, week 6, and week 12.

Mean Change in Food Frequency Assessment- Vegetables Eaten Per Day

时间窗: Baseline up to week 12

Total cups of vegetables eaten per day will be assessed using question 2 of a food frequency assessment adapted from the 17-item National Cancer Institute fruit and vegetable screener and the National Health and Nutrition Examination Survey (NHANES) Dietary Screener ("On average, how many total cups (use your fist as a measure of a cup) of vegetables do you eat each day? Count all that you eat whether in a combination dish or by itself"). Scoring range is categorical, with the following answer choices: 0; ½; 1; 1 ½ ; 2; 2 ½; 3; 3 ½; 4 or more. A higher score represents a greater amount of vegetables consumed. Assessed at baseline, week 6, and week 12.

Median Change in Food Frequency Assessment- Vegetables Eaten Per Day

时间窗: Baseline up to week 12

Total cups of vegetables eaten per day will be assessed using question 2 of a food frequency assessment adapted from the 17-item National Cancer Institute fruit and vegetable screener and the National Health and Nutrition Examination Survey (NHANES) Dietary Screener ("On average, how many total cups (use your fist as a measure of a cup) of vegetables do you eat each day? Count all that you eat whether in a combination dish or by itself"). Scoring range is categorical, with the following answer choices: 0; ½; 1; 1 ½ ; 2; 2 ½; 3; 3 ½; 4 or more. A higher score represents a greater amount of vegetables consumed. Assessed at baseline, week 6, and week 12.

Median Change in Food Frequency Assessment- Meal Preparation

时间窗: Baseline up to week 12

How often someone prepares meals at home will be assessed using question 14 of a food frequency assessment adapted from the 17-item National Cancer Institute fruit and vegetable screener and the National Health and Nutrition Examination Survey (NHANES) Dietary Screener ("Do you prepare meals at home?"). Scoring range is from 0-4. A higher score represents a greater frequency of preparing meals at home. Assessed at baseline, week 6, and week 12.

Mean Change in Food Frequency Assessment- Physical Activity

时间窗: Baseline up to week 12

Participants' amount of physical activity will be assessed using question 20 of a food frequency assessment adapted from the 17-item National Cancer Institute fruit and vegetable screener and the National Health and Nutrition Examination Survey (NHANES) Dietary Screener ("How much physical activity (exercise) do you do in a day?"). Scoring is categorical, with the following answer choices: 0-20 minutes; 21-30 minutes; 31-40 minutes; 41-60 minutes; more than 60 minutes. A higher score represents a greater amount of physical activity. Assessed at baseline, week 6, and week 12.

Median Change in Food Frequency Assessment- Physical Activity

时间窗: Baseline up to week 12

Participants' amount of physical activity will be assessed using question 20 of a food frequency assessment adapted from the 17-item National Cancer Institute fruit and vegetable screener and the National Health and Nutrition Examination Survey (NHANES) Dietary Screener ("How much physical activity (exercise) do you do in a day?"). Scoring is categorical, with the following answer choices: 0-20 minutes; 21-30 minutes; 31-40 minutes; 41-60 minutes; more than 60 minutes. A higher score represents a greater amount of physical activity. Assessed at baseline, week 6, and week 12.

Median Change in Food Frequency Assessment- Fruit Eaten Per Day

时间窗: Baseline up to week 12

Total cups of fruit eaten per day will be assessed using question 1 of a food frequency assessment adapted from the 17-item National Cancer Institute fruit and vegetable screener and the National Health and Nutrition Examination Survey (NHANES) Dietary Screener ("On average, how many total cups (use your fist as a measure of a cup) of fruit do you eat each day? Count all that you eat whether in a combination dish or by itself"). Scoring range is categorical, with the following answer choices: 0; ½; 1; 1 ½ ; 2; 2 ½; 3; 3 ½; 4 or more. A higher score represents a greater amount of fruit consumed. Assessed at baseline, week 6, and week 12.

Median Change in Food Frequency Assessment- Water Consumed Per Day

时间窗: Baseline up to week 12

Frequency of water consumed per day will be assessed using question 3 of a food frequency assessment adapted from the 17-item National Cancer Institute fruit and vegetable screener and the National Health and Nutrition Examination Survey (NHANES) Dietary Screener ("How often do you drink water (count tap, bottled, or sparkling water)?"). Scoring range is from 0-4. A higher score represents a greater frequency of water consumption. Assessed at baseline, week 6, and week 12.

Mean Change in Food Frequency Assessment- Water Consumed Per Day

时间窗: Baseline up to week 12

Frequency of water consumed per day will be assessed using question 3 of a food frequency assessment adapted from the 17-item National Cancer Institute fruit and vegetable screener and the National Health and Nutrition Examination Survey (NHANES) Dietary Screener ("How often do you drink water (count tap, bottled, or sparkling water)?"). Scoring range is from 0-4. A higher score represents a greater frequency of water consumption. Assessed at baseline, week 6, and week 12.

Mean Change in Food Frequency Assessment- Soda Consumed Per Day

时间窗: Baseline up to week 12

Frequency of soda consumed per day will be assessed using question 4 of a food frequency assessment adapted from the 17-item National Cancer Institute fruit and vegetable screener and the National Health and Nutrition Examination Survey (NHANES) Dietary Screener ("How often do you drink regular (not diet) soda?"). Scoring range is from 0-4. A higher score represents a greater frequency of soda consumption. Assessed at baseline, week 6, and week 12.

Median Change in Food Frequency Assessment- Soda Consumed Per Day

时间窗: Baseline up to week 12

Frequency of soda consumed per day will be assessed using question 4 of a food frequency assessment adapted from the 17-item National Cancer Institute fruit and vegetable screener and the National Health and Nutrition Examination Survey (NHANES) Dietary Screener ("How often do you drink regular (not diet) soda?"). Scoring range is from 0-4. A higher score represents a greater frequency of soda consumption. Assessed at baseline, week 6, and week 12.

Median Change in Food Frequency Assessment- Usage of 1% Milk, Skim Milk, and/or Low-fat Yogurt Per Day

时间窗: Baseline up to week 12

Usage of 1% milk, skim milk, and/or low-fat yogurt per day will be assessed using question 5 of a food frequency assessment adapted from the 17-item National Cancer Institute fruit and vegetable screener and the National Health and Nutrition Examination Survey (NHANES) Dietary Screener ("How often do you use 1% milk, skim milk, and/or low-fat yogurt?"). Scoring range is from 0-4. A higher score represents a greater usage of 1% milk, skim milk, and/or low-fat yogurt. Assessed at baseline, week 6, and week 12.

Mean Change in Food Frequency Assessment- Consumption of Greater Than 1 Kind of Fruit Per Day

时间窗: Baseline up to week 12

Frequency of consumption of greater than 1 kind of fruit per day will be assessed using question 6 of a food frequency assessment adapted from the 17-item National Cancer Institute fruit and vegetable screener and the National Health and Nutrition Examination Survey (NHANES) Dietary Screener ("Do you eat more than one kind of fruit each day (apple, peach, berries, etc.)"). Scoring range is from 0-4. A higher score represents a greater frequency of consuming more than one fruit per day. Assessed at baseline, week 6, and week 12.

Median Change in Food Frequency Assessment- Consumption of Greater Than 1 Kind of Fruit Per Day

时间窗: Baseline up to week 12

Frequency of consumption of greater than 1 kind of fruit per day will be assessed using question 6 of a food frequency assessment adapted from the 17-item National Cancer Institute fruit and vegetable screener and the National Health and Nutrition Examination Survey (NHANES) Dietary Screener ("Do you eat more than one kind of fruit each day (apple, peach, berries, etc.)"). Scoring range is from 0-4. A higher score represents a greater frequency of consuming more than one fruit per day. Assessed at baseline, week 6, and week 12.

Mean Change in Food Frequency Assessment- Usage of "Nutrition Facts" Label

时间窗: Baseline up to week 12

How often someone uses a "Nutrition Facts" label to when making food choices will be assessed using question 9 of a food frequency assessment adapted from the 17-item National Cancer Institute fruit and vegetable screener and the National Health and Nutrition Examination Survey (NHANES) Dietary Screener ("How often do you use the "Nutrition Facts" on the food label to make food choices?"). Scoring range is from 0-4. A higher score represents a greater frequency of using the "Nutrition Facts" when making food choices. Assessed at baseline, week 6, and week 12.

Mean Change in Food Frequency Assessment- Consideration of Food Label (Fat)

时间窗: Baseline up to week 12

How often someone uses a food label to select food with less saturated fat will be assessed using question 12 of a food frequency assessment adapted from the 17-item National Cancer Institute fruit and vegetable screener and the National Health and Nutrition Examination Survey (NHANES) Dietary Screener ("How often do you read food labels to select foods with less saturated fat?"). Scoring range is from 0-4. A higher score represents a greater frequency of using the food label when making food choices with less saturated fat. Assessed at baseline, week 6, and week 12.

Mean Change in Food Frequency Assessment- Whole Grain Consumption

时间窗: Baseline up to week 12

How often someone consumes whole grain instead of white or enriched flour ones will be assessed using question 13 of a food frequency assessment adapted from the 17-item National Cancer Institute fruit and vegetable screener and the National Health and Nutrition Examination Survey (NHANES) Dietary Screener ("How often do you eat whole grains (whole wheat bread, whole wheat tortillas, brown rice, oatmeal, etc.) in place of white or enriched flour ones?"). Scoring range is from 0-4. A higher score represents a greater frequency of consuming whole grains instead of white or enriched flour ones. Assessed at baseline, week 6, and week 12.

Mean Change in Food Frequency Assessment- Consideration of Food Label (Sugar)

时间窗: Baseline up to week 12

How often someone uses a food label to select food with less or no added sugar will be assessed using question 11 of a food frequency assessment adapted from the 17-item National Cancer Institute fruit and vegetable screener and the National Health and Nutrition Examination Survey (NHANES) Dietary Screener ("How often do you read food labels to select foods with less or no added sugar?"). Scoring range is from 0-4. A higher score represents a greater frequency of using the food label when making food choices with less or no added sugar. Assessed at baseline, week 6, and week 12.

Median Change in Food Frequency Assessment- Consideration of Food Label (Fat)

时间窗: Baseline up to week 12

How often someone uses a food label to select food with less saturated fat will be assessed using question 12 of a food frequency assessment adapted from the 17-item National Cancer Institute fruit and vegetable screener and the National Health and Nutrition Examination Survey (NHANES) Dietary Screener ("How often do you read food labels to select foods with less saturated fat?"). Scoring range is from 0-4. A higher score represents a greater frequency of using the food label when making food choices with less saturated fat. Assessed at baseline, week 6, and week 12.

Median Change in Food Frequency Assessment- Whole Grain Consumption

时间窗: Baseline up to week 12

How often someone consumes whole grain instead of white or enriched flour ones will be assessed using question 13 of a food frequency assessment adapted from the 17-item National Cancer Institute fruit and vegetable screener and the National Health and Nutrition Examination Survey (NHANES) Dietary Screener ("How often do you eat whole grains (whole wheat bread, whole wheat tortillas, brown rice, oatmeal, etc.) in place of white or enriched flour ones?"). Scoring range is from 0-4. A higher score represents a greater frequency of consuming whole grains instead of white or enriched flour ones. Assessed at baseline, week 6, and week 12.

Mean Change in Food Frequency Assessment- Meal Preparation

时间窗: Baseline up to week 12

How often someone prepares meals at home will be assessed using question 14 of a food frequency assessment adapted from the 17-item National Cancer Institute fruit and vegetable screener and the National Health and Nutrition Examination Survey (NHANES) Dietary Screener ("Do you prepare meals at home?"). Scoring range is from 0-4. A higher score represents a greater frequency of preparing meals at home. Assessed at baseline, week 6, and week 12.

Median Change in sum of University of California- Los Angeles Loneliness Scale Short form

时间窗: Baseline up to week 12

Loneliness will be assessed using the University of California- Los Angeles Loneliness Scale Short Form, a 6 item measure that assesses how often participants feel left out or not connected to other people. Scoring range is from 3-9. A higher score means greater loneliness. Assessed at baseline, week 6, and week 12.

Number of successful HDHM Deliveries made to participants in control group

时间窗: Baseline up to week 12

Program feasibility will be assessed using the number of successful HDHM deliveries made to participants during the study. This is defined as the delivery driver being able to deliver the HDHM to the participant's residence. A higher number of successful deliveries indicate greater feasibility.

Median Change in Food Frequency Assessment- Healthy Food Option Consideration

时间窗: Baseline up to week 12

How often someone considers healthy food choices when deciding what to eat will be assessed using question 8 of a food frequency assessment adapted from the 17-item National Cancer Institute fruit and vegetable screener and the National Health and Nutrition Examination Survey (NHANES) Dietary Screener ("When deciding what to eat, how often do you think about healthy food choices?"). Scoring range is from 0-4. A higher score represents a greater frequency considering healthy food choices when deciding what to eat. Assessed at baseline, week 6, and week 12.

Median Change in Food Frequency Assessment- Consideration of Food Label (Salt/Sodium)

时间窗: Baseline up to week 12

How often someone uses a food label to select food with less salt or sodium will be assessed using question 10 of a food frequency assessment adapted from the 17-item National Cancer Institute fruit and vegetable screener and the National Health and Nutrition Examination Survey (NHANES) Dietary Screener ("How often do you read food labels to select foods with less salt or sodium?"). Scoring range is from 0-4. A higher score represents a greater frequency of using the food label when making food choices with less salt or sodium. Assessed at baseline, week 6, and week 12.

Mean Change in Food Frequency Assessment- Strength Training

时间窗: Baseline up to week 12

How often someone includes strength training when they exercise will be assessed using question 19 of a food frequency assessment adapted from the 17-item National Cancer Institute fruit and vegetable screener and the National Health and Nutrition Examination Survey (NHANES) Dietary Screener ("Do you include strength training when you exercise?"). Scoring range is from 0-4. A higher score represents a greater frequency of strength training. Assessed at baseline, week 6, and week 12.

Median Change in Food Frequency Assessment- Usage of "Nutrition Facts" Label

时间窗: Baseline up to week 12

How often someone uses a "Nutrition Facts" label to when making food choices will be assessed using question 9 of a food frequency assessment adapted from the 17-item National Cancer Institute fruit and vegetable screener and the National Health and Nutrition Examination Survey (NHANES) Dietary Screener ("How often do you use the "Nutrition Facts" on the food label to make food choices?"). Scoring range is from 0-4. A higher score represents a greater frequency of using the "Nutrition Facts" when making food choices. Assessed at baseline, week 6, and week 12.

Mean Change in Food Frequency Assessment- Consideration of Food Label (Salt/Sodium)

时间窗: Baseline up to week 12

How often someone uses a food label to select food with less salt or sodium will be assessed using question 10 of a food frequency assessment adapted from the 17-item National Cancer Institute fruit and vegetable screener and the National Health and Nutrition Examination Survey (NHANES) Dietary Screener ("How often do you read food labels to select foods with less salt or sodium?"). Scoring range is from 0-4. A higher score represents a greater frequency of using the food label when making food choices with less salt or sodium. Assessed at baseline, week 6, and week 12.

Median Change in Food Frequency Assessment- Consideration of Food Label (Sugar)

时间窗: Baseline up to week 12

How often someone uses a food label to select food with less or no added sugar will be assessed using question 11 of a food frequency assessment adapted from the 17-item National Cancer Institute fruit and vegetable screener and the National Health and Nutrition Examination Survey (NHANES) Dietary Screener ("How often do you read food labels to select foods with less or no added sugar?"). Scoring range is from 0-4. A higher score represents a greater frequency of using the food label when making food choices with less or no added sugar. Assessed at baseline, week 6, and week 12.

Median Change in Food Frequency Assessment- Strength Training

时间窗: Baseline up to week 12

How often someone includes strength training when they exercise will be assessed using question 19 of a food frequency assessment adapted from the 17-item National Cancer Institute fruit and vegetable screener and the National Health and Nutrition Examination Survey (NHANES) Dietary Screener ("Do you include strength training when you exercise?"). Scoring range is from 0-4. A higher score represents a greater frequency of strength training. Assessed at baseline, week 6, and week 12.

Mean Change in Patient Health Questionaire-8

时间窗: Baseline up to week 12

Depressive symptoms will be assessed using the Patient Health Questionnaire-8, an 8-item measure that assesses the number of days a person has experienced various symptoms of depression over the past two weeks. Questions include assessing how often a participant has had little to no interest in doing things, how often they feel down, depressed, irritable, or hopeless, etc. Scoring range is from 0-24. A higher score means greater depressive symptoms. Assessed at baseline, week 6, and week 12.

Mean Change in sum of University of California- Los Angeles Loneliness Scale Short form

时间窗: Baseline up to week 12

Loneliness will be assessed using the University of California- Los Angeles Loneliness Scale Short Form, a 6 item measure that assesses how often participants feel left out or not connected to other people. Scoring range is from 3-9. A higher score means greater loneliness. Assessed at baseline, week 6, and week 12.

Number of successful HDHM Deliveries and Social Interactions made to participants in intervention group

时间窗: Baseline up to week 12

Program feasibility will be assessed using the number of successful HDHM deliveries including "friendly visits" made to intervention participant's homes during the study. This is defined as the delivery driver being able to deliver the HDHM to the participant's residence and complete a brief social interaction. A higher number of successful deliveries indicates greater feasibility of the program.

Mean Change of PRAPARE Score

时间窗: Baseline up to week 12

Distinct social determinant of health risks will be assessed using the Protocol for Responding to and Assessing Patients' Assets, Risks, and Experience (PRAPARE) assessment- a 21-item measure that assesses a participant's various social determinant of health risk responses. Questions include topics such as housing status, work situations, level of education, and others. Scoring range is from 0-22, with a higher score representing a higher amount of risks present. Assessed at baseline, week 6, and week 12.

Number of HDHM meals consumed by participants weekly

时间窗: Baseline up to week 12

Program feasibility will be assessed using the number of meals consumed by participants per week. A higher number of meals consumed indicates greater feasibility of the program.

Duration of Student Companion Calls

时间窗: Baseline up to week 12

Program feasibility will be assessed using the duration of Student Companion calls that take place during the study for participants in the intervention group. Duration will be assessed in minutes per week. A higher number of minutes indicates greater feasibility of the program.

Median Change of PRAPARE Score

时间窗: Baseline up to week 12

Distinct social determinant of health risks will be assessed using the Protocol for Responding to and Assessing Patients' Assets, Risks, and Experience (PRAPARE) assessment- a 21-item measure that assesses a participant's various social determinant of health risk responses. Questions include topics such as housing status, work situations, level of education, and others. Scoring range is from 0-22, with a higher score representing a higher amount of risks present. Assessed at baseline, week 6, and week 12.

Median Change in Patient Health Questionaire-8

时间窗: Baseline up to week 12

Depressive symptoms will be assessed using the Patient Health Questionnaire-8, an 8-item measure that assesses the number of days a person has experienced various symptoms of depression over the past two weeks. Questions include assessing how often a participant has had little to no interest in doing things, how often they feel down, depressed, irritable, or hopeless, etc. Scoring range is from 0-24. A higher score means greater depressive symptoms. Assessed at baseline, week 6, and week 12.