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PurposeThis 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.DesignCross-sectional, multi-site observational study using an instrumental-variables regression framework to reduce selection bias.SettingEleven community cafes operating under the pay-what-you-can model across the U.S.SampleThe analytic sample included 137 adult patrons who had eaten at a cafe within the past month (65% female, 65.7% White).MeasuresPrimary 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.AnalysisTwo-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.ResultsLonger 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.ConclusionSustained 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.