Experiences With a Combined Meal Delivery and Home-Based Exercise Intervention Among Homebound Older Adults

Background: Homebound older adults experience high rates of multimorbidity, frailty, and social isolation; yet few interventions target homebound older adults. We completed “Strength on Wheels”, a randomized controlled trial evaluating a nutrition and exercise intervention for homebound older adults that showed no differences in physical measures but improvements in loneliness for those in the exercise group. We now seek to understand their qualitative experiences with the intervention. Methods: This qualitative study analyzed free-text responses from biweekly surveys and an exit survey within the 12-week Strength on Wheels intervention, which combined home-delivered meals through Meals on Wheels with a home-based exercise program. Structured content analysis was used to identify prominent themes across participant comments. Results: Participants (N = 101, mean age 74 years) reported enjoying meals and engaging with the exercise materials, though many reported ongoing pain and concerns about falls. Experiences with a commercial activity tracker were mixed: some found it motivating, while others reported difficulty charging, interpreting icons, or keeping track of the device. Participants also identified additional supports, such as social engagement, cognitive activities, physical therapy, transportation, and home modifications, as important for maintaining independence. Conclusion: Future work should refine nutrition and exercise programs for homebound older adults to better address their complex needs and support independence at home.