The Effectiveness of Recipe4Health: A Quasi-Experimental Evaluation.

IF 4.3 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL American Journal of Preventive Medicine Pub Date : 2024-11-02 DOI:10.1016/j.amepre.2024.10.020
Lisa G Rosas, Steven Chen, Lan Xiao, Mike Baiocchi, Elliot Ng, Benjamin O Emmert-Aronson, Wei-Ting Chen, Ariana Thompson-Lastad, Erica Martinez, Josselyn Perez, Eric Melendez, Elizabeth Markle, Marcela D Radtke, June Tester
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Abstract

Introduction: Food as Medicine is increasingly recognized as an important strategy for addressing the related challenges of food insecurity and nutrition-related chronic conditions. Food as Medicine refers to integration of food-based nutrition interventions into healthcare to prevent and treat disease. However, there is limited evidence to understand the effectiveness of Food as Medicine.

Methods: Recipe4Health, a comprehensive Food as Medicine program, was implemented in 4 Federally Qualified Health Centers in California for patients with food insecurity and/or nutrition-related chronic conditions. Patients were referred by a healthcare provider to a 'Food Farmacy' (16 weekly produce home deliveries) alone or in combination with a 'Behavioral Pharmacy' (16 weekly group visits). A quasi-experimental study with pre/post surveys (4 months) and propensity score matched controls for Electronic Health Record (EHR) outcomes over 12 months was conducted. Participants were 2,643 Recipe4Health patients and 2,643 controls identified from 1/2020 to 12/2022; data were analyzed from 2023-2024.

Results: There was a significant increase in produce consumption from baseline to four months (0.41 servings/day [0.11, 0.72], p=0.007) in the Food Farmacy in combination with Behavioral Pharmacy. Compared to controls, there were improvements in non-HDL cholesterol for the Food Farmacy alone (-17.1 mg/dl[-26.9, -7.2], p<0.001) and in combination with Behavioral Pharmacy (-17 mg/dl [-28.3, -5.8], p=0.003) at 12 months. Compared to controls, HbA1c significantly decreased in the Food Farmacy alone at 12 months (-0.37%, 95% CI [-0.65, -0.08]; p=0.01), but not the Food Farmacy with Behavioral Pharmacy.

Conclusions: Recipe4Health resulted in improvements in diet and multiple clinical health outcomes, such as non-HDL cholesterol and HbA1c.

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Recipe4Health 的有效性:准实验评估。
导言:人们日益认识到,"食物即药物 "是应对食物不安全和营养相关慢性病等相关挑战的重要战略。食物即医学是指将食物营养干预措施纳入医疗保健,以预防和治疗疾病。然而,目前了解 "食物即医学 "有效性的证据还很有限:方法:在加利福尼亚州的 4 个联邦合格医疗中心实施了 "健康食谱"(Recipe4Health)这一全面的 "食物即药物 "计划,该计划针对的是食物无保障和/或与营养相关的慢性病患者。患者由医疗服务提供者转介到 "食品农场"(每周 16 次农产品送货上门),或与 "行为药房"(每周 16 次小组探访)相结合。在为期 12 个月的研究中,我们进行了一项准实验研究,对电子健康记录(EHR)结果进行了前后调查(4 个月)和倾向得分匹配对照。研究对象为 2020 年 1 月 1 日至 2022 年 12 月 12 日期间确定的 2,643 名 Recipe4Health 患者和 2,643 名对照组;数据分析期为 2023 年至 2024 年:结果:从基线到四个月期间,"食品农场 "与 "行为药房 "相结合的农产品消费量明显增加(0.41 份/天 [0.11, 0.72],p=0.007)。与对照组相比,"美食农园 "单独使用时,非高密度脂蛋白胆固醇有所改善(-17.1 毫克/分升[-26.9,-7.2],P=0.007):Recipe4Health 改善了饮食和多种临床健康结果,如非高密度脂蛋白胆固醇和 HbA1c。
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来源期刊
American Journal of Preventive Medicine
American Journal of Preventive Medicine 医学-公共卫生、环境卫生与职业卫生
CiteScore
8.60
自引率
1.80%
发文量
395
审稿时长
32 days
期刊介绍: The American Journal of Preventive Medicine is the official journal of the American College of Preventive Medicine and the Association for Prevention Teaching and Research. It publishes articles in the areas of prevention research, teaching, practice and policy. Original research is published on interventions aimed at the prevention of chronic and acute disease and the promotion of individual and community health. Of particular emphasis are papers that address the primary and secondary prevention of important clinical, behavioral and public health issues such as injury and violence, infectious disease, women''s health, smoking, sedentary behaviors and physical activity, nutrition, diabetes, obesity, and substance use disorders. Papers also address educational initiatives aimed at improving the ability of health professionals to provide effective clinical prevention and public health services. Papers on health services research pertinent to prevention and public health are also published. The journal also publishes official policy statements from the two co-sponsoring organizations, review articles, media reviews, and editorials. Finally, the journal periodically publishes supplements and special theme issues devoted to areas of current interest to the prevention community.
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