Category: Social and Community Context

26 - Delivering More Than A Meal - An Integrated Approach to Improving Healthy Aging

Research has demonstrated that Meals on Wheels helps low-risk older adults age-in-community and out of costly nursing homes. These programs provide client-centered services that address the social determinants of health needs of the populations they serve. This poster will provide a conceptual framework, with supporting health and well-being outcomes data, outlining promising, evidence-based approaches to manage or avert the onset of chronic diseases and maintain physical functioning, through the integration of nutrition, socialization, safety, and care coordination services. Insights from Meals on Wheels programs and implications for service delivery will also be presented.

The core of the Meals on Wheels model is the meals and nutrition services delivered to seniors in both congregate- and home-based settings. Nutrition status changes as individuals age which can place them at risk of poor dietary intake. There are countless threats to nutrition status for older adults. Of chief concern are those with limited social supports who are less able to access in-home and community-based services that sustain health and independence. The association between senior isolation and negative health outcomes like chronic illness and mortality suggest that loneliness is a threat to aging in place. Meals delivered by friendly volunteers are often the only point of social contact for isolated seniors. Results from a recent randomized control trial (RCT) indicate that daily meal delivery significantly reduces the sense of loneliness among senior clients. Daily meal deliveries are also crucial to maintaining seniors’ safety as volunteers conduct environmental scans for personal and environmental hazards. The same RCT study found that for every three seniors with a history of falling, one additional fall could be prevented, on average, by providing daily meal deliveries. In addition, those who received daily delivered meals demonstrated improvements in well-being and quality of life. The presence of volunteers in the home is also leveraged to identify changes in client conditions that trigger care coordination, or referrals to other services in the community.

The body of More Than a Meal research contributes to the science of healthy aging by addressing current gaps in our understanding about how the alignment of home-and community-based services and healthcare can improve the health and well-being of community-residing older adults aging independently and in-place. 


Marci LeFevre

Senior Director, Care Coordination - Strategy and Impact
Meals on Wheels America
Arlington, Virginia

Marci LeFevre, Senior Director - Care Coordination Strategy and Impact, leads the development and implementation of the Meals on Wheels America strategy on Care Coordination, the emerging pillar of the More Than A Meal model. Ms. LeFevre develops information resources and programmatic tools to support the network of senior nutrition programs in addressing this issue, and develops and implements research projects that contribute to the literature and build the evidence base for the critical role of senior nutrition programs. She has extensive experience in the nonprofit sector developing education campaigns and social change programs designed to improve the health and well-being of older adults in community-based settings. Ms. LeFevre holds a Master of Arts in Public Policy with a concentration in Women's Studies from The George Washington University (Washington, D.C.), and a Bachelor of Arts in International Relations from The College of Wooster (Wooster, OH).

Elise Hernandez

Research and Analytics Manager
Meals on Wheels America
Arlington, Virginia

Elise's research focuses on social support and isolation among vulnerable older adults. With a background in social work and developmental psychology, her work employs quantitative and qualitative methods to both understand the challenges of maintaining supportive relationships across the life course and investigate the effectiveness of community-based solutions. Currently, Elise leads a portfolio of work aiming to expand and enhance socialization efforts among Meals on Wheels programs across the country. As the Research and Analytics Manager for Meals on Wheels America, she also serves to help build the knowledge and evidence base demonstrating the impact of senior nutrition services.

Uche Akobundu

Senior Director, Nutrition Strategy and Impact
Meals on Wheels America
Arlington, Virginia

Dr. Uche Akobundu is a Registered Dietitian and serves as the Senior Director of Nutrition Strategy, where she leads the development and implementation of the Association’s strategy on nutrition and malnutrition. This work includes the design and execution of projects that demonstrate and strengthen the evidence base for senior nutrition programs. In addition, she works collaboratively at the national level to build knowledge and skills among nutrition and aging professionals in the healthcare integration, business acumen development, program evaluation, and food service management arenas. She also serves as the director of the National Resource Center on Nutrition and Aging, awarded to Meals on Wheels America by the Administration for Community Living of the U. S. Department of Health and Human Services. Dr. Akobundu holds a Masters in Nutrition with a concentration in Public Health from the University of Massachusetts – Amherst, and a PhD in Nutrition from the University of Maryland - College Park.