{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:34:49Z","timestamp":1792787689934,"version":"4.5.0"},"reference-count":31,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Texas Christian University","id":[{"id":"https:\/\/ror.org\/054b0b564","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Am J Health Promot"],"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>This study examined whether the frequency and duration of participation in community cafes\u2014nonprofit, pay-what-you-can restaurants\u2014are associated with food security, dietary improvement, and psychosocial well-being among adult patrons.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Cross-sectional, multi-site observational study using an instrumental-variables regression framework to reduce selection bias.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Eleven community cafes operating under the pay-what-you-can model across the U.S.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Sample<\/jats:title>\n                    <jats:p>The analytic sample included 137 adult patrons who had eaten at a cafe within the past month (65% female, 65.7% White).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measures<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Analysis<\/jats:title>\n                    <jats:p>\n                      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 (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.05). Estimates are interpreted as local effects for patrons whose participation is influenced by access.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/08901171261473018","type":"journal-article","created":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T07:53:10Z","timestamp":1785225190000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Community Cafes as a Health Promotion Model: Evidence on Food Security, Diet, and Social Well-Being"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-6380-5664","authenticated-orcid":false,"given":"Xingguo","family":"Wang","sequence":"first","affiliation":[{"name":"Texas A&M University"},{"name":"Texas A&M AgriLife Research"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr","given":"Rodolfo","family":"Nayga","sequence":"additional","affiliation":[{"name":"Texas A&M University"},{"name":"Korea University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lori","family":"Borchers","sequence":"additional","affiliation":[{"name":"Texas Christian University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather","family":"Eicher-Miller","sequence":"additional","affiliation":[{"name":"Purdue University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5115-2341","authenticated-orcid":false,"given":"Rebecca A.","family":"Seguin-Fowler","sequence":"additional","affiliation":[{"name":"Texas A&M AgriLife Research"},{"name":"Texas A&M University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob","family":"Szeszulski","sequence":"additional","affiliation":[{"name":"Texas A&M University"},{"name":"Texas A&M AgriLife Research"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3160-3050","authenticated-orcid":false,"given":"Alexandra L.","family":"MacMillan Uribe","sequence":"additional","affiliation":[{"name":"Texas A&M University"},{"name":"Texas A&M AgriLife Research"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,28]]},"reference":[{"key":"e_1_3_7_2_2","volume-title":"Household Food Security in the United States in 2022","author":"Coleman-Jensen A","year":"2023","unstructured":"Coleman-Jensen A, Rabbitt MP, Gregory CA, Singh A. 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