Trial of Food Is Medicine Approaches for Obesity Treatment in Adults With Food Insecurity (EatWell Rx)
A Randomized Controlled Trial of Food Is Medicine Approaches for Obesity Treatment in Adults With Food Insecurity
The goal of this clinical trial is to learn if increased access to healthy foods, combined with behavioral weight loss (BWL) interventions, results in greater weight loss for adults with obesity and food insecurity. It will also learn about changes in health-quality of life and dietary quality. The main questions it aims to answer are:
- Does BWL, combined with either home-delivered, medically-tailored (HOME) groceries or grocery vouchers (VOUCHER), result in greater weight loss than BWL alone?
- Is the addition of HOME to BWL more effective at supporting adults with food insecurity and obesity to lose weight when compared to BWL and VOUCHER?
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Participants will:
- Receive 21 sessions of BWL over 52 weeks delivered 1-on-1 with a counselor
- Visit the research team for 4 in-person assessments to assess measures like height, weight, blood pressure, pulse, complete dietary assessments, questionnaires and interviews, and evaluate skin carotenoid levels (a non-invasive measure)
- Be randomized (like picking numbers from a hat) to BWL-Alone; BWL+VOUCHER; or BWL+HOME. Participants in BWL+VOUCHER will receive grocery store gift cards every 2 weeks for the first 24 weeks of the study. Participants in BWL+HOME will receive groceries delivered to the home every 2 weeks for the first 24 weeks of the study.
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Ariana M Chao, PhD, CRNP, FNP-BC
- Phone Number: 667-208-7078
- Email: ariana.chao@jhu.edu
Study Locations
-
-
Maryland
-
Baltimore, Maryland, United States, 21205
- Recruiting
- Johns Hopkins University
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- BMI>30 kg/m2
- Screening positive for food insecurity using the well-validated, 10-item US Adult Food Security Survey Module.
- Age 18 years and older
- Completion of baseline assessments
- Ability to engage in physical activity (i.e., can walk at least 2 blocks without stopping for rest)
- Willing and able to provide pictures of food receipts to study team (or mail receipts to study team)
- Willing and able to provide written informed consent and participate in all study activities
- Female participants of child-bearing potential must agree in writing to use an approved method of contraception during the study
Exclusion Criteria:
- Significant psychiatric conditions (e.g., active substance abuse, schizophrenia) that may pose a risk to the participant during intervention, cause a change in weight, or limit ability to adhere to the program's behavioral recommendations
- Pregnant or planning pregnancy in the next year
- Planned move from the Baltimore area in the next year
- Recently began a course of or changed the dosage of medication that can cause significant weight change (±5 kg)
- Previous or planned obesity treatment with surgery or a weight-loss device
- Weight loss of >5 kg in the previous 90 days
- Household member already participating in study due to potential contamination effects
- Lack of stable residence and ability to store and prepare food
- Lack of telephone
- Severe food allergies
- Following a specialized dietary regimen (e.g., gluten-free)
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 |
|---|---|
|
Active Comparator: BWL-Alone
Participants receive BWL-Alone
|
Participants will receive a lifestyle modification program consisting of behavioral, physical activity, and dietary counseling delivered over 21, approximately 15 minute sessions delivered by trained interventionists.
Sessions will be weekly during weeks 0-4, every other week during weeks 6-24, monthly during weeks 25-52.
Treatment will be delivered remotely.
|
|
Experimental: BWL+Voucher
Participants receive BWL+Voucher
|
Participants will receive a lifestyle modification program consisting of behavioral, physical activity, and dietary counseling delivered over 21, approximately 15 minute sessions delivered by trained interventionists.
Sessions will be weekly during weeks 0-4, every other week during weeks 6-24, monthly during weeks 25-52.
Treatment will be delivered remotely.
During the initial 24 weeks, participants randomized to this group will receive the BWL program along with food vouchers distributed in the form of grocery store gift cards.
Gift cards worth $60 will be emailed to participants every 2 weeks after their BWL session.
From weeks 24-52, participants will continue to have monthly counseling sessions.
|
|
Experimental: BWL+Home
Participants receive BWL+Home
|
Participants will receive a lifestyle modification program consisting of behavioral, physical activity, and dietary counseling delivered over 21, approximately 15 minute sessions delivered by trained interventionists.
Sessions will be weekly during weeks 0-4, every other week during weeks 6-24, monthly during weeks 25-52.
Treatment will be delivered remotely.
During the initial 24 weeks, participants assigned to this group will receive home-delivered, medically tailored groceries alongside BWL.
The contents of each box will be approximately $60 ($30/week) and sent using Instacart.
From weeks 24-52, participants will continue to have monthly counseling sessions.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Percent initial weight loss at week 24 (BWL+VOUCHER and BWL+HOME to BWL-Alone)
Time Frame: Baseline to 24 weeks
|
Comparison of BWL+VOUCHER and BWL+HOME to BWL-Alone for weight loss (percent of baseline weight) at 24 weeks
|
Baseline to 24 weeks
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Percent initial weight loss at week 24 (BWL+VOUCHER versus BWL+HOME)
Time Frame: Baseline to 24 weeks
|
Comparison of BWL+VOUCHER versus BWL+HOME for weight loss (percent of baseline weight) at 24 weeks
|
Baseline to 24 weeks
|
|
Percent initial weight loss at week 52 (BWL+VOUCHER and BWL+HOME to BWL-Alone)
Time Frame: Baseline to 52 weeks
|
Comparison of BWL+VOUCHER and BWL+HOME to BWL-Alone for weight loss (percent of baseline weight) at 52 weeks
|
Baseline to 52 weeks
|
|
Percent initial weight loss at week 52 (BWL+VOUCHER versus BWL+HOME)
Time Frame: Baseline to 52 weeks
|
Comparison of BWL+VOUCHER versus BWL+HOME for weight loss (percent of baseline weight) at 52 weeks
|
Baseline to 52 weeks
|
|
Change from baseline to weeks 24 and 52 in SF-36 Physical Component Score
Time Frame: Baseline to week 24 and week 52
|
BWL-Alone, BWL+VOUCHER, and BWL+HOME in changes from baseline to weeks 24 and 52 in SF-36 Physical Component Score.
Scores range from 0 (lowest) to 100 (highest/best).
|
Baseline to week 24 and week 52
|
|
Change from baseline to weeks 24 and 52 in SF-36 Mental Component Score
Time Frame: Baseline to week 24 and week 52
|
BWL-Alone, BWL+VOUCHER, and BWL+HOME in changes from baseline to weeks 24 and 52 in SF-36 Mental Component Score.
Scores range from 0 (lowest) to 100 (highest/best).
|
Baseline to week 24 and week 52
|
|
Change from baseline to weeks 24 and 52 in total Impact of Weight on Quality of Life scale
Time Frame: Baseline to week 24 and week 52
|
BWL-Alone, BWL+VOUCHER, and BWL+HOME in changes from baseline to weeks 24 and 52 in total Impact of Weight on Quality of Life scale.
Scores range from 0 (lowest) to 100 (highest/best).
|
Baseline to week 24 and week 52
|
|
Change from baseline to weeks 24 and 52 in total Healthy Eating Index score as measured using the Automated Self-Administered 24-Hour (ASA24) Dietary Assessment Tool
Time Frame: Baseline to week 24 and week 52
|
BWL-Alone, BWL+VOUCHER, and BWL+HOME in changes from baseline to weeks 24 and 52 in total Health Eating Index score.
Scores range from 0 (lowest) to 100 (highest/best which reflect the set of foods aligns with key dietary recommendations and dietary patterns published in the Dietary Guidelines).
|
Baseline to week 24 and week 52
|
|
Change from baseline to weeks 24 and 52 in skin carotenoid levels as measured by the Veggie Meter
Time Frame: Baseline to week 24 and week 52
|
BWL-Alone, BWL+VOUCHER, and BWL+HOME in changes from baseline to weeks 24 and 52 in skin carotenoid levels with scores ranging from 0 (lowest) to 800 (highest)
|
Baseline to week 24 and week 52
|
|
Incremental cost-effectiveness per unit decrease in weight (kg)
Time Frame: Baseline to week 24 and week 52
|
This measure describes the additional cost required to achieve one kilogram of weight loss with BWL+VOUCHER or BWL+HOME compared with BWL-Alone.
It is calculated by dividing the difference in total costs between the two groups by the difference in average weight loss.
Lower values indicate that the intervention achieves weight loss at a lower cost.
|
Baseline to week 24 and week 52
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Ariana Chao, PhD, CRNP, FNP-BC, Johns Hopkins University
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
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
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- IRB00528955
- R01NR021699 (U.S. NIH Grant/Contract)
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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