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Living Hungry Healthy Foods Prescription Program

27. října 2020 aktualizováno: Dariush Mozaffarian, Tufts University
This study is a pre/post, pilot evaluation of the 4-month, Living Hungry program for food-insecure patients with uncontrolled diabetes. The program provides free produce, whole grains and legumes to participants and their household every-other week, in addition, to nutrition education and glucose monitoring devices. The study is analyzing diabetes management indicators, including HbA1c, dietary quality, food insecurity, and medication adherence, plus health care utilization.

Přehled studie

Postavení

Dokončeno

Podmínky

Detailní popis

The Living Hungry Collaborative, in partnership with the South Florida Hunger Coalition, previously operated a pilot program, Fresh Food Farmacy, staged from June 1, 2018, to September 29, 2018. The program consisted of nine Eat Well Pop-Up Pantry events at the My Clinic in Jupiter, Florida, serving 104 patients and feeding approximately 300 people including their families. Each set of groceries contained two weeks' worth of "medically tailored" groceries for diabetic-friendly meals for food-insecure patients diagnosed with diabetes or prediabetes. All clients involved in the intervention were referred by staff at the same four clinics that will participate in this study: My Clinic, C.L. Brumback Clinic in Jupiter, Jupiter Medical Center, and FoundCare. The Living Hungry Collaborative has an ongoing program to further evolve and test the "Fresh Food Farmacy", renamed as the Healthy Food Prescription Program intervention in Palm Beach County, for food-insecure, diabetic patients.

In addition to receiving diabetic appropriate groceries at the former Fresh Food Farmacy events, clients will be engaged in diabetes education classes led by volunteer doctors and nurses, cooking demonstrations, shared meals, 1:1 and group coaching by nutritionists and dietitians on best choices from a menu for diabetics, and tasting new recipes with produce from the pop-up event. The pilot program allowed Living Hungry to fine-tune the patient referral process, distribution logistics, and establish strong partnerships required for the next phase of the program. However, gaps exist to understand the extent to which the program design is improving the health of the participating diabetic patients.

Living Hungry will partner with Tufts University to conduct an evaluation of this existing program on key health outcomes that concern the partner clinics, specifically: biomarkers including Hemoglobin A1C, BMI, blood pressure, lipid profile, health care utilization including medication use, hospitalizations, emergency department visits, and health care costs, plus dietary quality, food insecurity, medication use, and quality of life indicators. The study is a pilot evaluation, implementing a quasi-experimental, pre/post study design.

The Living Hungry Healthy Foods Prescription Program is a community-based program that will be available to individuals whether or not they participate in the evaluation by Tufts University. This program is using the same referral and data collections procedures as the pilot, which include having physicians at the partner clinics refer patients with HbA1C levels greater than 8.0 mmol/mol and who are food insecure to Living Hungry to participate in the program. In addition, Living Hungry will again collect data on HbA1c, BMI, blood pressure, lipid profiles, and distribute a survey to participants.

Typ studie

Intervenční

Zápis (Aktuální)

35

Fáze

  • Nelze použít

Kontakty a umístění

Tato část poskytuje kontaktní údaje pro ty, kteří studii provádějí, a informace o tom, kde se tato studie provádí.

Studijní místa

    • Florida
      • West Palm Beach, Florida, Spojené státy, 33401
        • Living Hungry

Kritéria účasti

Výzkumníci hledají lidi, kteří odpovídají určitému popisu, kterému se říká kritéria způsobilosti. Některé příklady těchto kritérií jsou celkový zdravotní stav osoby nebo předchozí léčba.

Kritéria způsobilosti

Věk způsobilý ke studiu

18 let a starší (Dospělý, Starší dospělý)

Přijímá zdravé dobrovolníky

Ne

Pohlaví způsobilá ke studiu

Všechno

Popis

Inclusion Criteria:

  1. Referred patient from one of four medical partners: My Clinic, C.L. Brumback Clinic, FoundCare and Jupiter Medical Center and has been a patient for at least one-year.
  2. Diabetic with A1C over 8.0
  3. Adults 18 years of age or older
  4. Food-insecure

Exclusion Criteria:

  1. Referred patients with HbA1c levels below 8.0 mmol/mol
  2. Minors
  3. Adults with severe mental illness who cannot provide informed consent, unless they have present a lawful caregiver or power of attorney.
  4. Anyone who does not plan on staying in West Palm Beach for the next 4 months.
  5. Pregnant women (can still receive services through the program but will not be included in the analysis)

Studijní plán

Tato část poskytuje podrobnosti o studijním plánu, včetně toho, jak je studie navržena a co studie měří.

Jak je studie koncipována?

Detaily designu

  • Primární účel: Podpůrná péče
  • Přidělení: N/A
  • Intervenční model: Přiřazení jedné skupiny
  • Maskování: Žádné (otevřený štítek)

Zbraně a zásahy

Skupina účastníků / Arm
Intervence / Léčba
Experimentální: Healthy Food Prescription
Participants receive services through the Living Hungry program for food insecure diabetic patients.
Participants will receive diabetic appropriate groceries, diabetes education classes led by volunteer doctors and nurses, cooking demonstrations, shared meals, 1:1 and group coaching by dietitians.
Ostatní jména:
  • medically tailored food

Co je měření studie?

Primární výstupní opatření

Měření výsledku
Popis opatření
Časové okno
Change in Hemoglobin A1c
Časové okno: pre/post change in HbA1c in participants from baseline to completion of the program at 4 months
will be measured by blood draws at first and last program event
pre/post change in HbA1c in participants from baseline to completion of the program at 4 months

Sekundární výstupní opatření

Měření výsledku
Popis opatření
Časové okno
Change in frequency of hospitalizations
Časové okno: pre/post change in hospitalizations in participants from baseline to one month after completion of the program
will be measured through surveys and data from electronic medical records
pre/post change in hospitalizations in participants from baseline to one month after completion of the program
Change in frequency of emergency department admissions
Časové okno: pre/post change in emergency department admissions in participants from baseline to one month after completion of the program
will be measured through surveys and data from electronic medical records
pre/post change in emergency department admissions in participants from baseline to one month after completion of the program
Change in total health care costs
Časové okno: pre/post change in total health care costs in participants from baseline to one month after completion of the program
will be measured through data from hospital records
pre/post change in total health care costs in participants from baseline to one month after completion of the program
Change in food insecurity
Časové okno: pre/post change in food insecurity in participants from baseline to completion of the program at 4 months
Food insecurity will be measured using the USDA 9-question food insecurity screener
pre/post change in food insecurity in participants from baseline to completion of the program at 4 months
Change in daily servings of fruits and vegetables
Časové okno: pre/post change in daily servings of fruits and vegetables in participants from baseline to completion of the program at 4 months
Will be assessed through a food frequency questionnaire modeled off the USDA FINI assessment tool
pre/post change in daily servings of fruits and vegetables in participants from baseline to completion of the program at 4 months
Change in daily servings of whole grains
Časové okno: pre/post change in daily servings of whole grains in participants from baseline to completion of the program at 4 months
Will be assessed through a food frequency questionnaire modeled off the USDA FINI assessment tool
pre/post change in daily servings of whole grains in participants from baseline to completion of the program at 4 months
Change in daily servings of lean proteins
Časové okno: pre/post change in daily servings of lean proteins in participants from baseline to completion of the program at 4 months
Will be assessed through a food frequency questionnaire modeled off the USDA FINI assessment tool and includes: nuts, seeds, legumes, poultry, and fish.
pre/post change in daily servings of lean proteins in participants from baseline to completion of the program at 4 months
Change in daily servings of sugary snacks and drinks
Časové okno: pre/post change in daily servings of sugary snacks and drinks in participants from baseline to completion of the program at 4 months
Will be assessed through a food frequency questionnaire modeled off the USDA FINI assessment tool and includes: sugar sweetened beverages, pastries, cookies, cakes, candy, and other sweets
pre/post change in daily servings of sugary snacks and drinks in participants from baseline to completion of the program at 4 months
Change in medication adherence
Časové okno: pre/post change in medication adherence in participants from baseline to completion of the program at 4 months
Measured as a composite score that will be assessed through a survey. Components include: frequency of sacrificing medication purchases for other household needs (such as food, utilities) and change in medication use.
pre/post change in medication adherence in participants from baseline to completion of the program at 4 months
Change in adhering to recommended diabetes management plan
Časové okno: pre/post change in in adhering to recommended diabetes management in participants from baseline to completion of the program at 4 months
Measured as a composite scale that will be assessed through a survey. Components include frequency in which participants followed the recommendations of their physicians to manage their diabetes.
pre/post change in in adhering to recommended diabetes management in participants from baseline to completion of the program at 4 months
Change in blood LDL level
Časové okno: pre/post change in systolic blood LDL levels in participants from baseline to completion of the program at 4 months
measured at first and last program event through a blood draw
pre/post change in systolic blood LDL levels in participants from baseline to completion of the program at 4 months
Change in systolic blood pressure
Časové okno: pre/post change in systolic blood pressure in participants from baseline to completion of the program at 4 months
measured at first and last program event
pre/post change in systolic blood pressure in participants from baseline to completion of the program at 4 months
Change in diastolic blood pressure
Časové okno: pre/post change in diastolic blood pressure in participants from baseline to completion of the program at 4 months
measured at first and last program event
pre/post change in diastolic blood pressure in participants from baseline to completion of the program at 4 months

Spolupracovníci a vyšetřovatelé

Zde najdete lidi a organizace zapojené do této studie.

Vyšetřovatelé

  • Vrchní vyšetřovatel: Dariush Mozaffarian, MD, DrPH, Tufts University Friedman School of Nutrition Science and Policy

Termíny studijních záznamů

Tato data sledují průběh záznamů studie a předkládání souhrnných výsledků na ClinicalTrials.gov. Záznamy ze studií a hlášené výsledky jsou před zveřejněním na veřejné webové stránce přezkoumány Národní lékařskou knihovnou (NLM), aby se ujistily, že splňují specifické standardy kontroly kvality.

Hlavní termíny studia

Začátek studia (Aktuální)

14. prosince 2019

Primární dokončení (Aktuální)

25. července 2020

Dokončení studie (Aktuální)

13. října 2020

Termíny zápisu do studia

První předloženo

16. prosince 2019

První předloženo, které splnilo kritéria kontroly kvality

17. prosince 2019

První zveřejněno (Aktuální)

19. prosince 2019

Aktualizace studijních záznamů

Poslední zveřejněná aktualizace (Aktuální)

28. října 2020

Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality

27. října 2020

Naposledy ověřeno

1. října 2020

Více informací

Termíny související s touto studií

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  • 13491

Plán pro data jednotlivých účastníků (IPD)

Plánujete sdílet data jednotlivých účastníků (IPD)?

Ne

Informace o lécích a zařízeních, studijní dokumenty

Studuje lékový produkt regulovaný americkým FDA

Ne

Studuje produkt zařízení regulovaný americkým úřadem FDA

Ne

Tyto informace byly beze změn načteny přímo z webu clinicaltrials.gov. Máte-li jakékoli požadavky na změnu, odstranění nebo aktualizaci podrobností studie, kontaktujte prosím register@clinicaltrials.gov. Jakmile bude změna implementována na clinicaltrials.gov, bude automaticky aktualizována i na našem webu .

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