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
{"title":"The Effectiveness of Recipe4Health: A Quasi-Experimental Evaluation.","authors":"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","doi":"10.1016/j.amepre.2024.10.020","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>Recipe4Health resulted in improvements in diet and multiple clinical health outcomes, such as non-HDL cholesterol and HbA1c.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":null,"pages":null},"PeriodicalIF":4.3000,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"American Journal of Preventive Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.amepre.2024.10.020","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0
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.
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.