Addressing diabetes by elevating access to nutrition (ADELANTE) - A multi-level approach for improving household food insecurity and glycemic control among Latinos with diabetes: A randomized controlled trial.

Autor: Radtke MD; Propel Postdoctoral Fellow, Stanford University School of Medicine, Palo Alto, CA, USA; Department of Epidemiology and Population Health, Stanford University School of Medicine, Palo Alto, CA, USA., Chen WT; Department of Epidemiology and Population Health, Stanford University School of Medicine, Palo Alto, CA, USA., Xiao L; Department of Epidemiology and Population Health, Stanford University School of Medicine, Palo Alto, CA, USA., Rodriguez Espinosa P; Department of Epidemiology and Population Health, Stanford University School of Medicine, Palo Alto, CA, USA., Orizaga M; Department of Epidemiology and Population Health, Stanford University School of Medicine, Palo Alto, CA, USA., Thomas T; Department of Epidemiology and Population Health, Stanford University School of Medicine, Palo Alto, CA, USA., Venditti E; Department of Psychiatry, Univeristy of Pittsburgh, Pittsburgh, PA, USA., Yaroch AL; Executive Director, Gretchen Swanson Center for Nutrition, Omaha, NE, USA., Zepada K; Department of Epidemiology and Population Health, Stanford University School of Medicine, Palo Alto, CA, USA., Rosas LG; Department of Epidemiology and Population Health, Stanford University School of Medicine, Palo Alto, CA, USA; Department of Medicine, Division of Primary Care and Population Health, Stanford University School of Medicine, Palo Alto, CA, USA. Electronic address: lgrosas@stanford.edu., Tester J; Department of Pediatrics, University of California San Francisco, San Francisco, CA, USA. Electronic address: June.tester@ucsf.edu.
Jazyk: angličtina
Zdroj: Contemporary clinical trials [Contemp Clin Trials] 2024 Nov; Vol. 146, pp. 107699. Date of Electronic Publication: 2024 Sep 23.
DOI: 10.1016/j.cct.2024.107699
Abstrakt: Background: Latinx adults are disproportionately impacted by the interrelated challenges of food insecurity and nutrition sensitive chronic diseases. Food and nutrition insecurity can exacerbate the development and progression of chronic diseases, such as diabetes. Sustainable, effective interventions aimed at improving food insecurity and diabetes management for Latinx populations are needed.
Methods: This hybrid type 1 trial evaluates the effectiveness of a multi-level intervention that includes a medically supportive food and behavioral lifestyle program on the primary outcome of Hemoglobin A1c (HbA1c) at 6 months. Latinx adults (n = 355) with type 2 diabetes (HbA1c of 6.0-12.0 %), overweight/obesity (BMI > 25 kg/m 2 ), and self-reported risk of food insecurity will be randomized 1:1 to intervention (12 weekly deliveries of vegetables, fruits, and whole-grain foods + culturally-modified behavioral lifestyle program) versus control (food deliveries after a 6-month delay). Outcome asessments will occur at 0, 6 and 12 months, and include HbA1c, dietary intake, psychosocial health outcomes, and diabetes-related stressors. In addition, food insecurity and the impact of the intervention on up to two household members will be measured. Qualitative interviews with patients, healthcare providers, and community partners will be conducted in accordance with Reach, Effectivenes, Adoption, Implementation, and Maintenence (RE-AIM) framework to identify barriers and best practices for future dissemination.
Conclusions: The ADELANTE trial will provide novel insight to the effectiveness of a multi-level intervention on diabetes-related outcomes in Latinx adults. The mixed-method approach will also identity the reach of this 'Food is Medicine' intervention on additional household members to inform diabetes prevention efforts.
Clinical Trial Registration: NCT05228860.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2024 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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