A Qualitative Study of Factors Influencing Food Choices and Food Sources Among Adults Aged 50 Years and Older During the Coronavirus Disease 2019 Pandemic.

BACKGROUND: The coronavirus disease 2019 pandemic affected food availability and accessibility for many older adults, especially those experiencing food insecurity. Food citizenship is a theoretical framework that encourages the use of alternate over industrial food sources and can characterize where foods are acquired and how food choices are made. OBJECTIVE: The purpose of this study is to explore how Iowans aged 50 years and older made choices about what foods to acquire and where to acquire foods during the coronavirus disease 2019 pandemic using food citizenship as a theoretical framework. DESIGN: We used in-depth interviews with Iowans aged 50 years and older (N = 60). PARTICIPANTS: We recruited respondents through Area Agencies on Aging, food banks, and food pantries. Individuals who contacted the research team, were aged 50 years and older, and spoke English were eligible. Half of the sample screened as food insecure. STATISTICAL ANALYSIS: We conducted a thematic analysis to identify recurring themes. RESULTS: Food costs, personal preferences, and the healthfulness of food were cited as the most influential factors. Respondents said that the pandemic had not changed how they make choices, but increased prices had made costs more salient. Respondents primarily got their food from industrial food retailers, government programs, or food pantries. More than half of the respondents also acquired food from an alternate food source, such as a farmers' market. Reasons for not using alternate food sources included cost and transportation barriers. CONCLUSIONS: It is essential to ensure that older adults have access to affordable, healthy foods, especially during crises such as the coronavirus disease 2019 pandemic. Alternate food sources provided supplementary, healthy food for many respondents, but there are opportunities to expand the use of these food sources. Incentivizing the use of alternate food sources through government programs and connecting the emergency food system to local producers could increase the consumption of healthy food.

Meeting Older Adults' Food Needs: Interviews with Area Agency on Aging Staff, Food Bank Staff, and Older Adults.

Area Agencies on Aging (AAAs) and food banks provide nutritious food for in-need older adults. The objective of this study was to identify successes, challenges, and opportunities associated with meeting the food needs of older adults. We used semi-structured telephone interviews with AAA nutrition staff (n = 5), food bank program coordinators (n = 5) and executives (n = 6), and older adults (n = 60) in Iowa. AAAs and food banks identified providing healthy food and client satisfaction as successes and funding and staff/volunteer capacity as challenges. Before the pandemic, the relationships between these organizations were limited, but both saw opportunities for collaboration. Older adults described coordination between AAAs and food banks during the COVID-19 crisis. AAAs and food banks play an important role in meeting older adults' food needs, but their effectiveness is limited by challenges related to funding and capacity. There is a need to identify feasible and sustainable strategies for collaboration past this crisis.

Virtual Delivery of Fresh Conversations, a SNAP-Ed Program: Participant Perceived Impact and Satisfaction.

This four-month study evaluated the virtual delivery of Fresh Conversations (FC). Participants were community-residing Iowans ages 60+ years. They were placed in one of four meeting groups based on location and participant preference: Zoom™, Adobe Connect®, group-based Zoom™ meeting, and teleconference. Participants were invited to complete a post-meeting online survey. Data analyses were completed using data from the first survey completed by each participant (n = 115). Descriptive statistics assessed response frequencies for all questions. Chi-Square and Mann-Whitney U tests assessed the differences between groups. Overall, participants were "satisfied/very satisfied" (72.1%), learned something new (85.2%), and intended to make behavior change (79.1%); no differences were detected by the group for satisfaction or reported impacts. Only 24.3% reported technical difficulties; the Adobe Connect® group reported the most difficulties (p = .004). These findings suggest virtual delivery of FC is well-received and perceived to be effective by participants.