Team-Based Pilot Program Incorporates Food Vouchers to Improve Health in Patients with Diabetes

An evaluation of a team-based pilot program with food vouchers.

Single-arm prepost mixed-method study.

Two safety-net primary care clinics in San Francisco.

Black/African American and/or Hispanic/Latinx patients with uncontrolled diabetes (hemoglobin A1c >8%).

Six-month program including pharmacist and nutritionist visits, transportation assistance, and smoking cessation resources, plus $160 per month of grocery and produce vouchers.

Glycemic control and blood pressure. Secondary outcomes included qualitative insights into program benefits.

Descriptive statistics were used for patient characteristics, voucher use, and program satisfaction. Clinical outcomes used McNemar's tests for paired categorical variables and paired t tests for continuous variables. Interviews were transcribed and analyzed with deductive coding.

A total of 45 participants redeemed 68.7% of vouchers. Uncontrolled hypertension (≥ 140/90 mmHg) decreased significantly from 45.9% to 21.6% (P = 0.007, n = 41). There was no statistically significant change in mean hemoglobin A1c from baseline to program end (10.1% vs 9.7%; P = 0.17). Mean low-density and body mass index were not significantly different. Major themes from interviews include changes in health behaviors, improved relationships with food, and strengthened engagement with team-based care.

Combining vouchers and team-based care may be an avenue to improve care for patients with diabetes. Further investigation of this program model through a larger and rigorously designed study is needed for conclusive findings on this approach.