Optimizing Implementation of Food is Medicine Interventions in a Community-Based Healthcare Setting: Nutrition360 Pilot Intervention Results

Top Things to Know

Face-to-face delivery of produce prescriptions and nutrition counseling may be more acceptable and operationally efficient than virtual delivery models, as evidenced by higher attendance, greater satisfaction, and a lower cost-to-burden ratio.

Adding complementary wellness services (e.g., gym memberships and personal training) did not improve engagement or utilization, suggesting that simpler intervention models may be easier to implement without sacrificing effectiveness.

Higher dropout rates among younger, lower-income, and less-educated participants underscore the need for targeted retention strategies to ensure equitable participation in FIM programs.

Summary of Conclusion/Findings

This pilot optimization study evaluated different Food Is Medicine (FIM) delivery models in a community-based outpatient clinic in Jackson, Mississippi, with the goal of identifying intervention components that minimized participant burden while maximizing implementation efficiency. Among 48 randomized participants (32 completers), traditional face-to-face delivery that combined produce prescriptions, vouchers, and in-person nutrition counseling had the lowest cost-to-burden ratio and significantly higher attendance than virtual delivery models that paired telehealth counseling with meal subscriptions. Participants in both intervention modalities reported high use of the food benefits provided, with voucher recipients using an average of 79.0% of vouchers for fruits and vegetables and meal subscription participants consuming 73.7% of delivered meals. Dietary outcomes showed no significant differences in fruit or vegetable intake between modalities, but added sugar intake declined significantly over time across groups (F(3,48.916)=5.62, P=.009). Integrated delivery that added wellness visits, gym memberships, and personal training produced little additional benefit compared with traditional delivery, with no differences in wellness visit attainment or gym use. Attrition was higher among younger, lower-income, and less-educated participants, highlighting potential equity-related challenges for implementation and retention.