A PILOT AND FEASIBILITY EVALUATION OF FOOD PRESCRIPTION TO ADDRESS FOOD INSECURITY AMONG YOUTH WITH TYPE 1 DIABETES

Baylor College Of Medicine, Houston TX

Investigators

Abstract

Food insecurity is a major social determinant of health that impacts nearly 20% of youth with type 1 diabetes (T1D). Food insecurity contributes to a number of negative T1D health, dietary, and psychosocial outcomes among youth and their families. Food prescription (Food Rx) programs, which are partnerships between community-based food access programs and healthcare settings to provide healthful food to individuals with chronic health conditions, have strong potential to improve health, dietary, and psychosocial outcomes of youth with T1D. Indeed, Food Rx combined with a healthy eating intervention delivered by Community Health Workers (CHW) has been associated with improved glycemic outcomes among adults with type 2 diabetes. Yet, Food Rx combined with a healthy eating intervention has not been evaluated among youth with T1D and their families from food insecure households. The purpose of this study is to assess the feasibility and preliminary outcomes of a healthy eating program that consists of Food Rx combined with an evidence-based healthy eating family behavioral intervention refined for delivery by CHWs for families of youth with T1D (ages 10-15 years) from food insecure households. The program will be implemented through a partnership between the Texas Children's Hospital's (TCH) Diabetes Care Center and The Houston Food Bank's (HFB) Food Rx Program. The study will be conducted in two phases. Phase 1 is a formative phase where investigators will engage stakeholders consisting of T1D healthcare providers, primary care providers, community health center providers, the HFB Food Rx Program staff, and families of youth with T1D to refine the program for families of youth with T1D from food insecure households who receive care in various healthcare settings such as specialty diabetes clinics, primary care, and community health centers. In Phase 2, the healthy eating program (Food Rx + healthy eating family behavioral intervention) will be evaluated in a randomized pilot trial where families will be randomized 1:1 (intervention: standard diabetes care). Stakeholders will continue engagement with the study team in Phase 2 to finalize the study protocol, problem-solve challenges, and disseminate findings. This study will provide critical preliminary data about the feasibility and preliminary outcomes of a refined healthy eating program (Food Rx + healthy eating family behavioral intervention) for youth with T1D to prepare for a more extensive, fully-powered study.