Clinical trial NCT06324630: Implementation of Innovative Food Prescription Programs in Older Adults
Official title: Implementation of Innovative Food Prescription Programs in Older Adults
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Food Preferences
Food Habits
Lead sponsor: University at Buffalo
Sponsor class: OTHER
First posted: 2024-03-22
Enrollment: 67
Sex: ALL
Minimum age (years): 65
Standard ages: OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: PREVENTION

Brief summary: In the USA, about 10% of grown-ups have a hard time finding healthy food, like fruits and vegetables. It's even harder for older grown-ups who might be sick and find it tricky to move around, which makes it tough to get healthy food. The investigators are trying to fix this by testing two new ways to help older people (aged 65 and up) get nutritious food. The investigators are getting lots of help and ideas from older adults to make these ways work the best they can.

The study is happening at the Erie County Medical Center (ECMC) in the East Side of Buffalo, NY, where many African Americans live. This place hasn't been treated fairly, so there aren't many places to buy fresh fruits and vegetables in the local stores. On the ECMC campus, there are three clinics that can help people who can't easily get healthy food. Every participant in our study will be put into one of three programs, each lasting 12 weeks, and they will get food every week.

In the "usual care" program, a doctor writes an order, and the participant gets a voucher to buy more fruits and vegetables at a market or store.

In the "delivery of a produce prescription box" program, a box of fruits and vegetables is brought to the participant's home. The participant can pick what they like online or by calling a helper. If they don't pick, they get a regular box.

In the "delivery of a meal kit box" program, the participant gets the ingredients for three meals in a box. The participant can pick three meals they like online or by calling. If the participant doesn't pick, three meals will be chosen for the participant.

For the second and third programs, participants will get messages to remind the participant when to choose their food, when the time to choose is almost up, and when their food is on its way. If a participant can't use messages or the internet, they can call a helper for support. The investigators believe the study will show that these ways can help older adults who have a hard time getting food to eat more fruits and vegetables. The investigators will also find out which way works best compared to the usual way in the Buffalo, NY area.

Detailed description: Food insecurity in older adults is a complex issue that is growing in scale. This project will compare two innovative produce prescription delivery models against a usual care produce prescription model. The patient population is older adults (aged 65 and over) who have screened positive for food insecurity from one of three primary care clinics in Erie County Medical Center (ECMC). ECMC is located in a medically underserved area of Buffalo, New York, where the majority of the population identifies as African American. Each participant will be randomized to one of the three study arms. Each intervention will give a participant free food (21 servings of fruits and vegetables) weekly for 12 weeks. The usual care arm is receiving access to a mobile market-based produce prescription which can be redeemed at over 10 locations in the city. The first intervention arm will have a fully customizable box of fresh fruits and vegetables delivered to their home. The second intervention arm will be a meal kit delivery box where a participant can choose from 6-9 options weekly. Outcomes compared across arms include enrollment, redemption, and food usage. The investigators will also explore impact of the intervention on fruit and vegetable consumption and related psychosocial behaviors. The investigators will collaborate with an older adult patient advisory group in the development of the two novel interventions and utilize rapid weekly survey feedback to optimize the programs before the end of the 12-week time period. This research will help understand how to best address low utilization rates of food prescription programs with the goal of reducing food insecurity and chronic disease among older adults.

Eligibility criteria: Inclusion Criteria:

* Age 65 or over
* English-speaking

Exclusion Criteria:

* Under the age of 65
* Does not speak English
* Cognitively impaired (screen for cognitive function)

Primary outcomes:
measure: Program Redemption
timeFrame: Measured weekly for duration of 12-week intervention
Secondary outcomes:
measure: Program Usage
timeFrame: Measured weekly for duration of 12-week intervention
measure: Program Interest by Consenting to Being Contacted/Voiced Interest to Recruiter
timeFrame: Collected once per eligible individual during approximately 4-week recruitment period
measure: Program Enrollment
timeFrame: Collected once per eligible individual during approximately 4-week recruitment period
Other outcomes:
measure: Fruit and Vegetable Consumption
timeFrame: Collected at baseline and after 12-week intervention period
measure: Nutrition Security
timeFrame: Collected at baseline and after 12-week intervention period
measure: Self-Efficacy to Purchase, Prepare, and Eat Fresh Fruits and Vegetables
timeFrame: Collected at baseline and after 12-week intervention period
measure: Barriers to Eating Fruits and Vegetables
timeFrame: Collected at baseline and after 12-week intervention period
measure: Health Status and Disease Risk
timeFrame: Collected at baseline and after 12-week intervention period
measure: Quality of Life in Older Age
timeFrame: Collected at baseline and after 12-week intervention period
Locations:
city: Buffalo
country: United States
facility: University at Buffalo
state: New York
Study officials:
affiliation: University at Buffalo
name: Lucia Leone, PhD
role: PRINCIPAL_INVESTIGATOR
affiliation: University at Buffalo
name: Jill Tirabassi, MPH, MD
role: PRINCIPAL_INVESTIGATOR
References: