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Living Hungry Healthy Foods Prescription Program

27 oktober 2020 bijgewerkt door: 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.

Studie Overzicht

Toestand

Voltooid

Conditie

Gedetailleerde beschrijving

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.

Studietype

Ingrijpend

Inschrijving (Werkelijk)

35

Fase

  • Niet toepasbaar

Contacten en locaties

In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.

Studie Locaties

    • Florida
      • West Palm Beach, Florida, Verenigde Staten, 33401
        • Living Hungry

Deelname Criteria

Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.

Geschiktheidscriteria

Leeftijden die in aanmerking komen voor studie

18 jaar en ouder (Volwassen, Oudere volwassene)

Accepteert gezonde vrijwilligers

Nee

Geslachten die in aanmerking komen voor studie

Allemaal

Beschrijving

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)

Studie plan

Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.

Hoe is de studie opgezet?

Ontwerpdetails

  • Primair doel: Ondersteunende zorg
  • Toewijzing: NVT
  • Interventioneel model: Opdracht voor een enkele groep
  • Masker: Geen (open label)

Wapens en interventies

Deelnemersgroep / Arm
Interventie / Behandeling
Experimenteel: 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.
Andere namen:
  • medically tailored food

Wat meet het onderzoek?

Primaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Change in Hemoglobin A1c
Tijdsspanne: 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

Secundaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Change in frequency of hospitalizations
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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

Medewerkers en onderzoekers

Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.

Onderzoekers

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

Studie record data

Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.

Bestudeer belangrijke data

Studie start (Werkelijk)

14 december 2019

Primaire voltooiing (Werkelijk)

25 juli 2020

Studie voltooiing (Werkelijk)

13 oktober 2020

Studieregistratiedata

Eerst ingediend

16 december 2019

Eerst ingediend dat voldeed aan de QC-criteria

17 december 2019

Eerst geplaatst (Werkelijk)

19 december 2019

Updates van studierecords

Laatste update geplaatst (Werkelijk)

28 oktober 2020

Laatste update ingediend die voldeed aan QC-criteria

27 oktober 2020

Laatst geverifieerd

1 oktober 2020

Meer informatie

Termen gerelateerd aan deze studie

Andere studie-ID-nummers

  • 13491

Plan Individuele Deelnemersgegevens (IPD)

Bent u van plan om gegevens van individuele deelnemers (IPD) te delen?

Nee

Informatie over medicijnen en apparaten, studiedocumenten

Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel

Nee

Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct

Nee

Deze informatie is zonder wijzigingen rechtstreeks van de website clinicaltrials.gov gehaald. Als u verzoeken heeft om uw onderzoeksgegevens te wijzigen, te verwijderen of bij te werken, neem dan contact op met register@clinicaltrials.gov. Zodra er een wijziging wordt doorgevoerd op clinicaltrials.gov, wordt deze ook automatisch bijgewerkt op onze website .

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