Eat Well Produce Benefit for Diabetes and Food Insecurity
An Evaluation of Eat Well, a Produce Benefit, for Patients With Diabetes and At-risk for Food Insecurity
The goal of this clinical trial is to assess the impact of participation in Eat Well for diabetes patients who are at risk of food insecurity. The main questions it aims to answer are:
- whether there is a difference in Haemoglobin (Hb) A1c measurements and emergency department (ED) utilization between the Eat Well and control groups up to 18 months post-program completion.
- whether there are differences in cardiometabolic health-related outcomes for Eat Well participants.
Participants in the program will receive gift/debit cards for fruits and vegetables and educational nutrition materials. Researchers will compare Eat Well participants with those only receiving educational materials to see if there are differences in cardiometabolic health outcomes.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Connor Drake, PhD
- Phone Number: +1 919 724 2129
- Email: connor.drake@duke.edu
Study Contact Backup
- Name: Susan Spratt, MD
- Phone Number: +1 919 668 5360
- Email: susan.spratt@duke.edu
Study Locations
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North Carolina
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Durham, North Carolina, United States, 27708
- Duke University Health System
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Be active in the Duke Diabetes Registry in the past 12 months AND
- have had at least one outpatient A1c measurement AND
are at risk for food insecurity as defined by one of the following:
- answered often true or sometimes true on one or both of the food insecurity questions as part of the electronic health record social history section (Maestro Care/ Epic of Verona WI) OR
- answered hard or very hard to the financial stress question as part of the electronic health record social history section (Maestro Care/ Epic of Verona WI) OR
- has Medicaid as insurance payer OR
- lives in Area Deprivation Index (ADI) zip code of 7th decile or harder
Exclusion Criteria:
- none
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Eat Well
The experimental group will participate in the Eat Well Produce Prescription program, receiving an $80 monthly benefit for eligible produce for 12 months and diabetes education materials through email, including curated nutrition and diet information from the Diabetes Resource Page, consistent with standard of care at Duke University Health System.
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A program offered by Reinvestment Partners giving clients gift/debit cards that allow the purchase of WIC approved fruits and vegetables.
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No Intervention: Control
The control group will receive usual care (including diabetes educational materials) without the prescription benefit.
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change in HbA1C
Time Frame: 18 months pre program, during program enrollment, up to 12 months
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A measure of average blood sugar levels over the past 3 months.
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18 months pre program, during program enrollment, up to 12 months
|
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Change in number of ED Visits
Time Frame: up to 18 months pre program, during program enrollment, up to 12 months
|
Number of ED visits throughout the study period
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up to 18 months pre program, during program enrollment, up to 12 months
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change in weight
Time Frame: up to 18 months pre program, during program, and up to 18 months post program enrollment
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up to 18 months pre program, during program, and up to 18 months post program enrollment
|
|
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Outpatient visits
Time Frame: up to 18 months pre program, during program, and up to 18 months post program
|
Number of outpatient visits during the study period
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up to 18 months pre program, during program, and up to 18 months post program
|
|
Hospitalizations
Time Frame: up to 18 months pre program, during program, and up to 18 months post program
|
Number of patient hospitalizations during the study period
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up to 18 months pre program, during program, and up to 18 months post program
|
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Change in body mass index (BMI)
Time Frame: up to 18 months pre program, during program, and up to 18 months post program
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A measure of body fat based on height and weight.
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up to 18 months pre program, during program, and up to 18 months post program
|
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Change in cholesterol
Time Frame: up to 18 months pre program, during program, and up to 18 months post program
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Measure of lipids
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up to 18 months pre program, during program, and up to 18 months post program
|
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Medication adherence (proportion of days covered)
Time Frame: up to 18 months pre program, during program, and up to 18 months post program
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Medication adherence will be measured by linking EHR data with Surescripts e-prescription network data.
Surescripts facilitates medication refill information exchange between healthcare organizations and pharmacies.
Adherence will be calculated using the proportion of days covered (PDC) approach
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up to 18 months pre program, during program, and up to 18 months post program
|
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Change in number of diabetes and hypertension medications
Time Frame: up to 18 months pre program, during program, and up to 18 months post program
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Change in diabetes and hypertension medication numbers
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up to 18 months pre program, during program, and up to 18 months post program
|
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Change in blood pressure
Time Frame: up to 18 months pre program, during program, and up to 18 months post program
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Systolic and Diastolic blood pressure
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up to 18 months pre program, during program, and up to 18 months post program
|
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Change in HbA1C
Time Frame: 18 months post program
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A measure of average blood sugar levels over the past 3 months.
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18 months post program
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Change in number of ED Visits
Time Frame: 18 months post program
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Number of ED visits throughout the study period
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18 months post program
|
Collaborators and Investigators
Sponsor
Sponsor
Publications and helpful links
General Publications
- Rader A, Buckman C, Pignone M, German JC, Spratt SE, McPeek Hinz E, Brucker A, Hoeffler S, Kane RM, Drake C. Factors Associated with Produce Prescription Program Enrollment and Benefit Use Among Patients with Diabetes and At Risk for Food Insecurity. J Nutr. 2026 Apr 24:101548. doi: 10.1016/j.tjnut.2026.101548. Online ahead of print.
- Drake C, Buckman C, Brucker A, McPeek Hinz E, Pignone M, Shaikha H, Rader A, Granados I, Goldstein BA, Chamorro C, Hoeffler S, Wirth C, Spratt SE. Produce Prescription Subsidy for Patients With Diabetes: A Pragmatic Randomized Clinical Trial. JAMA Intern Med. 2026 Apr 1;186(4):416-424. doi: 10.1001/jamainternmed.2025.8008.
- Drake C, Granados I, Rader A, Brucker A, Hoeffler S, Goldstein BA, Chamorro C, Johnson F, Hinz EM, Bedoya AD, German JC, Hauser J, Thacker C, Spratt SE. Addressing cost barriers to healthy eating with Eat Well, a prescription produce subsidy, for patients with diabetes and at risk for food insecurity: Study protocol for a type 1 hybrid effectiveness-implementation pragmatic randomized controlled trial. Contemp Clin Trials. 2024 Oct;145:107655. doi: 10.1016/j.cct.2024.107655. Epub 2024 Aug 5.
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- Pro00112649
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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