Food Preferences and Meal Satisfaction of Meals on Wheels Recipients

The views, experiences and expectations of Australian Meals on Wheels customers: A national survey

OBJECTIVE

To investigate views and expectations of Australian Meals on Wheels (MOW) customers to inform the development of National Meal Guidelines and improve current services.

METHODS

A survey was designed through literature review and consultations with key stakeholders. National convenience sampling returned  337 surveys. Descriptive statistics and chi-squared analyses were applied to the survey data.

RESULTS

Meals on Wheels customers reported satisfaction with their current service, with the meal itself found to be the most valuable aspect. People living in small country towns were more likely to value the social contact provided by MOW than those in major cities (P = .001). Delivery of pantry items was the most popular additional option for future services.

CONCLUSION

Valuable information for inclusion in the development of the National Meal Guidelines was provided: nutritional content of meals, meal variety, packaging and presentation, opportunities for nourishing snacks and pantry items, and social contact.

Effective elements of home-delivered meal services to improve energy and protein intake: A systematic review

Home-delivered meal services are an example of a nutritional intervention in the home setting developed to enhance dietary intake and contribute to the independence of especially older adults. There is a lack of evidence about the contribution of specific elements of any home-delivered meal service on the improved outcomes. Therefore, a systematic review was performed to evaluate which elements of home-delivered meal services are effective to improve energy and protein intake, nutritional status, functional outcomes and satisfaction in adults. Pubmed, Embase and Web of Science databases were searched for studies assessing energy and protein intake, nutritional or functional status, or satisfaction of these services. The quality of the studies was assessed using the Quality Criteria Checklist for Primary Research. Of 138 studies meeting the search criteria, 19 were included, none of which met the criteria to be rated as high quality. These studies show that various elements of home-delivered meal services such as Meals on Wheels providing protein-enriched bread or snacks in addition to meals or providing meals and snacks for whole days can improve outcomes such as energy and protein intake and satisfaction. A distinction can be made between services focusing on supporting homebound, essentially healthy, older adults and services aiming at the optimal, nutritional, transmural care for patients at risk for malnutrition. This review shows that various elements of these meal services can improve key outcomes. Following the rising interest and importance of these interventions, there is an urgent need to optimize such services to improve nutritional care at home regarding the increasingly limited time frame of admission in hospitals.

The Factors Influencing Meal Satisfaction in Older Adults: A Systematic Review and Meta-analysis

PURPOSE

The aim of this study was to identify factors influencing meal satisfaction in older adults.

METHODS

Authors searched four databases Ovid MEDLINE, Ovid EMBASE, the Cochrane Library, and KoreaMed using the following key search terms: "(elderly-mp. OR aged), AND (meal OR food OR eating OR feeding), AND satisfaction." Only articles published between January 1946 and May 2018 were considered. The preferred reporting items for systematic reviews and meta-analyses guidelines were adopted for quality assessment. The authors ultimately selected 7 of 1,695 references for review and meta-analysis.

RESULTS

A meta-analysis was conducted to determine the factors influencing meal satisfaction in older adults aged more than 60 years. The results showed that meal satisfaction was low when age increased and the individual was served frozen meals. Satisfaction with meals was high when food choices were available and individuals were served high-quality food and when the food smelled and tasted good or was personally tailored. Satisfaction was also high when individuals ate with their families. Moreover, meal satisfaction seemed to be influenced by physical health, whereas it did not show a significant correlation with mental health.

CONCLUSION

Intending to improve the quality of life of older adults by increasing their meal satisfaction, the authors pointed out factors that institutions should attend to when providing meals to older adults. To contribute to the lack of any existing conceptual and theoretical framework in this field, further steps to be taken by the authors shall involve concept analysis that would assist in building a conceptual framework.

An evaluation by elderly people living at home of the prepared meals distributed by their municipality - a study with focus on the Swedish context

Prepared meals distributed by municipalities is a service to elderly people, or persons with health related impairments, who live in their own home, have difficulties preparing their own food and cannot meet their food requirements in any other way. This study aimed to provide a brief picture of how elderly people living at home perceive the food they receive through their municipal food service and what is important to them. The data was collected using questionnaires. 274 out of 276 participants answered the questionnaire (n=173 women 62% and n=101 man 37%). The data was analyzed using Principal Component Analysis (PCA). The results showed that the elderly persons receiving meals through the service were often satisfied, especially with the size of the portions and the delivery time. Those who had been using the food delivery service for a longer time were not satisfied with the alternative dishes they were been offered. There was no significant difference between the views of either gender. Further, those who were receiving special food were, in general, unsatisfied with the meals delivered. Development of the food distribution service by systematic quality insurance and interactive knowledge exchange between the producers and consumers seems to be a way to promote a more holistic and individual adjusted service. Evaluation of the municipal FD service is a powerful tool that can contribute to the development of this service. The food service can be improved and consequently even the quality of life and health of its receivers. The present survey should be revisited and developed in order to detect differences between genders.

Service quality, satisfaction, and behavioral intention in home delivered meals program

This study was conducted to evaluate recipients' perception of service quality, satisfaction, and behavioral intention in home delivered meals program in the US. Out of 398 questionnaires, 265 (66.6%) were collected, and 209 questionnaires (52.5%) were used for the statistical analysis. A Confirmatory Factor Analysis (CFA) with a maximum likelihood was first conducted to estimate the measurement model by verifying the underlying structure of constructs. The level of internal consistency in each construct was acceptable, with Cronbach's alpha estimates ranging from 0.7 to 0.94. All of the composite reliabilities of the constructs were over the cutoff value of 0.50, ensuring adequate internal consistency of multiple items for each construct. As a second step, a Meals-On-Wheels (MOW) recipient perception model was estimated. The model's fit as indicated by these indexes was satisfactory and path coefficients were analyzed. Two paths between (1) volunteer issues and behavioral intention and (2) responsiveness and behavioral intention were not significant. The path for predicting a positive relationship between food quality and satisfaction was supported. The results show that having high food quality may create recipient satisfaction. The findings suggest that food quality and responsiveness are significant predictors of positive satisfaction. Moreover, satisfied recipients have positive behavioral intention toward MOW programs.