Tailored Food is Medicine Programs as an effective approach to address dietary intake and blood pressure among rural and urban adults

BackgroundFood is Medicine (FIM) programs have shown potential at improving health outcomes, reducing food insecurity, and increasing dietary intake. However, few interventions have sought to individually tailor these programs based on user preferences and constraints. This program utilized a screening decision tool to allocate adults to a tailored FIM program to examine process and clinical outcomes. MethodsAdults ages 18-64 with hypertension were screened for food insecurity at two large hospital systems (one rural, one urban) in Kentucky. Participants who screened positively and wanted assistance with food were referred to the Food as Health Alliance hub to receive either medically tailored meals or grocery prescription (Rx). Medically tailored meals (MTM) provided 5 meals per week for 12 weeks. The grocery Rx program provided $100 each month for 3 months to purchase food consistent with guidelines for people with hypertension. Baseline and post-intervention outcomes were obtained from electronic medical records, and process measures included engagement, dose, and program acceptability. Semi-structured interviews were completed with a subset of 20 participants to obtain qualitative feedback on the program. ResultsA total of 159 participants referred were enrolled, and 144 participants completed all measures (complete case rate of 91%). There were no significant changes within grocery Rx or MTM for the primary outcome of systolic or diastolic blood pressure from baseline to post intervention. However, there were significant effects on dietary intake, financial strain, and self-reported general health among grocery Rx and MTM recipients. Among those receiving Supplemental Nutrition Assistance Program (SNAP) benefits who received grocery Rx, there was a significant change in systolic (-8.75 95% CI-16.83,-.67) and diastolic blood pressure (-5.42 95% CI-10.72,-.13) relative to those not receiving SNAP. Qualitative findings aligned with the quantitative findings in that participants reported high levels of satisfaction and that the program allowed them to eat healthier, helped ease the burdensome cost of food, and improved various aspects of their health. ConclusionA tailored FIM program can improve dietary intake and reduce blood pressure among key subpopulations participating in the program in the short-term. Clinical trial registration NCT07011251