(LB01-16-25) Pilot Outcomes of Optimizing Food is Medicine Interventions

Objectives: The two-phase pilot study utilized a multiphase optimization strategy (MOST) to determine the most feasible and cost-effective psychosocial and structural interventions for improving dietary behaviors among racial and ethnic minorities at risk for cardiometabolic disease.

Methods: The phase 1 study used a randomized crossover design to test psychosocial and structural interventions, aiming to select the best combination for further pilot testing. Participants were randomized to intervention groups and modality types (voucher/prescription, food pantry, meal subscription for structural; telephone, face-to-face, telehealth for psychosocial). Optimization criteria included participant burden, cost-effectiveness, and attendance. Phase 1 results led to a second-phase pilot (completed Dec 2024). Phase 2 participants were randomized to one of four arms for 12 weeks, voucher/prescription+face-to-face or meal subscription+telehealth, with integrated delivery including wellness services, while traditional delivery provided only the intervention.

Results: Phase 2 findings demonstrated all study arms met optimization criterion on participant burden scores. Although these scores were highest in the integrated voucher+face-to-face group, two-way ANOVA indicated no main effects on participant burden. Additionally, the traditional voucher+face-to-face delivery was the most cost-effective of the four arms, and both face-to-face groups achieved better attendance than the virtual groups, with a two-way ANOVA indicating a main effect of delivery method (but not modality or interactions) on attendance.

Conclusions: Findings from phase 2 pilot results examined the implementation of common Food is Medicine strategies in a real-world setting (a community-based outpatient clinic). Ultimately, these results support the design of a clinical trial to elucidate clinical effectiveness and implementation guidelines for an optimal Food is Medicine intervention in Mississippi.

Funding Sources: This project has been funded in whole/in part by the National Heart, Lung, and Blood Institute, National Institute of Health/NIH (Contract No.HHSN2682018000151) and Mississippi INBRE, National Institute of General Medical Sciences, NIH (Grant No.P20GM103476).