Community Cafes as a Health Promotion Model: Evidence on Food Security, Diet, and Social Well-Being

Purpose This study examined whether the frequency and duration of participation in community cafes—nonprofit, pay-what-you-can restaurants—are associated with food security, dietary improvement, and psychosocial well-being among adult patrons. Design Cross-sectional, multi-site observational study using an instrumental-variables regression framework to reduce selection bias. Setting Eleven community cafes operating under the pay-what-you-can model across the U.S. Sample The analytic sample included 137 adult patrons who had eaten at a cafe within the past month (65% female, 65.7% White). Measures Primary exposures were the frequency of cafe meals and the duration since first visit. Outcomes included food security (USDA six-item module), self-reported dietary improvement, social connectedness, and loneliness. Covariates included gender, race, and cafe site fixed effects. Analysis Two-stage instrumental-variable regression models used geographic distance as an instrument for cafe participation. Logistic regression estimated odds of food security, and linear models examined continuous outcomes ( P < 0.05). Estimates are interpreted as local effects for patrons whose participation is influenced by access. Results Longer duration since first cafe visit was associated with higher odds of being food secure (OR = 2.93, 95% CI = 1.21-7.09). No significant associations were observed for dietary or psychosocial outcomes. Conclusion Sustained engagement in cafes is associated with a greater likelihood of being food secure, indicating the importance of long-term participation in dignity-based health promotion strategies.