Food as medicine How 1 per day can increase food security and improve health Miranda Cook MPH Laney Graduate School Emory University introduction Diet behavior change is made more challenging by economic barriers for individuals in lowincome food insecure communities ID: 773799
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Food as medicine? How $1 per day can increase food security and improve health Miranda Cook, MPH, Laney Graduate School, Emory University
introductionDiet behavior change is made more challenging by economic barriers for individuals in low-income food insecure communities Especially true for those who experience diet-related chronic disease Food insecurity is associated with chronic disease, especially among women
Food Insecurity in Georgia1.7 million Georgian’s received SNAP benefits every month 1 in 7 Georgians are food insecure 1 in 5 Georgian children are food insecure
FVRx Program Overview Photo & visual courtesy of: Wholesome Wave Georgia 1. Participants attend FVRx clinic visits, cooking and nutrition education classes 2. Participants receive FVRx prescriptions* 3. Participants redeem prescriptions for fresh fruits and vegetables at local farmers markets 4. Participants prepare and eat healthy meals with family and schedule their next FVRx visit *FVRx prescription is equal to $1/day for each participant and household member; e.g., a family of 4 would receive $28 per week
Sites of intervention Harrisburg Family Health Care Clinic in Augusta, Georgia N = 43 Athens Nurses Clinic in Athens, Georgia N = 23Morehouse Healthcare (East Point, Georgia) N = 14 Good Samaritan Health Center (Atlanta, Georgia) N = 50 Grady Ponce De Leon Center (Atlanta, Georgia) N = 29Grady Primary Care Clinic (Atlanta, Georgia) N = 25Photos: Google Maps Street View images
Evaluation - Survey toolsPre- & Post-surveysParticipants completed surveys at baseline and at the end of the 6-month programMonthly-collected measuresClinical measurements & monthly surveys collected at monthly program visits Surveys were completed in paper formatData from surveys and monthly clinic visits double-entered into Qualtrics by staff at each site
Evaluation – Data collectedSome sites collected additional monthly measures:Grady IDP site: A1cTriglyceridesHDLLDLTotal cholesterol Augusta:Heart rateBlood glucoseInformation Collected in Pre-/Post-Surveys:Demographic characteristicsFood securityNutrition and cooking knowledge and confidenceDifficulties involved in purchasing & consuming produceFrequency of fruit & vegetable consumption Information Collected Monthly at all sites:Fruit & vegetable consumptionWeight Blood pressureWaist circumference (all except Augusta)
Results219 households enrolled in the program76% reported household income <$25,00054% reported receiving public assistance 78% were of non-Hispanic black race118 participants successfully graduated the program (~54% retention rate)$47,376 food subsidies redeemed
Results - Food security At baseline: 21% often couldn’t afford a balance meal 37% often cut the size of meals or skipped meals due to financial constraints32% were often hungry because there wasn’t enough foodPost-intervention: 8% often couldn’t afford a balance meal 20% often cut the size of meals or skipped meals due to financial constraints 5% were often hungry because there wasn’t enough food OVERALL
Results: Difficulties Decreased and & Knowledge improved Categories of knowledge BL mean score (N)Post-Intervention Mean Score (N)% DifferenceMean Change (95% CI)T-test P-ValueTypes of fruits and vegetables grown locally 1.3 (76)2.0 (75)53.80.8 (0.5, 1.0)<.0001How to prepare fresh fruits & vegetables2.1 (76)2.6 (76)23.80.6 (0.4, 0.8)<.0001Where to buy produce 1.8 (60)2.4 (75)33.30.6 (0.3, 0.9)<.0001Importance of fruits & vegetables in family’s diet2.2 (76)2.8 (75)27.30.5 (0.3, 0.7)<.0001
Results – Diet and Clinical Outcomes *There were no significant findings for BMI, cholesterol, waist circumference, or hemoglobin A1c outcomes
Questions & Contact InformationMiranda Cook, MPHPhD student, Nutrition & Health Sciences, Laney Graduate School, Emory University macook2@emory.edu Amy Webb-Girard, PhD Assistant Professor, Rollins School of Public Health, Emory University awebb3@emory.edu Denise Blake Executive Director, Wholesome Wave Georgiadenise@wholesomewavegeorgia.org