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Comparing Two Food is Medicine Trials Using the RE-AIM Framework.
Medrxiv : the Preprint Server for Health Sciences
|November 24, 2025
Summary
Food is Medicine (FIM) interventions show promise but face challenges with digital access and retail integration. Successful scaling requires hybrid models, strong partnerships, and sustainable funding for equitable healthcare.
Area of Science:
- Public Health
- Health Services Research
- Health Equity
Background:
- Food is Medicine (FIM) interventions are increasingly integrated into healthcare.
- Pilot studies were supported by the American Heart Association's Healthcare by Food initiative to test scalable FIM models.
- This study compares two pilot FIM interventions: NutriConnect and Makin' Healthy Groceries.
Purpose of the Study:
- To compare two pilot Food is Medicine (FIM) interventions using the RE-AIM framework.
- To identify cross-site lessons for FIM design, delivery, and implementation.
- To inform future policy and practice for scalable FIM models.
Main Methods:
- Comparative analysis of two FIM trials: NutriConnect and Makin' Healthy Groceries.
- Application of the RE-AIM framework (Reach, Effectiveness, Adoption, Implementation, Maintenance).
- Examination of participant characteristics, intervention delivery, operational challenges, and contextual facilitators.
Main Results:
- Digital barriers (e.g., email redemption, digital literacy) constrained reach in both trials.
- Retail system readiness impacted adoption, with tighter integration proving beneficial.
- Implementation faced staff burden and customization needs, while maintenance highlighted cost and funding reliance.
Conclusions:
- FIM trial design and delivery are heterogeneous, requiring alignment with participant behaviors and retail systems.
- Successful scale-up necessitates hybrid tech-human models, cross-sector partnerships, and sustainable reimbursement.
- Pilot insights guide the development of equitable FIM implementation strategies.
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