Food Rx & CHW: a community health worker-led medically tailored grocery intervention to address food insecurity and type 2 diabetes, a pilot randomized trial
Top Things to Know
Food alone did not significantly reduce HbA1c, but when paired with CHW coaching (nutrition education, cooking instruction, and help accessing food resources) patients achieved substantial and sustained improvements in glycemic control.
The Food + CHW group significantly increased their use of farmers’ markets and nutrition incentive programs, suggesting that CHWs help patients establish sustainable access to healthy foods even after the intervention ends.
Participants receiving CHW support developed stronger skills in reading nutrition labels, cooking from scratch, and preparing meals in advance, enabling them to use medically provided foods in ways that support chronic disease management.
Summary of Conclusion/Findings
This pilot randomized trial evaluated a medically tailored grocery intervention for food-insecure adults with type 2 diabetes, comparing weekly food deliveries alone to food deliveries paired with Community Health Worker (CHW) support. Participants in the Food + CHW group experienced significant reductions in HbA1c at 3 months (-0.85) and 6 months (-1.65), whereas the Food-only group showed no significant improvement. The Food + CHW group also reported healthier dietary behaviors, including increased fruit intake, more frequent reading of nutrition labels, and greater consumption of meals cooked from scratch. They additionally increased their use of farmers’ markets and food access resources, suggesting improved capacity to sustain healthier eating patterns beyond the intervention. No meaningful changes in blood pressure, weight, or healthcare utilization were observed in either group, though diastolic blood pressure increased in the Food-only group. Overall, findings indicate that CHWs play a critical role in helping patients leverage medically tailored groceries to achieve clinically meaningful improvements in glycemic control.