Impact of Food Literacy Education on Rural, Uninsured Patients With Diabetes

Top Things to Know

Food literacy skills (meal planning, shopping on a budget, and label reading) amplify the clinical impact of FIM programs.

Cultural tailoring food literacy education (incorporating traditional foods, language-appropriate materials, and familiar preparation methods) is iessential to achieving optimal FIM outcomes.

Integrating food literacy into FIM could strengthen long‑term dietary behavior change, increase voucher use, and enhance downstream health outcomes such as glycemic control.

Summary of Conclusion/Findings

This study evaluated the Fresh Start Food Is Medicine + Food Literacy intervention among 150 rural, uninsured adults with type 2 diabetes and found significant improvements in total food literacy scores after the program (P = 0.006). Participants’ skills in meal planning, shopping, nutrition resourcefulness, budgeting, and label reading all improved, although gains varied by racial and ethnic group. Hispanic participants consistently had lower baseline and post-intervention food literacy scores than White participants across most domains, indicating persistent disparities despite overall improvement. The greatest subgroup improvements were seen among Black participants in budgeting and among Hispanic participants in label reading/consumer awareness. Engagement varied, with only 42.6% completing both pre- and post-intervention surveys, but those who completed generally had higher exposure to classes and coaching. Overall, the intervention demonstrated that structured, skill‑based food literacy education can meaningfully enhance practical nutrition competencies in underserved rural populations.