Primary Care and Food Bank Collaboration to Address Food Insecurity: A Pilot Randomized Trial

Abstract

Food insecurity is common in the United States and linked to poor control of conditions influenced by diet. We conducted a pilot randomized trial to test whether a novel partnership between a primary care practice and a municipal food bank would improve control of type 2 diabetes among patients with food insecurity. Participants received food bank produce delivered twice monthly to the practice site, brief teaching from a food bank dietitian, and home-based education from a community health worker. After 6 months, glycosylated hemoglobin decreased (absolute change) by 3.1% in the intervention group vs 1.7% in the control group ( P = .012). Scores on Starting the Conversation–Diet, a brief dietary measure, improved in the intervention group by 2.47 on a 14-point scale ( P < .001). Body mass indexes (BMIs) were unchanged. In this early-stage study, onsite collaboration between primary care and a regional food bank generated clinically meaningful reductions in HbA1c and improvements in diet.

Screening and Referral Care Delivery Services and Unmet Health-Related Social Needs: A Systematic Review

“…All included studies (n = 35) had a screening and referral component and originated in the US ( Tables 1 and 2 ). Most screening and referral programs were implemented in pediatric clinics (n = 15) ( 21 , 26 , 29 , 30 , 34 – 37 , 39 , 43 , 47 , 49 , 50 , 54 , 55 ) and other primary care practices (n = 11) ( 22 , 23 , 25 , 27 , 28 , 31 , 32 , 38 , 40 , 41 , 53 ); the rest (n = 9) were in other settings ( 24 , 33 , 42 , 44 – 46 , 48 , 51 , 52 ). Included studies defined target populations by health conditions or behavioral risk factors (eg, patients with diabetes, or patients who smoke), and/or demographic characteristics (eg, age, sex).…”

“…The social needs addressed included education (eg, poor literacy, health education) ( 23 , 24 , 27 , 33 , 38 – 41 , 49 – 52 , 55 ), unemployment and income insecurity (eg, vocational training, financial burden) ( 23 , 24 , 26 , 31 , 33 , 36 , 38 – 41 , 43 , 48 – 52 , 55 ), food insecurity ( 22 – 24 , 26 , 28 , 30 , 31 , 35 – 41 , 43 , 45 – 47 , 49 – 51 , 53 – 55 ), housing insecurity (eg, poor housing conditions, homelessness) ( 23 , 24 , 26 , 29 , 31 , 35 , 36 , 38 – 41 , 43 , 49 – 52 , 55 ), interpersonal safety (eg, intimate partner violence) ( 21 , 24 , 32 – 36 , 38 , 39 , 43 , 44 , 49 , 55 ), transportation to health care site ( 24 , 31 , 35 , 39 , 41 , 50 , 51 , 55 <...>…”

The Mediterranean Diet in Osteoporosis Prevention: An Insight in a Peri- and Post-Menopausal Population

“…The score increased significantly (6.98 ± 1.74 vs. 7.53 ± 1.68, p < 0.001), and could be suggestive of an amelioration of dietary habits. Dietary screening and nutritional intervention have often been useful for the management of chronic conditions, such as obesity and diabetes, and to improve lifestyle [41][42][43]. In this population, the consumption of healthy food groups also increased, such as vegetables (p = 0.003) and nuts (p = 0.037), and the consumption of red and processed meats decreased simultaneously (p = 0.004).…”

Food Insecurity and Cardiometabolic Conditions: a Review of Recent Research

“…A pilot study of a medically tailored meal intervention found improved diet quality among individuals with type 2 diabetes and food insecurity [ 36 ]. Furthermore, a small randomized trial (n = 43 at follow-up) found a large decrease in hemoglobin A1c (1.4 percentage points, P = .01) with a collaborative primary care and food bank intervention [ 37 ]. However, a larger randomized trial (n = 568) of a combined food provision and diabetes self-management education intervention based at food pantries did not find a decrease in hemoglobin A1c (difference between intervention and control group 0.24 percentage points; 95% CI −0.09, 0.58), though it did find a reduction in food insecurity (risk ratio 0.85.…”