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

Area of Science:

• Clinical Medicine
• Public Health
• Health Services Research

Background:

• Uncontrolled diabetes and hypertension disproportionately affect Black/African American and Hispanic/Latinx populations.
• Team-based care models show promise for managing chronic conditions.
• Food insecurity and access to healthy food are significant barriers to diabetes management.

Purpose of the Study:

• To evaluate a team-based pilot program incorporating food vouchers for patients with uncontrolled diabetes.
• To assess the program's impact on glycemic control and blood pressure.
• To explore qualitative insights into patient experiences and perceived benefits.

Main Methods:

• A single-arm, pre-post mixed-method study conducted in two safety-net primary care clinics.
• Participants: Black/African American and/or Hispanic/Latinx patients with hemoglobin A1c >8%.
• Intervention: Six-month program with clinical support, health resources, and $160/month in grocery vouchers.

Main Results:

• Significant reduction in uncontrolled hypertension (45.9% to 21.6%, P=0.007).
• No significant change in mean hemoglobin A1c (10.1% to 9.7%, P=0.17).
• Qualitative data revealed improved health behaviors, food relationships, and engagement with care.

Conclusions:

• Integrating food vouchers with team-based care may improve hypertension control in diabetic patients.
• Further research with larger, randomized controlled trials is necessary to confirm these findings.
• This model offers a potential strategy for addressing social determinants of health in chronic disease management.