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Clinical Trials/NCT06784310
NCT06784310
Completed
Not Applicable

Feeding the Family: Nutrition Security Intervention to Improve Physical and Mental Health Among Low-resource Families

Alison Gustafson1 site in 1 country56 target enrollmentStarted: April 1, 2025Last updated:

Overview

Phase
Not Applicable
Status
Completed
Sponsor
Alison Gustafson
Enrollment
56
Locations
1
Primary Endpoint
Change in body mass index (BMI) percentile - child

Overview

Brief Summary

Food is Medicine for the whole will test an intervention which provides medically tailored meals, or grocery voucher cards, or a combination of these food and nutrition resources to a caregiver and children living in the household. The study will examine how providing healthy tailored food and nutrition services can improve health outcomes, such as blood pressure and cholesterol levels.

Detailed Description

The proposal addresses the key goals of Humana Foundation related to, "Effective and equitable interventions to increase access to healthy diets promoting physical & mental health benefits". The interdisciplinary team comprised of clinicians, researchers in public health, nutrition, mental health, and community partners will evaluate the effectiveness of a whole family nutrition security intervention to provide evidence supporting key policies on reimbursement of health-related social needs (HRSN) as a medically covered benefit. The study team will use a user-centered approach to examine how to engage the whole family in the short-term, while creating a sustainable model for clinic and community partnerships to use in the long-term. This proposal aims to answer the question "How can a food as medicine choice model with tailored dose improve health outcomes across the family?". To answer this question, investigators are proposing a pragmatic randomized control trial (pRCT) using a 2X2 factorial design among Medicaid families, adults with children ages 5-18, with an adult diagnosed with either hypertension or Type 2 Diabetes (T2DM), child has a BMI categorized as obese or overweight, and report being food insecure. The pRCT will take place in Louisville, Kentucky with University of Louisville Health as the clinic provider, in an urban setting with a high percentage of adults reporting race/ethnicity as Black or African American. The community partners are Dare to Care Food Bank as the medically tailored meal (MTM) provider, and Kroger Health/Soda Health as the grocery prescription provider (GP).

Study Design

Study Type
Interventional
Allocation
Randomized
Intervention Model
Parallel
Primary Purpose
Supportive Care
Masking
None

Eligibility Criteria

Ages
6 Years to 64 Years (Child, Adult)
Sex
All
Accepts Healthy Volunteers
No

Inclusion Criteria

  • Have at least one child ages 6-17, inclusive, living in the household with the adult at least 50% of the time
  • Diagnosis of stage 3 or 4 Hypertension in last 12 months, or diagnosis of T2DM in the last 12 months
  • Experiencing food insecurity as indicated by 2-item Hunger Vital Sign
  • English speaking
  • No plans to move from the area for at least 1 year
  • Willing and able to accept text messages
  • Free living to the extent that participant has control over dietary intake
  • Willing and able to provide written informed consent and participate in all study activities.

Exclusion Criteria

  • Participant in diabetes, nutrition, or weight research intervention in last 12 months
  • Considering bariatric surgery in the next year or prior bariatric surgery
  • Lack of safe, stable residence and ability to store meals
  • Lack of telephone which can receive text messages
  • Pregnancy/breastfeeding or intended pregnancy in the next year
  • History of malignancy, other than non-melanoma skin cancer, unless surgically or medically cured \> 5 years ago or in remission
  • Advanced kidney disease (estimated creatinine clearance \< 30 mL/min)
  • Known drug or alcohol misuse in the past 2 years
  • Known psychosis or major psychiatric illness that prevents participation with study activities
  • Intermittent use of medications (e.g., oral or intravenous glucocorticoids) that are likely to affect blood sugar.

Arms & Interventions

MTM (medically tailored meals)

Active Comparator

Fully prepared meals are delivered on a weekly basis, and tailored to specific health needs

Intervention: Medically Tailored Meals (Behavioral)

MTM (medically tailored meals)

Active Comparator

Fully prepared meals are delivered on a weekly basis, and tailored to specific health needs

Intervention: Nutritional Counseling (Behavioral)

GP (grocery prescription)

Active Comparator

cards are issued to each participant per month to be spent on eligible healthy food items

Intervention: Grocery Prescription (Behavioral)

GP (grocery prescription)

Active Comparator

cards are issued to each participant per month to be spent on eligible healthy food items

Intervention: Nutritional Counseling (Behavioral)

MTM + GP (medically tailored meals and grocery prescription)

Active Comparator

delivered weekly MTM meals and the GP monthly grocery funds

Intervention: Medically Tailored Meals and Grocery Prescription (Behavioral)

MTM + GP (medically tailored meals and grocery prescription)

Active Comparator

delivered weekly MTM meals and the GP monthly grocery funds

Intervention: Nutritional Counseling (Behavioral)

Nutrition Counseling

Placebo Comparator

30 minutes per week of nutrition counseling and assistance. This group will receive the Grocery Prescription package after the last set of study measures are completed

Intervention: Nutritional Counseling (Behavioral)

Outcomes

Primary Outcomes

Change in body mass index (BMI) percentile - child

Time Frame: Baseline, post intervention (week 12), and month 6

BMI percentile is automatically calculated in the Electronic Health Record (EHR) from height and weight using age- and gender-specific CDC growth charts

Change in body mass index percentile - adult

Time Frame: Baseline, post intervention (week 12), and month 6

BMI percentile is automatically calculated in the Electronic Health Record from height and weight

Change in systolic blood pressure - child

Time Frame: Baseline, post intervention (week 12), and month 6

blood pressure measurements will be taken from the electronic health record

Change in diastolic blood pressure - child

Time Frame: Baseline, post intervention (week 12), and month 6

blood pressure measurements will be taken from the electronic health record

Change in systolic blood pressure - adult

Time Frame: Baseline, post intervention (week 12), and month 6

blood pressure measurements will be taken from the electronic health record

Change in diastolic blood pressure - adult

Time Frame: Baseline, post intervention (week 12), and month 6

blood pressure measurements will be taken from the electronic health record

Change in Hemoglobin A1c - child

Time Frame: Baseline, post intervention (week 12), and month 6

A1c measures are collected at the clinic or affiliated lab and entered into the patient's EHR

Change in Hemoglobin A1c - adult

Time Frame: Baseline, post intervention (week 12), and month 6

A1c measures are collected at the clinic or affiliated lab and entered into the patient's EHR

Change in total cholesterol - child

Time Frame: Baseline, post intervention (week 12), and month 6

data will be pulled from the EHR

Change in total cholesterol - adult

Time Frame: Baseline, post intervention (week 12), and month 6

data will be pulled from the EHR

Change in high-density lipoprotein (HDL) - child

Time Frame: Baseline, post intervention (week 12), and month 6

data will be pulled from the EHR

Change in high-density lipoprotein (HDL) - adult

Time Frame: Baseline, post intervention (week 12), and month 6

data will be pulled from the EHR

Change in low-density lipoprotein (LDL) - child

Time Frame: Baseline, post intervention (week 12), and month 6

data will be pulled from the EHR

Change in low-density lipoprotein (LDL) - adult

Time Frame: Baseline, post intervention (week 12), and month 6

data will be pulled from the EHR

Secondary Outcomes

  • Change in Dietary Intake(Baseline, post intervention (week 12), and month 6)
  • Change in Nutrition Security(Baseline, post intervention (week 12), and month 6)
  • Change in Food Security(Baseline, post intervention (week 12), and month 6)
  • Change in Family Stress(Baseline, post intervention (week 12), and month 6)

Investigators

Sponsor
Alison Gustafson
Sponsor Class
Other
Responsible Party
Sponsor Investigator
Principal Investigator

Alison Gustafson

Professor

University of Kentucky

Study Sites (1)

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