2nd Edition of Public Health World Conference (PHWC) 2026

Abstract

Population aging has intensified the need for accessible, affordable, and nutritious community-based meal services for older adults. Community canteens for older adults have become an important component of China's home- and community-based eldercare system, yet many programs continue to face challenges related to service fit, sustainable operation, user retention, and equitable access. This study examined demand differentiation and service optimization strategies for community canteens in Nanjing, China, with the aim of generating evidence for more targeted and sustainable public health service delivery. A mixed-methods design was used. The study combined literature and policy review, semi-structured interviews with 50 older users, family caregivers, and service providers, online public opinion analysis of 3,776 social media comments using text mining and SnowNLP sentiment analysis, and a structured questionnaire survey conducted across 11 districts of Nanjing. A total of 1,650 valid questionnaires were collected. Among respondents who had heard of and used community canteens, 1,122 cases were further analyzed using K-modes clustering, random forest classification, structural equation modeling, and importance-performance analysis. The findings identified four demand segments: support-dependent users (29.10%), who were generally older, less mobile, more price-sensitive, and more reliant on family assistance; health-and-nutrition-oriented users (27.87%), who valued dietary balance and credible health information; quality-and-safety-oriented users (25.41%), who had stronger digital skills, higher willingness to pay, and greater concern for hygiene and service standardization; and convenience-and-efficiency-oriented users (17.62%), who prioritized time-saving, smooth payment, and rapid meal access. Random forest results suggested that digital capability, acceptable meal price, mobility condition, prior use frequency, education, pension level, payment method, family decision-making, and walking distance were key predictors of user segment membership. Structural equation modeling showed a significant stepwise pathway from awareness to interaction, use, and sharing, indicating that value recognition and communication experiences are critical bridges between service exposure and sustained use. Importance-performance analysis showed that food hygiene, transparent pricing, and pickup efficiency were current strengths, while food taste and staff attitude required priority improvement. Age-friendly environments and travel convenience showed segment-specific improvement needs. These results suggest that community canteens should move beyond uniform provision toward segmented, chain-oriented service design. Policy and operational strategies should combine affordability safeguards, nutrition communication, transparent food safety management, non-digital access channels, family-supported ordering, and efficient pickup or delivery mechanisms. The study provides empirical evidence for strengthening community nutrition support, healthy aging, and equitable access to eldercare services in urban China.