Year of Publication



Public Health

Date Available


Degree Name

Master of Public Health (M.P.H.)

Committee Chair

Dr. Jerod Stapleton

Committee Member

Dr. Anne Ray

Committee Member

Dr. Caitlin Pope


The population of the United States of America is aging at a faster rate than ever before. More than 1 in 6 Americans are now 65 or older (The Washington Post, 2023). Since 2010, compared to people under 65, there has been close to a two-hundred percent increase in people 65 and above (The Washington Post, 2023). The rise in the aging U.S. population is due to increased life span and people living longer (U.S. Census Bureau, 2020). Furthermore, life expectancy for the total U.S. population is projected to increase by six years, from 79.7 in 2017 to 85.6 by 2060 (U.S. Census Bureau, 2020). Although the increase in life expectancy is due to improved food and nutrition for seniors, nonetheless, 5.5 million seniors (60 and up) and 3.8 million older adults (50-59) experienced food insecurity in 2021 (The State of Senior Hunger, 2021). As the U.S. population ages the need to reduce food insecurity experienced by older Americans therefore has become a current public health issue and a top priority for all of us at the Kentucky Health Department of Public Health, KDPH.

On behalf of the Kentucky Health Department of Public Health, KDPH, we propose the Meals on Wheels-Breathitt, a home-delivered meal service to reduce food insecurity for older Americans who are 65 and older and residing within these three settings: independent living, retired living, and the Breathitt County Senior Citizen Center. We plan to conduct a pilot study from January 2025 to June 2026 consisting of 100 older Americans 65 and older in Breathitt County, Kentucky to assess the effectiveness of the intervention Moreover, the pilot study will be based on three assessment points 1, 2, and 3. The Food Habits Questionnaire (FHQ) administered during assessment point 1 and assessment point 2 will be used for outcome evaluation assessing the effectiveness of the MOW-Breathitt program. The FHQ survey has evidence for being effective as an instrument and at assessing patterns of dietary behaviors. The reliability for the total scale score of the FHQ is a=0.73 (Birkett & Boulet, et al. 1995). Whereas the test-retest reliability for the total scale is also good (r=0.74) (Spoon, et al. 2002).

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