(P11-004-25) Food Is Medicine Models During Pregnancy for Women With Lower-Income Status: Pragmatic Randomized Controlled Trial Recruitment Results

Objectives: Women from lower income homes are more likely to experience food insecurity and disparities in maternal outcomes. As women from lower income homes historically have low recruitment response rates, we report recruitment results from an ongoing trial testing health system models to improve enrollment into the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC).

Methods: This pragmatic randomized controlled trial recruited pregnant women, aged 18 years, English speaking, with public or no insurance (proxy for lower income) who intended to deliver at the recruiting health system. Individuals already enrolled in WIC or unwilling to participate for 12 months were excluded. We identified potential participants using electronic health record data, then contacted potential participants by email (via personal and patient portal), text, and phone calls. The study aimed to enroll 200 participants in a 6-month period.

Results: The study achieved targeted recruitment early and remaining resources were used to overrecruit by 20%. A total of 1,539 potential participants were EHR-identified and emailed recruitment materials. Of these, 514 (33%) completed screening: 355 (69%) online and 159 (31%) via phone. Of the persons screened, 140 (23%) were ineligible mostly due to WIC enrollment. Among the remaining 374 (73%) eligible participants, 109 (29%) were not interested and 25 (7%) did not return consent before recruitment closed. A total of 240 (64%) eligible participants were enrolled. Among participants, 64% are White, 14% are Black, and 22% are other race; the mean (standard deviation) body mass index is 30.5 (8.31) kg/m² and age 29.2 (6.2) years. Non-participants were similar except that all were food secure whereas 40.4% of participants reported low or very low food security. 21.3% of participants live in a rural area and 74% live in areas characterized by high or very high community-level socioeconomic deprivation.

Conclusions: The Food Is Medicine approach calls for strategies that integrate food provision and healthcare. Health system tools including EHR-identification and email strategies contributed to successful recruitment of women with social and/or structural risks (low income, food insecure, rural, minoritized racial or ethnic group) associated with inequities in health outcomes.

Funding Sources: American Heart Association