Addressing food insecurity and chronic conditions in community health centres: protocol of a quasi-experimental evaluation of Recipe4Health.

Autor:	Rosas LG; Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, California, USA lgrosas@stanford.edu.; Department of Medicine, Division of Primary Care and Population Health, Stanford School of Medicine, Palo Alto, CA, USA.; Community Engagement, Stanford School of Medicine, Palo Alto, CA, USA., Chen S; Recipe4Health, Alameda County Health Care Services Agency, San Leandro, California, USA., Xiao L; Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, California, USA., Emmert-Aronson BO; Open Source Wellness, Oakland, California, USA., Chen WT; Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, California, USA.; Community Engagement, Stanford School of Medicine, Palo Alto, CA, USA., Ng E; Community Health Center Network, San Leandro, California, USA., Martinez E; Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, California, USA., Baiocchi M; Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, California, USA., Thompson-Lastad A; Osher Center for Integrative Medicine and Department of Family and Community Medicine, UC San Francisco School of Medicine, San Francisco, California, USA., Markle EA; Open Source Wellness, Oakland, California, USA., Tester J; Department of Pediatrics, University of California San Francisco, San Francisco, California, USA.
Jazyk:	angličtina
Zdroj:	BMJ open [BMJ Open] 2023 Apr 06; Vol. 13 (4), pp. e068585. Date of Electronic Publication: 2023 Apr 06.
DOI:	10.1136/bmjopen-2022-068585
Abstrakt:	Introduction: Chronic conditions, such as diabetes, obesity, heart disease and depression, are highly prevalent and frequently co-occur with food insecurity in communities served by community health centres in the USA. Community health centres are increasingly implementing 'Food as Medicine' programmes to address the dual challenge of chronic conditions and food insecurity, yet they have been infrequently evaluated. Methods and Analysis: The goal of this quasi-experimental study was to evaluate the effectiveness of Recipe4Health, a 'Food as Medicine' programme. Recipe4Health includes two components: (1) a 'Food Farmacy' that includes 16 weekly deliveries of produce and (2) a 'Behavioural Pharmacy' which is a group medical visit. We will use mixed models to compare pre/post changes among participants who receive the Food Farmacy alone (n=250) and those who receive the Food Farmacy and Behavioural Pharmacy (n=140). The primary outcome, fruit and vegetable consumption, and secondary outcomes (eg, food security status, physical activity, depressive symptoms) will be collected via survey. We will also use electronic health record (EHR) data on laboratory values, prescriptions and healthcare usage. Propensity score matching will be used to compare Recipe4Health participants to a control group of patients in clinics where Recipe4Health has not been implemented for EHR-derived outcomes. Data from surveys, EHR, group visit attendance and produce delivery is linked with a common identifier (medical record number) and then deidentified for analysis with use of an assigned unique study ID. This study will provide important preliminary evidence on the effectiveness of primary care-based strategies to address food insecurity and chronic conditions. Ethics and Dissemination: This study was approved by the Stanford University Institutional Review Board (reference protocol ID 57239). Appropriate study result dissemination will be determined in partnership with the Community Advisory Board. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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