Conceptual Framework and Key Considerations for Field-Based Infrastructure in Food Is Medicine Research

In 2023, the American Heart Association launched the Healthcare by Food (HCXF) initiative to establish a rigorous evidence base for Food Is Medicine (FIM) programs, so that patients with acute or chronic disease could access FIM programs as a covered benefit under their health insurance. The HCXF initiative is engaging in research, advocacy, and education to support the development and testing of interventions that improve health outcomes. The HCXF initiative launched 9 task forces aligned with research progress, including the Field-Based Infrastructure task force designed to examine broader questions to help support either earlier or later stages of the HCXF initiative in parallel. The goal of the Field-Based Infrastructure task force is to outline the essential elements for delivering FIM interventions within health care systems, with an eye toward tactical recommendations on tools for testing and implementation. Our central question is: How do we assist different stakeholders in an FIM ecosystem to fully participate, and what infrastructure tools are needed for successful FIM research? We outline a conceptual framework with recommendations within this framework on 4 key considerations for field readiness to conduct FIM research: (1) centering on core principles of community-engaged research; (2) considering behavior science and implementation science theory for FIM; (3) building strong partnerships and alliances; and (4) creating space for shared knowledge. In conclusion, the framework and considerations outlined here advance FIM research and equitable health by building community capacity, connections with the health care sector and available FIM resources, alongside supporting community well-being and resiliency.