Beyond food provision: a qualitative study of older adults’ participation and sustained engagement in community meal assistance services based on Andersen’s Behavioural Model

Background Community meal assistance services have emerged as an important initiative supporting community-based ageing support, contributing not only to improved nutritional status but also to enhanced social participation and overall well-being among community-dwelling older adults. However, qualitative evidence regarding older adults’ experiences of participating in community meal assistance services in China remains limited. Guided by Andersen’s Behavioural Model, this study aimed to explore older adults’ experiences of using community meal assistance services, identify factors influencing their continued participation, and examine their unmet needs and expectations regarding service provision. Methods Utilising Andersen’s Behavioural Model as a conceptual framework, this qualitative study recruited 16 older adults from four communities in three cities within Guangxi, China using purposive sampling. Semi-structured interviews were conducted, and data were analysed using reflexive thematic analysis. NVivo 14.0 software was used to support data organisation and coding. Results Analysis of the interview data revealed four themes: 1) lifestyle changes as catalysts for service engagement; 2) environmental support via resources and services; 3) moving from basic provision to multidimensional needs; 4) how service engagement facilitates transitions in lifestyle and needs. Conclusions The findings highlight that participation in community meal assistance services is closely associated with multiple factors, including individual needs, family support, service provision, and participation experiences. These services provide benefits that extend beyond nutritional support, contributing to social participation and overall well-being among older adults. Future service development should focus on strengthening the role of community meal assistance services as integrated community-based platforms that support ageing in place and healthy ageing, while remaining responsive to the evolving and multidimensional needs of older adults to encourage continued participation.