Evaluation of Medicaid Food & Nutrition Support Program for Pregnant Women

Evaluation of Medicaid Grocery Gift Cards & Nutrition Education Program for Pregnant Women on Maternal and Infant Outcomes

With funding from the Episcopal Health Foundation, the researchers will conduct a secondary data analysis to evaluate the impact of Driscoll Health Plan's Nurture program for pregnant members using claims data.

Study Overview

• Status: Active, not recruiting
• Conditions: Pregnancy Related; Nutrition, Healthy; Financial Gift
• Intervention / Treatment: Behavioral: Nurture program; Other: Regular benefits

Detailed Description

This record describes a quality improvement program (called "Nurture") piloted by Driscoll Health Plan, which included nutrition education and food purchase support offered to a subset of pregnant women aged 30 years and above and covered by the Medicaid Managed Care Organization (MCO) plan in their "STAR" and "CHIP" programs during October 2022 and July 2023.

Factor Health lab at Dell Medical School at the University of Texas at Austin will do a secondary data analysis to evaluate the impact of DHP's program.

Driscoll Health Plan (DHP) is a non-profit, community-based health insurance plan that provides coverage to South Texas and the Rio Grande Valley communities. Their insurance products include STAR Medicaid, STAR Kids, CHIP, and CHIP Perinatal.

With input from Factor Health lab at Dell Medical School, DHP introduced the Nurture program for its members as a quality improvement initiative, designed to expand members' access to nutrition education and food purchase support to improve health and pregnancy outcomes.

Nurture included up to 8 packages mailed every four weeks until the member reaches the end of pregnancy. Each package included USD $40 in the form of gift cards to a large-chain grocery store, a healthy eating information sheet selected from Brighter Bites (https://brighterbites.org/), a set of three recipes, and nutrition-related Frequently Asked Questions during pregnancy (in four out of the eight packages). Members also received two 30-minute nutritional consultations over the phone.

Members had the flexibility to opt out of the program at any time and discontinue receiving packages. Consultations were optional. If they opted out, they continued to receive the DHP benefits as part of their regular coverage.

• Study Type: Interventional
• Enrollment (Actual): 224
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Texas
    • Corpus Christi, Texas, United States, 78415
      • Driscoll Health Plan

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Member of Driscoll Health Plan
• Pregnant
• Aged 30 or older

Exclusion Criteria:

• Not a member of Driscoll Health Plan
• Not pregnant
• Younger than 30 years of age

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Nurture + regular benefits (exposed group); Monthly packages sent every four weeks until end of pregnancy with maximum of eight packages. Each package includes:US $40 grocery store gift card A healthy eating information sheet selected from Brighter Bites project. (https://brighterbites.org/).A set of three recipes. Nutrition-related Frequently Asked Questions (in four of eight packages).; Two 30-minute telephonic nutritional consultations. Designed by a Registered Dietitian Nutritionist (RDN) who trained a bilingual nutrition specialist to deliver the consultations. Topics revolved around healthy eating during pregnancy, such as food choices, portion sizes, budget-friendly shopping, food safety, and food preparation. No nutrition therapy advice to manage diseases was provided.; Regular benefits Includes regular healthcare services offered as part of the health plan coverage with Medicaid/CHIP.	Behavioral: Nurture program; Nurture Monthly Packages: Sent every four weeks until the member reaches the end of pregnancy (delivery or other reasons, e.g., miscarriage), with a maximum of eight packages. Each package includes:A US$40 gift card (2 x $20 each) to a grocery store.A healthy eating information sheet selected from Brighter Bites project (https://brighterbites.org/).A set of three recipes.Nutrition-related Frequently Asked Questions (included in four out of the eight packages).; Two 30-Minute Nutritional Consultations over the phone: Designed by a Registered Dietitian Nutritionist (RDN) who trained a bilingual nutrition specialist to deliver the consultations. Topics revolved around healthy eating during pregnancy, such as food choices, portion sizes, budget-friendly shopping, food safety, and food preparation. No nutrition therapy advice to manage diseases was provided.; Other: Regular benefits; Includes regular healthcare services offered as part of the health plan coverage with Medicaid/CHIP.
Active Comparator: Regular benefits (comparison group); Regular benefits Includes regular healthcare services offered as part of the health plan coverage with Medicaid/CHIP.	Other: Regular benefits; Includes regular healthcare services offered as part of the health plan coverage with Medicaid/CHIP.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Composite outcome 1: Adverse health events during pregnancy	Composite includes health claims (paid or non-paid) with codes related to: Gestational Diabetes Mellitus; Excessive weight gain during pregnancy; Pregnancy-associated hypertension	At pregnancy delivery
Composite outcome 2: Adverse health events at birth and newborn-related	Composite includes health claims (paid or non-paid) with codes related to: Pre-term birth (<37 weeks); Neonatal Intensive Care Unit (NICU); Small for gestational age; Large for gestational age; Stillbirths	At pregnancy delivery

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Emergency Department visits	Health claims with codes related to visits to emergency department.	At pregnancy delivery
Cost (outpatient)	Cost of outpatient services (e.g., primary care visits, screening) as available in paid health claims.	At pregnancy delivery
Cost (inpatient)	Cost of inpatient services (e.g., delivery) as available in paid health claims.	At pregnancy delivery
Cost (pharmacy/medication)	Cost of medication as available in paid health claims.	At pregnancy delivery
Cost (total)	Total cost of care as available in paid health claims.	At pregnancy delivery
Delivery mode (vaginal, C-section)	Health claims with codes related to mode of delivery.	At pregnancy delivery
Birthweight	Requested from hospital's electronic health records (as available)	At pregnancy delivery
Prenatal visits	Number of prenatal visits during study pregnancy	At pregnancy delivery
Gift card usage	Binary response was gift card fully used	30 days after inactive from program
Nutritional consults attended	Categorical description of nutritional consults attended, both/one/none	At pregnancy delivery

Collaborators and Investigators

• Sponsor: University of Texas at Austin
• Collaborators: Driscoll Health Plan

Publications and helpful links

Helpful Links

• Source of nutrition education materials included in the Nurture packages mailed to participants.

Study record dates

Study Major Dates

• Study Start (Actual): October 17, 2022
• Primary Completion (Estimated): July 1, 2024
• Study Completion (Estimated): August 1, 2024

Study Registration Dates

• First Submitted: April 11, 2024
• First Submitted That Met QC Criteria: April 15, 2024
• First Posted (Actual): April 16, 2024

Study Record Updates

• Last Update Posted (Estimated): June 18, 2024
• Last Update Submitted That Met QC Criteria: June 14, 2024
• Last Verified: June 1, 2024

More Information

Terms related to this study

• Keywords: nutrition education; telephone; medicaid; gift card; nutrition consultation; food purchase; recipe; health claims
• Other Study ID Numbers: STUDY00005622

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: No data will be shared with other researchers.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No