“It’s Not Just a Simple Meal. It’s So Much More”: Interactions Between Meals on Wheels Clients and Drivers

Abstract

Background and Objectives:

Meals on Wheels (MOW) programs provide home-delivered meals to over 1.5 million older adults; yet, very little is known about the drivers who make meal deliveries possible. Specifically, we do not have clear insight into their interaction with clients or the benefits that they may receive through their service. The objective of this article is to describe the characteristics of MOW drivers, the interactions among drivers and clients, and the benefits of the program to both.

Research Design and Method:

This qualitative research study reports on interviews with 84 MOW staff (leadership, case managers/client assessors, volunteer coordinators) and drivers at six geographically and operationally distinct programs across the United States.

Results:

Qualitative analysis of the interviews with MOW staff and drivers revealed the following key themes: (a) clients have multiple vulnerabilities; (b) clients appear to derive social, as well as nutritional benefit from receiving meals; (c) drivers report they provide additional support to their clients beyond delivering the meal; (d) social bonds between drivers and clients were reported to strengthen over time; (e) drivers claim that they, too, derive validation and personal benefit through their meal delivery.

Discussion and Implications:

This research highlights the significant contributions that meal delivery drivers made in the lives of MOW clients beyond the actual meal itself. This research also spotlights the perceived benefits experienced by the drivers and points to the importance of conducting further research to determine the effects of meal delivery on client and drivers’ outcomes, more broadly.

Introduction

There are close to 50 million seniors (age 65 and older) in the United States (U.S. Census Bureau, 2017) an estimate that is expected to nearly double by 2050 (Ortman, Velkoff, & Hogan, 2014). Among those age 65 years and older, approximately 2 million are considered homebound and are characterized by multiple chronic conditions, functional impairments, and high levels of frailty (Ornstein et al., 2015). In addition to being medically complex, homebound older adults often require additional supportive services (e.g., nutrition services, transportation, personal care, etc.) to enable them to maintain their functional independence and remain in their homes and communities, where the majority of older adults prefer to reside (Keenan, 2010).

Since its initial implementation in the United States, the Meals on Wheels (MOW) network has become a major provider of nutrition and social services to homebound older Americans. With over 2 million paid employees and volunteers nationally, MOW programs provide home-delivered meals to over 800,000 individuals who might otherwise not be able to acquire and prepare their own meals or suffer from hunger and food insecurity (Meals on Wheels (MOW) America, 2017). While clients may pay privately for their meals, funding for meals and program operations comes primarily through other sources (e.g., Title III of the Older Americans Act, State general funds, Medicaid, charitable contributions). In addition to the nutritional benefits from the program (Gollub & Weddle, 2004; Sahyoun & Vaudin, 2014; Zhu & An, 2013), research has begun to establish the additional benefits that recipients of these programs recognize, including decreased rates of depression, loneliness, falls, and hospitalizations (Berkowitz et al., 2018; Thomas, Akobundu, & Dosa, 2016; Thomas, Parikh, Zullo, & Dosa, 2018; Wright, Vance, Sudduth, & Epps, 2015; Xu et al., 2010). Recipients of home-delivered meals also report very high levels of satisfaction with MOW services and indicate that it helps them to eat healthier foods, improves their health, and allows them to live independently and remain in their own home (Lloyd & Wellman, 2015; Mabli et al., 2017). As we learn more about the impact of these programs in participants’ lives, it becomes important to understand the mechanisms behind these various beneficial outcomes, particularly the role of the drivers who deliver these meals to clients daily.

Despite the network of more than 5,000 providers and the many communities served by meal delivery programs across the United States, very little is known about the drivers who make programs such as MOW possible. Specifically, we do not have a clear insight into the role of drivers in achieving the beneficial outcomes documented in the literature or the needs of clients that drivers are able to meet through their regular interaction. Furthermore, while previous research suggests that volunteerism has both tangible and intangible benefits for volunteers (Binder, 2015; Corporation for National and Community Service, Office of Research and Policy Development, 2007; Piliavin & Siegl, 2007), we do not have evidence of the benefits that MOW drivers may receive through their service. Therefore, the objective of this article is to describe the interactions of MOW drivers and their clients, and the perceived benefits of the program to the volunteers who make it possible.

Method

As part of the groundwork for a research initiative seeking to expand the scope of the home-delivered meal service, we conducted qualitative interviews with MOW staff and drivers at six geographically and operationally distinct sites around the country. These interviews were part of a larger study aimed to understand the organizational structure and operation of individual MOW programs, as well as perceptions and experiences of program leaders and drivers. This article explores the interview results to illuminate specific ways clients and drivers interact in the program.

Development and Testing of Interview Guides

Interview questions used with MOW staff (including leadership positions such as President or CEO, volunteer coordinators, and case managers/client assessors) and drivers (both volunteers and paid drivers) were developed into guides through several steps: interview questions were developed for each of the four roles (drivers, leadership, volunteer coordinators, and case managers/client assessors); interview questions were reviewed by the project team for comprehension and completeness; guides were then piloted at two MOW programs, and, by incorporating this feedback, were further refined for clarity.

The project team was comprised of individuals from Brown University, Meals on Wheels America, and West Health Institute. Among the larger team, there were two smaller teams: a qualitative team and a site visit team. The qualitative team designed the data collection instruments and analyzed the site visit data (including KST, EAG, RRS, and DMD), and the site visit team who conducted the site visits and interviews (including AMM). The site visit team was trained by the qualitative team. Training consisted of an in-person didactic session and participation in the first site visit. Specifically, the qualitative team observed 15 interviews with drivers and MOW staff. At the end of the first site visit, the qualitative team participated in a debrief with the site visit team about how interviews were conducted; team members advised and provided suggestions for future site visits, as well as discussed impressions of what was learned during the visit. The site visit team then conducted site visits and interviews at five additional study sites.

Data Collection

Site visits and semi-structured interviews were conducted by the site visit team between July 2016 and October of 2016 with staff and drivers at six MOW programs located across the United States. Our purposive sample (Curry & Nunez-Smith, 2015; Miles, Huberman, & Saldana, 2014) of sites was identified by Meals on Wheels America as part of a selection process for identifying potential sites for a pilot project to develop a mobile application for drivers to track changes in clients’ conditions. In order to ensure diversity, sites were selected based on staffing levels, volunteer capacity, current or potential partnership(s) with healthcare providers, and willingness to participate in on-site observations and interviews. Participating sites included MOW programs located in California, New Jersey, North Carolina, Ohio, Texas, and Wisconsin. The six programs served a mix of clients from different geographical areas: four programs delivered in rural areas, five programs delivered meals in suburban areas, and three programs delivered in urban areas. The total annual organizational budget for these programs ranged from US$340,000 to US$6.6 million and the programs served anywhere from an estimated 71,000 meals annually to 925,000 meals. The majority of clients served by these programs was over the age of 60 (ranging from 84% to 99% aged above 60 years). Four of these programs received Title III Older Americans Act funding for the meals. Five of the programs delivered 5 days a week and one program offered meals six or more days a week. One program relied exclusively on paid drivers, one program relied only on one paid driver for their rural route, and two programs had less than five paid drivers to supplement their primarily volunteer-run (100+ volunteers) programs.

Within these programs, MOW staff participants were identified based on job descriptions and selected in an effort to understand their respective responsibility for the following job duties: overall planning and management of the MOW program, client intake and assessment, and coordination of volunteer recruitment, management, and training. Staff filling these positions were invited to participate in the interviews. For each site, eight to 10 drivers with at least 6 months of experience delivering meals were recruited for participation. Site visits and interviews occurred across 2 days per site and were led by at least two members of the site visit team. The analytic sample consists of 84 participants and includes senior leadership, staff (coordinators, client assessors/case managers), and drivers (paid and volunteer). Individual interviews took place in a private setting, each lasting approximately 30 to 45 minutes. Written consent to be interviewed and recorded was obtained from participants. Participants were instructed that they were free to decline to be interviewed and/or end the interview at any point.

Following each site visit, the site visit team participated in a debrief with the entire project team to review field notes and observations. Notes and observations were used to develop detailed summaries that were shared and discussed with the qualitative team and incorporated into the study audit trail (Curry & Nunez-Smith, 2015; Holloway & Wheeler, 1996; Lincoln & Guba, 1985; Miles et al., 2014; Ritchie & Lewis, 2012). The study protocol was approved by the Western IRB and the qualitative data analysis was deemed exempt by the Brown University IRB.

Analysis

Interviews from each of the sites were transcribed by an independent party and sent to the qualitative team for review. Upon receipt, each transcript was individually read and coded by at least two of the qualitative team members using a thematic approach suggested by Crabtree and Miller (1999). As part of the pilot testing, a thematic coding matrix was developed and vetted by the qualitative team with input from the larger project team. Refinements of the coding structure were made iteratively as analysis proceeded and codes were added and modified; these modifications were recorded in the audit trail.

Upon completion of the initial transcript review, two members of the qualitative team met to discuss and reconcile their individual coding. These pairs rotated throughout the study. Discrepancies in coding were discussed until a reconciled agreement was reached. Discrepancies that could not be reconciled were brought to the qualitative team meeting held at bimonthly intervals. Coded data were described, sorted, and managed using NVivo software. The steps undertaken to ensure the credibility of the data included: the audit trail that outlined ongoing ideas about codes and emerging themes; ongoing discussion about themes during the bimonthly meetings of the four qualitative team members; seeking and discussing alternative explanations of the data as needed, including disconfirming evidence for each potential theme; and themes were discussed with the site visit team during monthly project team meetings to vouch for the accuracy of the portrayal.

Results

A total of 84 subjects were interviewed across the six sites. Drivers comprised the majority of respondents (n = 47, 56%). While the demographics of participants were not queried, we did ask drivers to share about their experience with MOW and how long they had been delivering meals. Interviews with drivers and MOW staff across the six sites found that drivers varied significantly in terms of their length of tenure and age. For example, it was reported that whereas some volunteers have only delivered meals for a short period of time, others have been delivering meals for many years. One organization stated it provides awards for volunteers who reach 30 and 35 years of service. In addition, drivers ranged in ages, as reported by one individual,

We have all types of volunteers. We have some that are, of course, retired. We have some that are stay at home moms. Home school moms … People who are employed and, and do it at their lunchtime; we just have a broad range of different volunteers that we work with on a day to day basis.

Analysis of the interviews with MOW staff and drivers revealed the following key themes: (a) clients have multiple vulnerabilities; (b) clients appear to derive social, as well as nutritional benefit from receiving meals; (c) drivers report they provide additional support to their clients beyond delivering the meal; (d) social bonds between drivers and clients were reported to strengthen over time; (e) drivers claim that they, too, derive validation and personal benefit through their meal delivery. Each theme is discussed below with representative quotes from participants.

Drivers Report Clients Have Multiple Vulnerabilities

A general theme reported by drivers and staff was discussion about the vulnerabilities of the population of clients who receive services from MOW. Drivers consistently noted that MOW clients are homebound, lack social support, have physical disabilities or decreased functional capabilities, suffer from economic hardship, are single, live alone, and are lonely or isolated. As indicated by one driver from Texas:

The majority of [MOW clients] cannot drive. They cannot go out to eat … Even if it’s not their legs, a lot of times they may have arthritis in their hands and can’t cook … That’s the majority of them. Others are due to economic hardships. They don’t have money for groceries, things like that.

According to a driver from Wisconsin, MOW clients comprised “a lot of elderly shut ins.” Participants also mentioned the loneliness or isolation that many clients experience. As one driver from New Jersey said,

Many, many, many times we’re the only person some of these people see in a day.

The following theme describes additional benefits MOW clients are considered to obtain from the program.

Interview Participants Believe Clients Derive Social as well as Nutritional Benefits From Receiving Meals

Interview participants noted that clients received benefits beyond meal delivery from their MOW programs. Benefits included feeling safe, the ability to continue to live independently at home, companionship from drivers and MOW staff, and a healthy meal. As a MOW case manager from North Carolina noted,

[Clients] feel safe knowing that somebody does come and care, that they really care. And, that gives me a reward in knowing that at the end of the day, that we really save someone. We save them by allowing them to still live independently, and their dignity, you know, is still intact. And they might come to the door with a cane, but they came to the door and it’s their door.

A leadership person at the Ohio site reported,

A lot of people who have not received the service or provided the service thinks it’s just a simple meal coming to your home … and it is not just a simple meal. It is so much more. It’s that health check, that safety check … making sure that they’re okay.

Drivers also reinforced the idea that MOW allows clients to remain at home. As one Texas driver suggested, “A lot of them will tell me, ‘I just could not live alone if you weren’t bringing my meals to me.’”

When describing the meal delivery process, a driver from New Jersey said, “If you’re doing it right, it’s a lifeline” for the clients.

Drivers also discussed how clients looked forward to their weekday visit and the companionship that drivers provided. As one driver from California said, “By talking to them, I sense that I’m making their day.”

Another driver from Wisconsin suggested that because clients “probably don’t get to see their family often or maybe they don’t have family to visit them,” receiving meals “gives them a chance to see someone else … and that makes them happy.”

Drivers and MOW staff uniformly agree that MOW provides more than just nutritional benefits to clients; as discussed in the next theme, this is largely because drivers do more than just deliver the meal to their clients.

Drivers Provide Additional Support to Their Clients Beyond Delivering the Meal

Drivers and MOW staff reported that much of the benefit that clients derive from the program is likely attributable to the additional services and support that drivers and the program provide clients. While some drivers did express that their role solely consisted of delivering the meal and exchanging brief pleasantries, the majority of drivers noted providing additional support to their clients beyond delivering the meal. For example, according to MOW staff, drivers do a number of things around the house to help clients. A case manager from Texas said,

Oh I love our drivers, they’re great … And they do stuff that, I mean, whether it’s getting the mail, or taking out the trash, or you know like I have one client, the Friday driver every week puts him last on the list and cuts his front yard … there’s just little things out there like that. And there’s people that’s gone into homes and fixed air conditioners while they’re there. It’s just a matter of a switch or something that’s been, you know—simple, or the TV remote won’t work, and they fix that for them, or … What’s the number I’m supposed to call if, you know. If they didn’t have that person to person contact they would, sometimes they wouldn’t even know to do that.

Drivers also reported noticing things around the house that could be remedied, and that they go above their standard duties to help. As one driver from Wisconsin recounted,

[A client] needed some furniture moved and she had the vacuum cleaner out. I said, ‘Why don’t I come back after I deliver the meal. I’ll take the last one, and then I’ll come back.’ And I moved her furniture and vacuumed for her … I’m happy to do it.

A driver from Texas shared an experience in which their contributions benefited the health and well-being of the client:

I had one little ninety something year old guy, sometimes he’d want me to fill his oxygen tank with water, you know, put water in the tank thing. One time his heating system wasn’t working properly. Well, it wasn’t on, because his niece was paying his bills and she forgot to pay his bill I guess. So I had to call the electric company and tell them, I said, ‘This gentleman is 93 years old, he can’t be in this house in the dead of winter without his heat. I said, so, evidently his niece forgot to pay the bill but you guys have to turn his electricity back on because, in the meantime, he can’t be in this house and not have some heat.’ And they did, they came out that afternoon and turned it back on. And I called his niece and left her a voice mail because she didn’t answer. And told her, you know, to make sure she paid his bill because they had turned off his utility. And so, she did. She took care of it. The next time I went everything was working. I had called him a couple of times during that week to make sure everything was going okay.

Similarly, a driver from NJ shared his perspective about the additional services he provided:

There was sometime during the summer, her [94-year old woman’s] apartment was beastly hot, and I kind of waited a few minutes to see if she was going to ask me to help because I didn’t want to impose, but then she said, “It’s really hot in here, and someone is not helping me with the air conditioning. Will you?” So I did. I was happy about that. I stayed for a few minutes. The air kicked on. I knew it was going to get better for her. I didn’t want to leave. I think it was 84 degrees in her apartment.

The additional support that drivers provide was not always tangible but was considered no less important. The social interaction afforded by the quality time and visits from drivers was also considered a benefit to clients. As one driver from Wisconsin said,

I also really like the one-on-one interaction; and, I’m very well aware that for some of these folks I’m probably the only human contact they get for a day … You can kind of tell when somebody wants to have a little conversation or something. I always kind of stick back for a couple moments and just kind of chat with them.

Drivers also displayed other forms of support. For example, a case manager from North Carolina reported that their volunteers “will go out and deliver and they’ll pray with people.”

Therefore, we learned from participants that clients not only receive direct support from drivers, but considerable emotional support as well. As is discussed in the next theme, this emotional support is reported to strengthen over time.

Drivers’ Social Bonds With Clients Were Reported to Strengthen Over Time

As an example of helping to strengthen social bonds, we heard from drivers and staff that the benefits to clients increase as drivers develop relationships with clients over time. As one California driver said,

You get to know all of your people. You see them once a week for months and months and months and months and you know how they’re doing, you ask them how they’re feeling.

Drivers also reported that through their frequent interactions, they have gotten to know the clients. For example, one long-term driver from Texas said,

I have folks on my route that I’ve seen every week for four years. So we give them Christmas gifts, which is fabulous … my wife makes a banana bread and we give banana bread out for their birthday. And then we do something on Thanksgiving too, so yeah, I mean, you get kind of a relationship built up with them.

Drivers noted that their enduring relationship and knowledge of the clients over time helped them identify safety issues and notice a worrisome change; this knowledge of changes over time provided additional benefit to clients. One Wisconsin driver reported,

“You get to know the people on your route … as you get to know the people, you can tell just from talking to them for a few minutes, whether they’re doing well or not doing well.” The driver added that if the client needs anything, they call the program staff and the clients “get service either here or get referred to whomever can help them.”

Another driver from Texas referenced a similar sentiment:

When you do the same people over, and over, and over, you can see things change. You can see their mental capacity sometimes change, which you really don’t want to see, but you see that. Then, sometimes you can see the house. Something is wrong, and so you come back, and get a, get a caseworker there, to take care of that.

Such findings suggest that the relationship that develops between the MOW driver and the client benefits clients in multiple ways beyond the meal.

Drivers Obtain Their Own Benefits Through Meal Delivery

Although we expected that clients would derive additional benefits from the relationship with drivers beyond the meal, the frequency with which drivers mentioned that they, too, expressed gratification from interactions with clients was unexpected. For example, drivers indicated that delivering meals made them feel fulfilled and provided an opportunity to give something back to their community. As one driver from North Carolina said,

I deliver Meals on Wheels because I always feel great after delivering a meal … And it inspires me to do more. And that’s the clincher right there, that it’s the right thing to do … This is the most basic thing you can do, give food to somebody and them say something back to you. It doesn’t get any more basic than giving food to somebody.

A driver from California shared a similar sentiment “I wanted something that was fulfilling when I retired, and so I do enjoy this because of that.”

Another driver from California noted that the opportunity to deliver meals was, “just very rewarding work, and I feel like I’m giving something to the community, so it’s worth, very worthwhile.”

Drivers also derived value in recognizing how much their interaction added to their clients’ quality of daily life. One driver from Wisconsin said,

The most wonderful thing is I come up to a house and a lady comes there or a gentleman and they’ve been waiting because you’re the only person they’re going to see today. The only one they’re gonna talk to and it’s just nice to give them a smile, exchange a few words.

MOW staff confirmed that the MOW drivers develop meaningful relationships with their clients. For example, one case manager in Wisconsin shared that their drivers visit their clients even after meal service had ended, particularly, “if they have moved or been admitted to a hospital or rehab facility.” This participant added, “There’s so many of our volunteers that care about the clients. If we have somebody that does go into rehab or does go into assisted living, we speak with the family members to determine if a volunteer requests the information of where so and so is …” whether or not they want that information shared with drivers. The case manager reported that “generally they [the clients] want the volunteers and the staff to know where they’ve gone” and that the volunteers will go to visit the clients.

These results suggest that the benefit of home-delivered meals is likely to be shared by clients and drivers. As summed up by one driver from New Jersey, “I often say we get more out of delivering than we’re giving to the clients. We really, really do.”

Discussion

This research highlights the important contributions of drivers to recipients of meal delivery programs around the country: participants noted the perceived contributions that drivers made in the lives of MOW clients beyond the actual delivery of the meal itself. According to participants, benefits included the comradery fostered by regularly scheduled visits, a perceived reduction in clients’ social isolation, drivers’ ability to triage potential problems in a timely manner, and the importance of the “above and beyond” contributions they made to the lives of those receiving services. In addition, participants noted the profound vulnerabilities of older adults receiving home-delivered meals, including lack of social support, high rates of disability, and loneliness or isolation. We also heard for the first time the benefits that drivers derive from their work with MOW programs.

Previous research suggests that there are benefits to vulnerable seniors receiving home-delivered meals beyond the provision of services (Campbell, Godfryd, Buys, & Locher, 2015). For example, a prospective study of vulnerable older adults on waiting lists for home-delivered meals who enrolled in the MOW program found improved outcomes among clients, including reductions in loneliness and falls (Thomas et al., 2016; Thomas et al., 2018). The present study highlights potential causal mechanisms that might underlie the positive associations between home-delivered meals and clients’ outcomes, many of which may never be examined statistically due to lack of quantitative data detailing these interactions. In addition, the data provided by participants reinforces the notion that home-delivered meals provide more than nutritional assistance to clients. Furthermore, these findings provide additional support for the value of regular interactions between drivers and clients during meal delivery service.

Our study also found that drivers obtain positive outcomes from their role in delivering meals. This supports previous evidence that suggests volunteers derive benefits from volunteering (Binder, 2015; Corporation for National and Community Service, Office of Research and Policy Development, 2007; Piliavin & Siegl, 2007). As we found in the current study, several drivers noted that their relationship with their clients often deepened over time, resulting in social bonds that increased the benefits of the MOW service to the drivers themselves. Important benefits noted by drivers included the increased validation that they felt for their efforts to deliver meals and an overall increase in their significance to their clients’ lives.

This research suggests the perceived utility of meal delivery programs to their drivers and clients. It goes beyond existing literature in highlighting examples of varied ways drivers and clients benefit by the service and are enriched by it. How MOW staff and drivers express their experiences, perceptions, and responses to the program in their own words adds flesh and credibility to why the program is meaningful to them. In addition, these findings further support the documented benefits of MOW programs and their sustainability.

Strengths of this research include the large sample size for a qualitative study and the variability in site characteristics, ranging from urban to more rural and larger to smaller programs. Furthermore, rigorous qualitative research and analysis steps, such as the careful team approach of independent coding and group reconciliation, were undertaken to enhance the credibility of the findings. However, there are some limitations to note regarding this study. Though care was taken to select sites of various compositions and across the country, sites were selected as part of a larger effort to implement an electronic assessment tool for drivers. Therefore, these findings are cross sectional and may not be generalizable to all MOW sites. Nevertheless, care was taken to include subjects from urban/rural sites in addition to large/small programs. Likewise, comments by drivers and staff cannot be generalized to all MOW drivers, staff, and clients. Though we took care to select drivers at random, it is possible that self-selection bias may have contributed to a driver sample that was more strongly positive and enthusiastic than other drivers in these programs who did not participate. In addition, the perspectives shared about the characteristics of clients and benefits of the program to them are limited by the fact that they come from drivers and staff only. Though this was the intention for the present research, future research is needed that includes the voices of clients to better understand their characteristics as well as their interactions with drivers and value they place on that relationship. Nonetheless, there has been little formal work conducted on the interaction between MOW drivers and their clients; therefore, this research is a significant contribution despite these limitations.

Implications for Future Research and Practice

The findings of this qualitative study suggest the importance of conducting additional research to further describe and quantify the effects of meal delivery on the lives of clients who receive this important service. Our study suggests the regular contact, safety check, relationships that are established, and additional assistance provided by drivers may be underlying mechanisms driving home-delivered meals’ effects on clients’ overall well-being. Further work is needed to establish which elements of the interaction are resulting in positive outcomes for these homebound older adults. In addition, the findings from this study yield an important first look into the benefits of meal delivery programs to drivers. It sets the stage for follow-up work to better understand the elements of the role that facilitate positive experiences. This and future work could be useful in informing or adding to existing theory about retirement, volunteerism, and roles. Further understanding the mechanisms behind the benefits experienced by drivers could inform efforts to increase volunteer recruitment and retention in this and other settings. For example, community-based service organizations could highlight the social value that volunteers may receive in any recruitment efforts. In addition, programs may tailor volunteer training on ways to best engage and build rapport with clients given the benefits this study suggests exists for both clients and drivers through establishment of these relationships. This work also supports initiatives to leverage the client and driver relationship and interaction as an opportunity to identify and address clients’ unmet needs. Given the reported social bond that drivers and clients describe, it sets the stage for additional interventions that capitalize on this unique and valuable relationship.

Conclusion

This research continues to build the evidence base that home delivered meals represent more than just the provision of food to a client. Rather, it benefits the client holistically. This research also spotlights the benefits experienced by the drivers themselves and points to the importance of conducting further research to determine the effects of meal delivery on client and drivers’ outcomes more broadly. These results provide insights that may aid organizations that help older community-dwelling adults recruit and involve staff and volunteers in ways that could benefit the organization as well as the clients.