Designing Medically Tailored Meal Interventions: The Food as Medicine for Families (FAME-F) Factorial Randomized Clinical Trial

Top Things to Know

MTM interventions can be person‑centered without feeding the entire household.

MTM programs may safely use commercial shipping to expand geographic reach and operational efficiency.

MTMs function as a stabilizing medical intervention within FIM models.

Summary of Conclusion/Findings

This factorial randomized clinical trial evaluated key design choices for medically tailored meal (MTM) programs within a FIM framework, specifically comparing feeding only the enrolled individual versus feeding the entire household, and delivery by dedicated drivers versus commercial shippers. Among 93 adults receiving MTMs for 12 weeks, the study found no significant differences in diet quality, as measured by the Healthy Eating Index‑2020, between participants whose meals were provided only for themselves versus for their whole household. Similarly, there were no significant differences in loneliness or other mental health outcomes between those receiving meals from dedicated delivery drivers and those receiving meals via commercial shippers. Food insecurity decreased across all study arms, regardless of dosing or delivery strategy, and participants reported high acceptability of the intervention overall. The findings suggest that concerns about “underdosing” individuals due to household food sharing may be less critical than previously assumed. Collectively, the results indicate that MTM programs have flexibility in program design without compromising core patient outcomes.