Food Pharmacies as a Clinic-to-Community Model for Supporting Lifestyle Change among Food Insecure Populations
Food insecurity is a household condition of unreliable access to an adequate, nutritious food supply that is associated with poor dietary quality, chronic disease risk, and poor disease management outcomes. This condition can be a major barrier to healthy lifestyle change for underserved and vulnerable populations. “Clinic-to-community models” offer a direct approach for healthcare systems to link food insecure patients to community food resources, and can involve physician food “prescriptions” that can be filled on-site at clinics through medically-tailored “food pharmacies.” Few published studies describe the design and implementation of these programs, which may provide opportunities to address immediate food needs of patients, while also teaching nutrition-related disease self-management skills. The University of Oklahoma (OU) Food Pharmacy was designed to accomplish 3 outcomes: 1) improve patient knowledge and intake of affordable, medically-appropriate foods, 2) reduce household food insecurity, and 3) reduce nutrition-related clinical risk factors for cardiometabolic disease. It was developed as a pilot project between the Community Food Bank of Eastern Oklahoma and researchers at the OU-TU School of Community Medicine and the OU College of Public Health. Tests sites included two OU-affiliated clinics that provide free, ongoing chronic disease management to uninsured patients, many of whom are diagnosed with hypertension, diabetes, and/or hyperlipidemia.
This presentation will review components of our intervention, which consisted of a monthly prescription food package, low-cost healthy recipes, behavioral counseling by a registered dietitian or medical student, and an educational curriculum for uninsured patients (n=80). We will discuss lessons learned during implementation of the intervention as well as outcomes of this longitudinal pilot study. Participants experienced significant improvement in daily dietary fiber intake (M=14.0 to 17.1, t=-4.110, p < .0001) and a slight, yet non-significant increase in daily fruit and vegetable intake (M=3.4 cups to 3.6 cups, t=-1.597, p=0.118), compared to baseline. Among those participants accessing food assistance at least 4 times who had high blood pressure at enrollment (n=17), diastolic blood pressure also significantly improved (M=90.9 to 83.9, t=2.950, p=.009). We will conclude our presentation with a summary of the evidence that indicates lifestyle counseling and supportive measures can be used to promote health equity among food insecure populations through community-engaged food bank-clinic partnerships.