Increasing senior citizen participation in a community-based nutritious meal program.
A cheap mailed gift menu beats home visits, radio spots, and phone calls for both recruiting seniors to community meals and keeping them there.
01Research in Context
What this study did
Researchers wanted more seniors to sign up for a free community meal program. They tried four outreach tactics: radio ads, home visits, phone calls, and a mailed menu of small gifts. Later they added on-site activities plus the same gift menu to keep people coming.
The team tracked how many seniors enrolled and how many kept showing up. They compared each tactic's cost to its payoff.
What they found
Home visits worked, but the mailed gift menu worked just as well and cost less. Once seniors were in, the same little incentives kept the once-a-month crowd coming back. Low-attenders tripled their visits when gifts were on the table.
How this fits with other research
Davison et al. (1984) ran the same play in a family clinic: a small discount co-pay lifted follow-up visits. Both studies show that tiny financial perks beat polite reminders.
Winters et al. (2026) later found the dark side—cash for HIV appointments halved no-shows, but attendance crashed the day payments stopped. Hamm et al. (1978) did not test fade-out, so keep an eye on maintenance if you copy the model.
Siegel et al. (1970) got there first: donated household items quintupled welfare-recipient meeting attendance. The core idea—trade something tangible for boots on the ground—has held for fifty years across seniors, patients, and job trainees alike.
Why it matters
If you run any adult program—clinic, day center, support group—skip the glossy flyers. Mail a stamp, a small gift card, or a coupon. One stamp can do the work of a staff visit at a fraction of the price. Just remember to plan how you will taper the incentive so the habit sticks after the goodies stop.
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02At a glance
03Original abstract
Two experiments were conducted to compare the effects of several prompting and reinforcement procedures on the participation of elderly citizens in a nutritious meal program. Experiment I employed a variation of the multiple-baseline design across three groups of approximately 60 households each. Elderly persons not previously participating in the program were introduced to the following conditions: (1) public service radio announcements for four weeks to advertise the meal program and the availability of free transportation, (2) a home visit that served as a personal invitation and a second prompt for participation, (3) a followup telephone call, and (4) an incentive menu for participation, which was sent through the mail. Results indicated that the home visits and incentives were both effective as recruitment procedures and superior to other conditions; however, incentives proved to be the most cost-effective intervention. Experiment II used a variation of the multi-element design to compare the effects of scheduled activities and incentives in maintaining higher levels of participation by those persons who had attended the meal program at least once in the past, but whose current rate of participation was low. Results showed that activities improved attendance levels somewhat and that incentives substantially increased the number of meal program participants. Data from these experiments thus indicate that relatively inexpensive procedures may be used effectively to increase the extent to which elderly persons make use of potentially beneficial community-based services.
Journal of applied behavior analysis, 1978 · doi:10.1901/jaba.1978.11-75