Lessons from the fields of Kansas: Food is medicine implementation in a predominantly rural state

Top Things to Know

Rural FIM implementation requires substantial adaptation to local conditions.

Community partnerships, including food banks and local food providers, are central implementation assets.

Long-term sustainability will likely depend on systems-level change rather than short-term grant funding.

Summary of Conclusion/Findings

This implementation report describes Food Is Medicine pilots conducted across six federally qualified health centers in Kansas after a structured preimplementation process. Programs differed in food delivery mechanisms, staffing models, referral strategies, and community partnerships, creating an opportunity to identify implementation barriers and solutions. Across sites, meaningful proportions of participants achieved clinically relevant hemoglobin A1c reductions, although engagement and food-distribution adherence varied substantially. Common challenges included food access limitations, staffing shortages, transportation barriers, workforce turnover, and supply-chain constraints. The authors conclude that successful scaling in rural settings requires sustained funding, adaptable workflows, community partnerships, and attention to local food-system infrastructure.