Addressing food insecurity and chronic conditions in community health centres: protocol of a quasi-experimental evaluation of Recipe4Health

Chronic conditions, such as diabetes, obesity, heart disease and depression, are highly prevalent and frequently co-occur with food insecurity in communities served by community health centres in the USA. Community health centres are increasingly implementing 'Food as Medicine' programmes...

Full description

Saved in:
Bibliographic Details
Published in:BMJ open 2023-04, Vol.13 (4), p.e068585-e068585
Main Authors: Rosas, Lisa G, Chen, Steven, Xiao, Lan, Emmert-Aronson, Benjamin O, Chen, Wei-Ting, Ng, Elliot, Martinez, Erica, Baiocchi, Mike, Thompson-Lastad, Ariana, Markle, Elizabeth A, Tester, June
Format: Article
Language:English
Subjects:
Blood pressure
Chronic Disease
Chronic illnesses
Clinical outcomes
Community Health Centers
Delivery of Health Care
Diabetes
Farms
Food
Food Insecurity
Food security
Fruits
Health behavior
Health facilities
Humans
Hypertension
Medicine
Mental depression
Mindfulness
Monetary incentives
Nutrition
Obesity
Patient satisfaction
Pharmacy
Prescriptions
Primary care
Public Health
Quasi-experimental methods
Socioeconomic factors
Citations: Items that this one cites
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Chronic conditions, such as diabetes, obesity, heart disease and depression, are highly prevalent and frequently co-occur with food insecurity in communities served by community health centres in the USA. Community health centres are increasingly implementing 'Food as Medicine' programmes to address the dual challenge of chronic conditions and food insecurity, yet they have been infrequently evaluated. The goal of this quasi-experimental study was to evaluate the effectiveness of Recipe4Health, a 'Food as Medicine' programme. Recipe4Health includes two components: (1) a 'Food Farmacy' that includes 16 weekly deliveries of produce and (2) a 'Behavioural Pharmacy' which is a group medical visit. We will use mixed models to compare pre/post changes among participants who receive the Food Farmacy alone (n=250) and those who receive the Food Farmacy and Behavioural Pharmacy (n=140). The primary outcome, fruit and vegetable consumption, and secondary outcomes (eg, food security status, physical activity, depressive symptoms) will be collected via survey. We will also use electronic health record (EHR) data on laboratory values, prescriptions and healthcare usage. Propensity score matching will be used to compare Recipe4Health participants to a control group of patients in clinics where Recipe4Health has not been implemented for EHR-derived outcomes. Data from surveys, EHR, group visit attendance and produce delivery is linked with a common identifier (medical record number) and then deidentified for analysis with use of an assigned unique study ID. This study will provide important preliminary evidence on the effectiveness of primary care-based strategies to address food insecurity and chronic conditions. This study was approved by the Stanford University Institutional Review Board (reference protocol ID 57239). Appropriate study result dissemination will be determined in partnership with the Community Advisory Board.
ISSN:2044-6055
2044-6055
DOI:10.1136/bmjopen-2022-068585