Food Insecurity Interventions to Improve Blood Pressure: The Healthy Food First Factorial Randomized Clinical Trial

Top Things to Know

Food subsidies that allow individuals to make their own culturally and personally relevant healthy food choices led to better blood pressure outcomes than pre-selected food boxes.

The lack of added benefit from lifestyle counseling and longer intervention duration suggests that FIM interventions may be more effective if tailored to individual readiness and needs.

While all interventions improved food security, only the food subsidy improved blood pressure, highlighting that simply increasing food access is not enough.

Summary of Conclusion/Findings

This randomized clinical trial evaluated the effectiveness of different food insecurity interventions on blood pressure among 458 adults with hypertension and food insecurity. Participants were assigned to one of eight combinations of interventions varying by food resource type (grocery store food subsidy vs. home-delivered food box), lifestyle counseling (offered vs. not offered), and intervention duration (6 vs. 12 months). The study found that participants receiving a food subsidy had significantly lower systolic and diastolic blood pressure at 6 and 18 months compared to those receiving food boxes. However, offering lifestyle counseling and extending the intervention duration to 12 months did not significantly improve blood pressure outcomes. All groups experienced improvements in food security, but there were no significant differences between intervention types. The findings suggest that flexible, participant-directed food subsidies may be more effective than pre-packaged food boxes in improving blood pressure among food-insecure individuals.