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Background <p>Food insecurity increases an individual’s risk of poor health outcomes from costly and preventable chronic diseases such as type 2 diabetes.</p> Methods <p>In this pilot study, primary care patients with self-reported food insecurity and a diagnosis of type 2 diabetes received 12 weekly home deliveries of fresh produce and shelf-stable foods. About half of the participants were also supported by a community health worker (CHW) providing nutrition education, cooking instruction, and resource linkages (Food + CHW). Participants (<i>n</i>=31) self-checked hemoglobin A1C, blood pressure, and weight on devices at home at three time points: baseline, three months, and six months.</p> Results <p>Participants (84% female, 32% Black, 66% White, 22% Hispanic, and 58 years old on average) had an average HbA1c of 8%. For the Food-only group (<i>n</i>=15), there was no significant change in hemoglobin A1c&#xa0;at either time point. For the Food + CHW group (<i>n</i>=16), the mean change in HbA1c was -0.85 (95% CI, [-0.048, -1.66], <i>P</i> value = 0.039) from baseline to 3 months and -1.65 (95% CI, [-2.84 – 0.472], <i>P</i> value = 0.012) from baseline to 6 months and a majority of participants (81%) had a reduction in hemoglobin A1c at six months. Diastolic blood pressure for the Food-only group increased by an average of 6.5 mmHg (<i>p</i>= 0.02) between baseline and 3 months but remained stable for the Food + CHW group. In both groups, systolic blood&#xa0;pressure and weight did not change significantly. Participants in the Food + CHW group reported significant increases in daily servings of fruit, nutrition label&#xa0;reading, eating meals cooked from scratch,&#xa0;and farmer's market&#xa0;shopping while the Food-only group did not.</p> Conclusion <p>These findings suggest that CHWs&#xa0;support a patient’s ability to reduce hemoglobin A1c through dietary behavior changes and&#xa0;sustain this reduction over time.​ This trial was retrospectively registered at ClinicalTrials.gov (NCT06476990) on June 20, 2024.</p>

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Food Rx + CHW: a community health worker-led medically tailored grocery intervention to address food insecurity and type 2 diabetes, a pilot randomized trial

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年2月16日

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  • Kristina M. Bridges,
  • Jennifer Woodward,
  • Megan Murray,
  • Alyssa Leibengood,
  • Leonidas Bantis,
  • Leny Montero,
  • Donna Young,
  • Manuel Solano,
  • Vanessa Camacho,
  • Angela McCall,
  • Debra K. Sullivan,
  • K. Allen Greiner

摘要

Background

Food insecurity increases an individual’s risk of poor health outcomes from costly and preventable chronic diseases such as type 2 diabetes.

Methods

In this pilot study, primary care patients with self-reported food insecurity and a diagnosis of type 2 diabetes received 12 weekly home deliveries of fresh produce and shelf-stable foods. About half of the participants were also supported by a community health worker (CHW) providing nutrition education, cooking instruction, and resource linkages (Food + CHW). Participants (n=31) self-checked hemoglobin A1C, blood pressure, and weight on devices at home at three time points: baseline, three months, and six months.

Results

Participants (84% female, 32% Black, 66% White, 22% Hispanic, and 58 years old on average) had an average HbA1c of 8%. For the Food-only group (n=15), there was no significant change in hemoglobin A1c at either time point. For the Food + CHW group (n=16), the mean change in HbA1c was -0.85 (95% CI, [-0.048, -1.66], P value = 0.039) from baseline to 3 months and -1.65 (95% CI, [-2.84 – 0.472], P value = 0.012) from baseline to 6 months and a majority of participants (81%) had a reduction in hemoglobin A1c at six months. Diastolic blood pressure for the Food-only group increased by an average of 6.5 mmHg (p= 0.02) between baseline and 3 months but remained stable for the Food + CHW group. In both groups, systolic blood pressure and weight did not change significantly. Participants in the Food + CHW group reported significant increases in daily servings of fruit, nutrition label reading, eating meals cooked from scratch, and farmer's market shopping while the Food-only group did not.

Conclusion

These findings suggest that CHWs support a patient’s ability to reduce hemoglobin A1c through dietary behavior changes and sustain this reduction over time.​ This trial was retrospectively registered at ClinicalTrials.gov (NCT06476990) on June 20, 2024.