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Schier HE, Chetty KS, Garrity K, Westrick M, Copeland KA, Miller A, Gunther C. A narrative review of clinic-community food provision interventions aimed at improving diabetes outcomes among food-insecure adults: examining the role of nutrition education. Nutr Rev 2024; 82:1407-1419. [PMID: 37837324 DOI: 10.1093/nutrit/nuad125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2023] Open
Abstract
BACKGROUND Food provision interventions (eg, produce/food prescriptions, food pharmacies, food voucher programs) that bridge clinic and community settings for improved nutritional health outcomes of at-risk patients have gained momentum. Little is known about the role of nutrition education and potential augmented impact on patient outcomes. OBJECTIVE To describe intervention designs and outcomes of direct food provision clinic-community programs aimed at improving diabetes-related outcomes (glycated hemoglobin [HbA1c] levels) among patients with type 2 diabetes (T2DM) or prediabetes and food insecurity, and to compare nutrition education components across interventions. METHODS The PubMed and Academic Search Complete databases were systematically searched for original peer-reviewed articles (published during 2011-2022) that described the impact of clinic-community food provision programs (ie, produce/food prescriptions, food pharmacies, and food voucher programs) onHbA1c values among adults diagnosed with T2DM or prediabetes and who screened positive for food insecurity or low income. Study designs, intervention approaches, program implementation, and intervention outcomes were described. RESULTS Ten studies representing 8 distinct programs were identified. There was a high degree of variation in the studies' design, implementation, and evaluation. Across the 8 programs, 6 included nutrition education; of these, 1 used a theoretical framework, and 3 incorporated goal setting. Nutrition education covered multiple topical contents, including general nutrition knowledge, fruit and vegetable consumption, and accessing resources (eg, enrolling in the Supplemental Nutrition Assistance Program). Furthermore, the education was delivered through various formats (from 1-on-1 to group-based sessions), educators (community health workers, registered dietitians, physicians), and durations (from a single session to biweekly). All programs with a nutrition education component reported reduced participant HbA1c, and 4 demonstrated an increase in fruit and vegetable purchases or improved dietary quality. The remaining 2 programs that did not include nutrition education yielded mixed results. CONCLUSION The majority of programs included a nutrition education component; however, there was a high degree of heterogeneity in terms of content, educator, and duration. Patients who participated in programs that included nutrition education had consistent reductions in HbA1c. These observational trends warrant further exploration to conclusively determine the impact of nutrition education on patient outcomes participating in clinic-community food provision programs.
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Affiliation(s)
- Heather E Schier
- Department of Human Sciences, College of Education and Human Ecology, The Ohio State University, Columbus, OH, USA
| | - Krithika S Chetty
- College of Public Health, The Ohio State University, Columbus, OH, USA
| | - Katharine Garrity
- College of Medicine, School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, OH, USA
| | - Miranda Westrick
- College of Medicine and Life Sciences, University of Toledo, Toledo, OH, USA
| | - Kristen A Copeland
- Division of General and Community Pediatrics, Cincinnati Children's Hospital, Cincinnati, OH, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Abigail Miller
- College of Public Health, The Ohio State University, Columbus, OH, USA
| | - Carolyn Gunther
- College of Nursing, Martha S. Pitzer Center for Woman, Children, and Youth, The Ohio State University, Columbus, OH, USA
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Drake C, Granados I, Rader A, Brucker A, Hoeffler S, Goldstein BA, Chamorro C, Johnson F, Hinz EM, Bedoya AD, German JC, Hauser J, Thacker C, Spratt SE. Addressing cost barriers to healthy eating with Eat Well, a prescription produce subsidy, for patients with diabetes and at risk for food insecurity: Study protocol for a type 1 hybrid effectiveness-implementation pragmatic randomized controlled trial. Contemp Clin Trials 2024; 145:107655. [PMID: 39111387 DOI: 10.1016/j.cct.2024.107655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Revised: 07/29/2024] [Accepted: 08/03/2024] [Indexed: 08/25/2024]
Abstract
BACKGROUND Patients with diabetes at risk of food insecurity face cost barriers to healthy eating and, as a result, poor health outcomes. Population health management strategies are needed to improve food security in real-world health system settings. We seek to test the effect of a prescription produce program, 'Eat Well' on cardiometabolic health and healthcare utilization. We will also assess the implementation of an automated, affirmative outreach strategy. METHODS We will recruit approximately 2400 patients from an integrated academic health system in the southeastern United States as part of a two-arm parallel hybrid type 1 pragmatic randomized controlled trial. Patients with diabetes, at risk for food insecurity, and a recent hemoglobin A1c reading will be eligible to participate. The intervention arm receives, 'Eat Well', which provides a debit card with $80 (added monthly) for 12 months valid for fresh, frozen, or canned fruits and vegetables across grocery retailers. The control arm does not. Both arms receive educational resources with diabetes nutrition and self-management materials, and information on existing care management resources. Using an intent-to-treat analysis, primary outcomes include hemoglobin A1C levels and emergency department visits in the 12 months following enrollment. Reach and fidelity data will be collected to assess implementation. DISCUSSION Addressing food insecurity, particularly among those at heightened cardiometabolic risk, is critical to equitable and effective population health management. Pragmatic trials provide important insights into the effectiveness and implementation of 'Eat Well' and approaches like it in real-world settings. REGISTRATION ClinicalTrials.gov Identifier: NCT05896644; Clinical Trial Registration Date: 2023-06-09.
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Affiliation(s)
- Connor Drake
- Department of Population Health Sciences, Duke University School of Medicine, 215 Morris St, Durham, NC 27701, USA; Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Health Care System, 411 West Chapel Hill St, Durham, NC 27701, USA.
| | - Isa Granados
- Department of Population Health Sciences, Duke University School of Medicine, 215 Morris St, Durham, NC 27701, USA; Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Health Care System, 411 West Chapel Hill St, Durham, NC 27701, USA; Duke Center for Childhood Obesity Research, Duke University School of Medicine, 3116 N. Duke Street, Room 1028, Durham, NC 27704, USA
| | - Abigail Rader
- Department of Population Health Sciences, Duke University School of Medicine, 215 Morris St, Durham, NC 27701, USA
| | - Amanda Brucker
- Department of Biostatistics & Bioinformatics, Duke University School of Medicine, Duke University Medical Center 2424 Erwin Road, Suite 1102 Hock Plaza Box 2721, Durham, NC 27710, United States of America
| | - Sam Hoeffler
- Reinvestment Partners, 110 E Geer St, Durham, North Carolina 27701, United States of America
| | - Benjamin A Goldstein
- Department of Population Health Sciences, Duke University School of Medicine, 215 Morris St, Durham, NC 27701, USA; Department of Biostatistics & Bioinformatics, Duke University School of Medicine, Duke University Medical Center 2424 Erwin Road, Suite 1102 Hock Plaza Box 2721, Durham, NC 27710, United States of America
| | - Ceci Chamorro
- Duke Office of Clinical Research, Duke University School of Medicine, 2200 West Main Street, Durham, NC 27705, United States of America
| | - Fred Johnson
- Duke Population Health Management Office, Duke University Health System, 3100 Tower Blvd Suite 1100, Durham, NC 27707, United States of America; Division of Community Health, Department of Family Medicine and Community Health, Duke University School of Medicine, DUMC 2914, Durham, NC, 27710, United States of America
| | - Eugenia McPeek Hinz
- Division of General Internal Medicine, Department of Medicine, Duke University School of Medicine, 40 Duke Medicine Circle, Durham, NC 27710, United States of America
| | - Armando D Bedoya
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Duke University School of Medicine, Durham, NC 27710, United States of America; Department of Biostatistics & Bioinformatics, Duke University School of Medicine, Duke University Medical Center 2424 Erwin Road, Suite 1102 Hock Plaza Box 2721, Durham, NC 27710, United States of America
| | - Jashalynn C German
- Division of Endocrinology, Metabolism, and Nutrition, Department of Medicine, Duke University School of Medicine, Durham, NC 27710, United States of America
| | - Jillian Hauser
- Division of General Internal Medicine, Department of Medicine, Duke University School of Medicine, 40 Duke Medicine Circle, Durham, NC 27710, United States of America
| | - Connie Thacker
- Division of Endocrinology, Metabolism, and Nutrition, Department of Medicine, Duke University School of Medicine, Durham, NC 27710, United States of America
| | - Susan E Spratt
- Duke Population Health Management Office, Duke University Health System, 3100 Tower Blvd Suite 1100, Durham, NC 27707, United States of America; Division of Endocrinology, Metabolism, and Nutrition, Department of Medicine, Duke University School of Medicine, Durham, NC 27710, United States of America; Division of Community Health, Department of Family Medicine and Community Health, Duke University School of Medicine, DUMC 2914, Durham, NC, 27710, United States of America
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Harrison C, Peyyety V, Rodriguez Gonzalez A, Chivate R, Qin X, Zupa MF, Ragavan MI, Vajravelu ME. Prediabetes Prevalence by Adverse Social Determinants of Health in Adolescents. JAMA Netw Open 2024; 7:e2416088. [PMID: 38861258 PMCID: PMC11167496 DOI: 10.1001/jamanetworkopen.2024.16088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 04/10/2024] [Indexed: 06/12/2024] Open
Abstract
Importance Several clinical practice guidelines advise race- and ethnicity-based screening for youth-onset type 2 diabetes (T2D) due to a higher prevalence among American Indian and Alaska Native, Asian, Black, and Hispanic youths compared with White youths. However, rather than a biological risk, this disparity likely reflects the inequitable distribution of adverse social determinants of health (SDOH), a product of interpersonal and structural racism. Objective To evaluate prediabetes prevalence by presence or absence of adverse SDOH in adolescents eligible for T2D screening based on weight status. Design, Setting, and Participants This cross-sectional study and analysis used data from the 2011 to 2018 cycles of the National Health and Nutrition Examination Survey. Data were analyzed from June 1, 2023, to April 5, 2024. Participants included youths aged 12 to 18 years with body mass index (BMI) at or above the 85th percentile without known diabetes. Main Outcomes and Measures The main outcome consisted of an elevated hemoglobin A1c (HbA1c) level greater than or equal to 5.7% (prediabetes or undiagnosed presumed T2D). Independent variables included race, ethnicity, and adverse SDOH (food insecurity, nonprivate health insurance, and household income <130% of federal poverty level). Survey-weighted logistic regression was used to adjust for confounders of age, sex, and BMI z score and to determine adjusted marginal prediabetes prevalence by race, ethnicity, and adverse SDOH. Results The sample included 1563 individuals representing 10 178 400 US youths aged 12 to 18 years (mean age, 15.5 [95% CI, 15.3-15.6] years; 50.5% [95% CI, 47.1%-53.9%] female; Asian, 3.0% [95% CI, 2.2%-3.9%]; Black, 14.9% [95% CI, 11.6%-19.1%]; Mexican American, 18.8% [95% CI, 15.4%-22.9%]; Other Hispanic, 8.1% [95% CI, 6.5%-10.1%]; White, 49.1% [95% CI, 43.2%-55.0%]; and >1 or other race, 6.1% [95% CI, 4.6%-8.0%]). Food insecurity (4.1% [95% CI, 0.7%-7.5%]), public insurance (5.3% [95% CI, 1.6%-9.1%]), and low income (5.7% [95% CI, 3.0%-8.3%]) were each independently associated with higher prediabetes prevalence after adjustment for race, ethnicity, and BMI z score. While Asian, Black, and Hispanic youths had higher prediabetes prevalence overall, increasing number of adverse SDOH was associated with higher prevalence among White youths (8.3% [95% CI, 4.9%-11.8%] for 3 vs 0.6% [95% CI, -0.7% to 2.0%] for 0 adverse SDOH). Conclusions and Relevance Adverse SDOH were associated with higher prediabetes prevalence, across and within racial and ethnic categories. Consideration of adverse SDOH may offer a more actionable alternative to race- and ethnicity-based screening to evaluate T2D risk in youth.
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Affiliation(s)
- Caleb Harrison
- Center for Pediatric Research in Obesity and Metabolism, UPMC Children’s Hospital of Pittsburgh, Pittsburgh, Pennsylvania
- Division of Pediatric Endocrinology, Diabetes, and Metabolism, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | | | - Adriana Rodriguez Gonzalez
- Center for Pediatric Research in Obesity and Metabolism, UPMC Children’s Hospital of Pittsburgh, Pittsburgh, Pennsylvania
- Division of Pediatric Endocrinology, Diabetes, and Metabolism, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Rutha Chivate
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Xu Qin
- Department of Health and Human Development at the School of Education, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Margaret F. Zupa
- Division of Endocrinology and Metabolism, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Maya I. Ragavan
- Division of General Academic Pediatrics, University of Pittsburgh Medical Center Children’s Hospital of Pittsburgh, Pittsburgh, Pennsylvania
| | - Mary Ellen Vajravelu
- Center for Pediatric Research in Obesity and Metabolism, UPMC Children’s Hospital of Pittsburgh, Pittsburgh, Pennsylvania
- Division of Pediatric Endocrinology, Diabetes, and Metabolism, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
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Oshman L, Waselewski M, Hisamatsu R, Kim N, Young L, Hafez Griauzde D, Chang T. Grocery Delivery to Support Individuals With Type 2 Diabetes: Protocol for a Pilot Quality Improvement Program. JMIR Res Protoc 2024; 13:e54043. [PMID: 38748461 PMCID: PMC11137422 DOI: 10.2196/54043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 02/25/2024] [Accepted: 03/21/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND People with low income are disproportionately affected by type 2 diabetes (T2D), and 17.6% of US adults with T2D experience food insecurity and low diet quality. Low-carbohydrate eating plans can improve glycemic control, promote weight loss, and are associated with improved cardiometabolic health and all-cause mortality. Little is known about supporting low-carbohydrate eating for people with T2D, although food-as-medicine interventions paired with nutrition education offer a promising solution. OBJECTIVE This program aims to support the initiation of dietary changes by using grocery delivery and low-carbohydrate education to increase the quality of low-carbohydrate nutrition among people with T2D and food insecurity. METHODS This program was a nonrandomized pilot conducted at 21 primary care practices in Michigan. Adults with T2D and food insecurity or low income were eligible to enroll. Patients were referred by primary care clinic staff. All participants received the 3-month program, which included monthly US $80 credits for healthy foods, free grocery delivery from Shipt, and low-carbohydrate nutrition education. Food credits were restricted to the purchase of healthy foods. Education materials, developed in collaboration with providers and patients, included print, digital, interactive web, and video formats. At enrollment, participants completed a survey including demographics, diabetes health, diet and physical activity, and diabetes management and knowledge. After the 3-month program, participants completed a survey with repeat assessments of diabetes health, diet and physical activity, and diabetes management and knowledge. Perspectives on participant experience and perceived program impact, food purchasing behaviors, and use of educational materials were also collected. Diabetes health information was supplemented with data from participant medical records. We plan to perform mixed methods analysis to assess program feasibility, acceptability, and impact. Primary quality improvement (QI) measures are the number of patients referred and enrolled, use of US $80 food credits, analysis of food purchasing behavior, participant experience with the program, and program costs. Secondary QI measures include changes in hemoglobin A1c, weight, medications, self-efficacy, diabetes and carbohydrate knowledge, and activity between baseline and follow-up. RESULTS This program started in October 2022. Data collection is expected to be concluded in June 2024. A total of 151 patients were referred to the program, and 83 (55%) were enrolled. The average age was 57 (SD 13; range 18-86) years, 72% (57/79) were female, 90% (70/78) were White, and 96% (74/77) were of non-Hispanic ethnicity. All participants successfully ordered grocery delivery during the program. CONCLUSIONS This pilot QI program aimed to improve diet quality among people with T2D and food insecurity by using grocery delivery and low-carbohydrate nutrition education. Our findings may help inform the implementation of future QI programs and research studies on food-as-medicine interventions that include grocery delivery and education for people with T2D. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/54043.
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Affiliation(s)
- Lauren Oshman
- Department of Family Medicine, University of Michigan, Ann Arbor, MI, United States
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, United States
| | - Marika Waselewski
- Department of Family Medicine, University of Michigan, Ann Arbor, MI, United States
| | - Rina Hisamatsu
- Department of Family Medicine, University of Michigan, Ann Arbor, MI, United States
| | - Noa Kim
- Michigan Medicine Quality Department, Ann Arbor, MI, United States
| | - Larrea Young
- Michigan Medicine Quality Department, Ann Arbor, MI, United States
| | - Dina Hafez Griauzde
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, United States
- Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI, United States
| | - Tammy Chang
- Department of Family Medicine, University of Michigan, Ann Arbor, MI, United States
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, United States
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Whitehouse CR, Akyirem S, Petoskey C, Huang S, Lendvai D, Batten J, Whittemore R. A Systematic Review of Interventions That Address Food Insecurity for Persons With Prediabetes or Diabetes Using the RE-AIM Framework. Sci Diabetes Self Manag Care 2024; 50:141-166. [PMID: 38545669 DOI: 10.1177/26350106241232649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/16/2024]
Abstract
PURPOSE The purpose of this study is to systematically review interventions that address food insecurity for persons with prediabetes or type 2 diabetes using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) framework. METHODS Six databases (OVIDMEDLINE, OVIDEMBASE, OVID APA PsycINFO, Web of Science, Cochrane Central Registry of Controlled Trials, and EBSCO CINAHL Complete) were searched through January 2023. Research team members independently performed screening of abstracts and full texts, data abstraction, and risk assessment. RESULTS In all, 3,139 unique citations were identified, and 20 studies met inclusion criteria. Interventions included medically tailored meals/groceries (n = 10) or produce prescriptions/vouchers (n = 10). Reach and effectiveness were the highest reported RE-AIM elements. Interventions reached a high-risk population via food banks, community-based outreach, and federally qualified health centers. A majority of participants identified as female, Black, or Hispanic/Latinx and were living below the federal poverty level. Most studies reported at least 1 diabetes outcome (ie, A1C, hypoglycemia, diabetes distress, diabetes self-management). Seventeen studies reported impact on A1C, with the majority reporting a decrease in A1C and 53% (9/17) of studies demonstrating a decrease over time. Self-management improved in 50% (3/6) of studies that evaluated this outcome. Self-efficacy improved in 40% (2/5) of studies, and improvements were seen in depressive symptoms/diabetes distress (4/7 studies) and quality of life (5/5 studies). Seven studies reported statistically significant improvements in food insecurity. CONCLUSION Food insecurity has been associated with higher risks and adverse clinical outcomes in adults with diabetes. Implementing interventions that address food insecurity among adults with or at risk for diabetes can enhance food security and clinically important diabetes-related outcomes. Additional research dedicated to the sustainability of interventions is needed.
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Affiliation(s)
| | | | | | - Shuyuan Huang
- NYU Rory Meyers College of Nursing, New York, New York
| | - Dora Lendvai
- VA Connecticut Healthcare System, West Haven, Connecticut
| | - Janene Batten
- Harvey Cushing/John Hay Whitney Medical Library, Yale University, Orange, Connecticut
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Fu P, Wen J, Duan X, Hu X, Chen F, Yuan P. Association between adult food insecurity and mortality among adults aged 20-79 years with diabetes: A population-based retrospective cohort study. Diabet Med 2024; 41:e15268. [PMID: 38140919 DOI: 10.1111/dme.15268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 11/23/2023] [Accepted: 12/03/2023] [Indexed: 12/24/2023]
Abstract
AIMS There is limited research on the relationship between food insecurity and mortality among individuals with diabetes. This study aims to investigate the impact of food insecurity on all-cause and cause-specific mortality in adults with diabetes. RESEARCH DESIGN AND METHODS This study included 5749 adults with diabetes from the National Health and Nutrition Examination Survey cycles 2003-2018 and followed up until 31 December 2019. Food insecurity was measured by the Food Security Survey Module. Cox proportional hazard models were employed to estimate hazard ratios (HRs) and 95% confidence intervals for both all-cause mortality and cause-specific mortality. RESULTS The weighted prevalence of full food security, marginal food security, low food security, and very low food security was 70.8%, 11.0%, 10.4%, and 7.8%, respectively. Food insecurity demonstrated a significant correlation with diminished diet quality and reduced consumption of healthy foods. Over the course of 42,272.0 person-years of follow-up, we documented 1091 deaths, of which 370 were attributed to cardiovascular disease and 180 to cancer. After adjusting for multiple variables, food insecurity scores were significantly and linearly associated with increased all-cause mortality. Comparing to full food security, participants experiencing very low food security had a multivariate-adjusted HR of 1.48 (1.12, 1.95) for all-cause mortality (ptrend = 0.010). CONCLUSIONS Food insecurity was associated with increased all-cause mortality and compromised diet quality, especially in individuals experiencing very low food security. Future strategies may necessitate the monitoring of and interventions for food insecurity among individuals with diabetes.
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Affiliation(s)
- Pengbo Fu
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Jin Wen
- Institude of Hospital Management, West China Hospital, Sichuan University, Chengdu, China
| | - Xiaoxia Duan
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Xiaowen Hu
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Fangyan Chen
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Ping Yuan
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
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Diaz-Amaya Y, Star Z, McClure ST. Food security and diet quality, not vitamin D status are significantly associated with depression: Results from NHANES 2015-2018. J Affect Disord 2024; 347:150-155. [PMID: 38000464 DOI: 10.1016/j.jad.2023.11.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 09/11/2023] [Accepted: 11/18/2023] [Indexed: 11/26/2023]
Abstract
BACKGROUND Observational research has suggested a link between vitamin D insufficiency and depression, while evidence from randomized trials examining the association have yielded inconsistent results. Food security and diet quality are also associated with both vitamin D insufficiency and depression. However, the potential interactions between these factors have not been well described. METHODS In order to examine the associations between depression, vitamin D status, food security, and diet quality, data from 8988 US adults (≥20 years) in NHANES (National Health and Nutrition Examination Surveys) 2015-2018 were analyzed. Questionnaire-assessed depression, food security, and diet quality and laboratory-analyzed serum vitamin D were used. RESULTS Lack of full food security and a 10-point decrease in Healthy Eating Index 2015 score were independently associated with higher risk of mild to severe depression (OR 3.72 and 1.20, respectively, p < 0.001). The association between insufficient serum vitamin D (<75 nmol/L) and depression was fully attenuated after adjusting for food security and diet quality (p = 0.41). LIMITATIONS A major limitation of this paper, like all analyses of NHANES, is the inability to establish the temporality of the relationships between food security and diet quality with depression. CONCLUSIONS Food security and diet quality, but not vitamin D status, were significantly associated with depression. This highlights how evaluating food security and diet quality are critical in research and public health interventions related to depression. Future interventions, especially into vitamin D insufficiency, as well as health policies should assess and address these factors.
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Affiliation(s)
- Yohanna Diaz-Amaya
- Department of Public Health, College of Arts and Sciences, Shenandoah University, Winchester, VA, USA
| | - Zoe Star
- Department of Public Health, College of Arts and Sciences, Shenandoah University, Winchester, VA, USA
| | - Scott T McClure
- Department of Public Health, College of Arts and Sciences, Shenandoah University, Winchester, VA, USA.
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Hicks PM, Simmons K, Newman-Casey PA, Woodward MA, Elam AR. Spatial Vision Inequalities: A Literature Review of the Impact of Place on Vision and Eye Health Outcomes. Transl Vis Sci Technol 2024; 13:22. [PMID: 38285463 PMCID: PMC10829826 DOI: 10.1167/tvst.13.1.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 12/28/2023] [Indexed: 01/30/2024] Open
Abstract
"Neighborhood and built environment" is one of the five domains of social determinants of health that has been outlined by Healthy People 2030, and this domain impacts an individual's well-being, health, and quality of life. Social risk factors (SRFs) in the neighborhood and built environment domain include unstable or unsafe housing, poor access to transportation, lack of green spaces, pollution, safety concerns, and neighborhood measures of inequity. In this narrative literature review, we assess the relationship between neighborhood and built environment SRFs and eye health and vision outcomes. We explain how mapping neighborhood-level SRFs may be used to advance health equity in the field of eye health and vision care.
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Affiliation(s)
- Patrice M. Hicks
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI, USA
| | - Kirsten Simmons
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI, USA
| | - Paula Anne Newman-Casey
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI, USA
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA
| | - Maria A. Woodward
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI, USA
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA
| | - Angela R. Elam
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI, USA
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA
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Mori Y, Tachi T, Hamano H, Kimura K, Matsumoto K, Sakurai H. Association between internet use and self-rated health of patients living with diabetes in the community. Digit Health 2024; 10:20552076241260369. [PMID: 39221080 PMCID: PMC11363046 DOI: 10.1177/20552076241260369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 05/21/2024] [Indexed: 09/04/2024] Open
Abstract
Objective It is not clear whether self-rated health is associated with internet use among community-dwelling patients living with diabetes. This study investigated what kind and level of use of the internet is desirable for the subjective sense of health among patients living with diabetes in the community. Research Design and Methods This was a cross-sectional study of patients living with diabetes aged 18 years or older who visited our clinic between April 2022 and June 2022. The final analysis included 654 subjects (mean age: 56-90 years). The objective variable was self-rated health, and the explanatory variable was purpose of internet use. We used logistic regression analysis to identify odds ratios (ORs) and 95% confidence intervals (CIs) for the association between internet use and self-rated health by purpose of internet use. Results Of the 654 patients living with diabetes using our clinic, 488 (64.7%) were internet users. Communication with friends/family (66.6%) was the most common use of the internet, followed by social media (54.3%) and shopping (36.7%). Logistic regression models showed that social media (OR: 1.81; 95% CI [1.02, 3.21], p = 0.04), shopping for food and other items (OR: 1.95; 95% CI [1.00, 3.77], p = 0.04), online securities and banking (OR: 2.75; 95% CI [1.02, 7.39], p = 0.04) were associated with self-rated health. Conclusions Using the internet for social media, shopping, and banking were found to be associated with self-rated health. Use for these purposes could help support diabetic care.
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Affiliation(s)
- Yuta Mori
- Department of Rehabilitation, Hananooka Hospital, Matsusaka-city, Mie, Japan
- Diabetology, Endocrinology, and Metabolism, Matsumoto Clinic, Matsusaka-city, Mie, Japan
- Department of Public Health, Graduate School of Medicine, Chiba University, Chiba-city, Chiba, Japan
| | - Tomoki Tachi
- Comprehensive Rehabilitation Center, Syutaikai Hospital, Yokkaichi-city, Mie, Japan
| | - Hatsue Hamano
- Faculty of Nursing, Toyama Prefectural University, Toyama City, Toyama Prefecture, Japan
| | - Keisuke Kimura
- Department of Rehabilitation, Toyota Regional Medical Center, Toyota-city, Aichi, Japan
| | - Kazutaka Matsumoto
- Department of Rehabilitation, Hananooka Hospital, Matsusaka-city, Mie, Japan
- Diabetology, Endocrinology, and Metabolism, Matsumoto Clinic, Matsusaka-city, Mie, Japan
| | - Hiroaki Sakurai
- Department of Health Sciences, Fujita Health University, Toyoake-city, Aichi, Japan
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Wetherill MS, Bridges KM, Talavera GE, Harvey SP, Skidmore B, Burger ES. Planting Seeds for Food Is Medicine: Pre-Implementation Planning Methods and Formative Evaluation Findings From a Multi-Clinic Initiative in the Midwest. J Prim Care Community Health 2024; 15:21501319241241465. [PMID: 38523426 PMCID: PMC10962037 DOI: 10.1177/21501319241241465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 03/05/2024] [Accepted: 03/07/2024] [Indexed: 03/26/2024] Open
Abstract
Food is medicine (FIM) initiatives are an emerging strategy for addressing nutrition-related health disparities increasingly endorsed by providers, payers, and policymakers. However, food insecurity screening protocols and oversight of medically-tailored food assistance programs are novel for many healthcare settings. Here, we describe the pre-implementation planning processes used to successfully engage federally-qualified health centers (FQHCs) across Kansas to develop new FIM initiatives. A Kansas-based philanthropic foundation facilitated pre-implementation planning for FQHCs over 17 months across 3 stages: 1) Community inquiry, 2) FIM learning event with invitation for FQHC attendees to request pre-implementation funding, and 3) Pre-implementation planning workshops and application assignments for FQHC grantees to develop a FIM implementation grant proposal. We evaluated satisfaction and perceived utility of these pre-implementation planning activities via post-workshop surveys and qualitative comparisons of FIM design components from pre-implementation and implementation grant applications. All 7 FQHCs attending the learning event applied for and were awarded pre-implementation planning grants; 6 submitted an implementation grant application following workshop completion. FQHCs rated pre-implementation support activities favorably; however, most clinics cited limited staff as a barrier to effective planning. As compared to pre-implementation planning grant proposals, all FQHCs elected to narrow their priority population to people with pre-diabetes or diabetes with better articulation of evidence-based nutrition prescriptions and intervention models in their final program designs. In the midst of a nationwide FIM groundswell, we recommend that funders, clinic stakeholders, and evaluators work together to devise and financially support appropriate pre-implementation planning activities prior to launching new FIM initiatives.
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Sastre LR, Stroud B, Haldeman L. Simple but Tailored: Developing Culinary-Focused Nutrition Education Along With a Produce Prescription Program. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2023; 55:841-845. [PMID: 37747379 DOI: 10.1016/j.jneb.2023.07.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 07/03/2023] [Accepted: 07/31/2023] [Indexed: 09/26/2023]
Affiliation(s)
- Lauren R Sastre
- Department of Nutrition Science, College of Allied Health Sciences, East Carolina University, Greenville, NC.
| | - Brandon Stroud
- Department of Nutrition Science, College of Allied Health Sciences, East Carolina University, Greenville, NC
| | - Lauren Haldeman
- Department of Nutrition, The University of North Carolina at Greensboro, Greensboro, NC
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12
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Avelino DC, Duffy VB, Puglisi M, Ray S, Lituma-Solis B, Nosal BM, Madore M, Chun OK. Can Ordering Groceries Online Support Diet Quality in Adults Who Live in Low Food Access and Low-Income Environments? Nutrients 2023; 15:862. [PMID: 36839221 PMCID: PMC9964317 DOI: 10.3390/nu15040862] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Revised: 01/29/2023] [Accepted: 02/07/2023] [Indexed: 02/10/2023] Open
Abstract
During the COVID-19 pandemic, U.S. food assistance programs allowed the use of program benefits to order groceries online. We examined relationships between the food environment, food assistance, online grocery ordering, and diet quality among adults from one low-income, low food access community in Northeastern Connecticut during the pandemic. Via online survey, adults (n = 276) reported their perceived home and store food environments, food assistance participation, whether they ordered groceries online, and consumption frequency and liking of foods/beverages to calculate diet quality indices. Those who ordered groceries online (44.6%) were more likely to participate in food assistance programs and report greater diet quality. Perceived healthiness of store and home food environments was variable, with the ease of obtaining and selecting unhealthy foods in the neighborhood significantly greater than healthy foods. Healthier perceived home food environments were associated with significantly higher diet qualities, especially among individuals who participated in multiple food assistance programs. Ordering groceries online interacted with multiple measures of the food environment to influence diet quality. Generally, the poorest diet quality was observed among individuals who perceived their store and home food environments as least healthy and who did not order groceries online. Thus, ordering groceries online may support higher diet quality among adults who can use their food assistance for purchasing groceries online and who live in low-income, low-access food environments.
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Affiliation(s)
- Daniela C. Avelino
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT 06269, USA
| | - Valerie B. Duffy
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT 06269, USA
| | - Michael Puglisi
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT 06269, USA
| | - Snehaa Ray
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT 06269, USA
| | - Brenda Lituma-Solis
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT 06269, USA
| | - Briana M. Nosal
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT 06269, USA
| | - Matthew Madore
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT 06269, USA
| | - Ock K. Chun
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT 06269, USA
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