Planting Seeds for Food Is Medicine: Pre-Implementation Planning Methods and Formative Evaluation Findings From a Multi-Clinic Initiative in the Midwest.

IF 3 Q1 PRIMARY HEALTH CARE Journal of Primary Care and Community Health Pub Date : 2024-01-01 DOI:10.1177/21501319241241465
Marianna S Wetherill, Kristina M Bridges, Gabrielle E Talavera, Susan P Harvey, Brandon Skidmore, Elizabeth Stewart Burger
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Abstract

Food is medicine (FIM) initiatives are an emerging strategy for addressing nutrition-related health disparities increasingly endorsed by providers, payers, and policymakers. However, food insecurity screening protocols and oversight of medically-tailored food assistance programs are novel for many healthcare settings. Here, we describe the pre-implementation planning processes used to successfully engage federally-qualified health centers (FQHCs) across Kansas to develop new FIM initiatives. A Kansas-based philanthropic foundation facilitated pre-implementation planning for FQHCs over 17 months across 3 stages: 1) Community inquiry, 2) FIM learning event with invitation for FQHC attendees to request pre-implementation funding, and 3) Pre-implementation planning workshops and application assignments for FQHC grantees to develop a FIM implementation grant proposal. We evaluated satisfaction and perceived utility of these pre-implementation planning activities via post-workshop surveys and qualitative comparisons of FIM design components from pre-implementation and implementation grant applications. All 7 FQHCs attending the learning event applied for and were awarded pre-implementation planning grants; 6 submitted an implementation grant application following workshop completion. FQHCs rated pre-implementation support activities favorably; however, most clinics cited limited staff as a barrier to effective planning. As compared to pre-implementation planning grant proposals, all FQHCs elected to narrow their priority population to people with pre-diabetes or diabetes with better articulation of evidence-based nutrition prescriptions and intervention models in their final program designs. In the midst of a nationwide FIM groundswell, we recommend that funders, clinic stakeholders, and evaluators work together to devise and financially support appropriate pre-implementation planning activities prior to launching new FIM initiatives.

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播下 "食物即药物 "的种子:中西部多临床倡议的实施前规划方法和形成性评估结果。
食物即药物(FIM)倡议是一项新兴战略,用于解决与营养相关的健康差异问题,越来越多地得到医疗服务提供者、支付者和政策制定者的认可。然而,对于许多医疗机构来说,食物不安全筛查协议和医疗定制食物援助计划的监督都是新鲜事物。在此,我们介绍了在堪萨斯州各地成功吸引联邦合格医疗中心 (FQHC) 参与制定新的 FIM 计划时所采用的实施前规划流程。一家位于堪萨斯州的慈善基金会在 17 个月的时间里为联邦合格医疗中心的实施前规划工作提供了便利,共分为 3 个阶段:1) 社区调查;2) FIM 学习活动,邀请 FQHC 参与者申请实施前资助;3) 实施前规划研讨会,并为 FQHC 受资助者分配申请任务,以制定 FIM 实施资助提案。我们通过研讨会后调查以及对实施前和实施拨款申请中的 FIM 设计内容进行定性比较,评估了这些实施前规划活动的满意度和可感知的效用。参加学习活动的 7 家 FQHC 全部申请并获得了实施前规划补助金;6 家在研讨会结束后提交了实施补助金申请。联邦定点医疗保健机构对实施前的支持活动给予了较高的评价;但是,大多数诊所认为人员有限是有效规划的障碍。与实施前的规划赠款提案相比,所有的 FQHC 都选择将优先人群缩小到糖尿病前期或糖尿病患者,并在最终的计划设计中更好地阐述了循证营养处方和干预模式。在全国范围内掀起 FIM 热潮之际,我们建议资助者、诊所利益相关者和评估者共同努力,在启动新的 FIM 计划之前,设计并资助适当的实施前规划活动。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
4.80
自引率
2.80%
发文量
183
审稿时长
15 weeks
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