User-centered design food is medicine intervention baseline and post intervention

Background: Food is medicine programs have shown potential at improving health outcomes, reducing food insecurity, and increasing dietary intake. However, there are few interventions that 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 food is medicine program to examine process and clinical outcomes.

Methods: Adults ages 18-64 with hypertension were screened for food insecurity at two large hospital systems (one rural, one urban) in Kentucky. Participants who screened positive and wanted assistance with food were referred to the Food as Health Alliance hub. 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 foods consistent with guidelines for people with hypertension. Baseline and post-intervention health data were obtained from electronic medical records, and process measures included engagement, dose, and program acceptability.

Dataset: Baseline variables of biomarkers, survey data are included as well as post intervention data of the same biomarkers and survey data. Primary outcome of systolic and diastolic blood pressure. Secondary outcomes of food insecurity, nutrition security, diet quality, general health status, financial strainIn addition, the dataset contains process measures of net promoter score, budget impact, engagement metrics.

This dataset is open source based on American Heart Association guidelines for open source data. 

Methods
Eligibility Criteria: To be eligible for participating in this pilot study, patients had to be between the ages 18-64, have a diagnosis of hypertension (ICD-10 code I10), and speak conversational English. Only one patient per household was eligible to participate. Participants were recruited over 45 days from two large hospital systems in rural and urban communities in Kentucky. 

Screening: Two screening processes were used, based on the current structure and preferences of the health system partners. The automated procedure consisted of the patient receiving the Hunger Vital Signs screener25 via text or e-mail before check in and documenting their response in the electronic medical record (EMR). The face-to-face procedure consisted of the nurse or clinic staff asking the patient the Hunger Vital Signs screener in the patient room and documenting response in the EMR.

Referral: If the patient expressed interest in participating, the healthcare clinic staff would input their relevant contact and eligibility information into the REDCap system for the Food as Health Alliance team to contact the patient for further enrollment procedures.

Enrollment into the HCxF program: Staff from the Food as Health Alliance Hub at the University of Kentucky coordinated the enrollment of patients and subsequent delivery of the food package. Referred patients received a welcome message via text and email with a link and phone number to enroll. Follow-up messages were sent two days later to patients not enrolled, after which staff made three attempts by phone to assist with enrollment. Enrollment consisted of informed consent for the pilot study, use of a screening decision tool to match participants to the appropriate program, and a baseline survey. This study was approved by the University of Kentucky IRB (Protocol #93234). All participants completed informed consent.