Author:
Ranjit Nalini,Aiyer Jennifer N.,Toups Jack D.,Liew Esther,Way Kenia,Brown Henry Shelton,McWhorter John Wesley,Sharma Shreela V.
Abstract
Abstract
Background
Food prescription programs are gaining interest from funders, policy makers, and healthcare payers as a way to provide value-based care. A small body of research suggests that such programs effectively impact health outcomes; however, the quality of existing studies is variable, and most studies use small samples. This study attempts to address these gaps by utilizing a quasi-experimental design with non-equivalent controls, to evaluate clinical outcomes among participants enrolled in a food prescription program implemented at scale.
Methods
We completed a secondary analysis of participant enrollment and utilization data collected between May 2018 and March 2021, by the Houston Food Bank as part of its multi-institution food prescription program. Enrollment data was obtained from 16 health care partners and redemption data from across 40 food pantries in Houston, Texas. Our objective was to assess if program participation impacted multiple cardio-metabolic markers. Exposure was defined as any visit to a food pantry after receipt of prescription. Linear and logistic regression models were used to estimate change in outcomes by exposure status and number of food pantry visits.
Results
Exposed patients experienced a −0.28% (p = 0.007) greater change in HbA1c than unexposed patients, over six months. Differences across exposure categories were seen with systolic blood pressure (−3.2, p < 0.001) and diastolic blood pressure (−2.5, p = 0.028), over four months. The odds of any decline in HbA1c (OR = 1.06 per visit, p < 0.001) and clinically meaningful decline in HbA1c (OR = 1.04 per visit, p = 0.007) showed a linear association with visit frequency.
Conclusions
Our study of a large food prescription program involving multiple health care and food pantry sites provides robust evidence of a modest decline in HbA1c levels among participants. These results confirm that food prescription programs can continue to be effective at scale, and portend well for institutionalization of such programs.
Publisher
Springer Science and Business Media LLC
Subject
General Biochemistry, Genetics and Molecular Biology,General Medicine
Reference20 articles.
1. Gregory CA, Mancino L, Coleman-Jensen A. Food security and food purchase quality among low-income households: Findings from the national household food acquisition and purchase survey (FoodAPS), ERR-269 U.S. Department of Agriculture, Economic Research Service, August 2019.
2. Mofleh D, Ranjit N, Chuang RJ, Cox JN, Anthony C, Sharma SV. Association between food insecurity and diet quality among early care and education providers in the pennsylvania head start program. Prev Chronic Dis. 2021;18:E60.
3. Leung CW, Epel ES, Ritchie LD, Crawford PB, Laraia BA. Food insecurity is inversely associated with diet quality of lower-income adults. J Acad Nutr Diet. 2014;114(12 e2):1943–53.
4. Morales ME, Berkowitz SA. The relationship between food insecurity, dietary patterns, and obesity. Curr Nutr Rep. 2016;5(1):54–60.
5. Stinson EJ, Votruba SB, Venti C, Perez M, Krakoff J, Gluck ME. Food insecurity is associated with maladaptive eating behaviors and objectively measured overeating. Obesity. 2018;26(12):1841–8.
Cited by
5 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献