TY - JOUR
AU - L. G. Rosas
AU - S. Chen
AU - L. Xiao
AU - M. Baiocchi
AU - E. Ng
AU - B. O. Emmert-Aronson
AU - W. T. Chen
AU - A. Thompson-Lastad
AU - E. Martinez
AU - J. Perez
AU - E. Melendez
AU - E. Markle
AU - M. D. Radtke
AU - J. Tester
A1 - 
AB - INTRODUCTION: Food as Medicine is increasingly recognized as an important strategy for addressing the related challenges of food insecurity and nutrition-related chronic conditions. Food as Medicine refers to integration of food-based nutrition interventions into healthcare to prevent and treat disease. However, there is limited evidence to understand the effectiveness of Food as Medicine. METHODS: Recipe4Health (R4H), a comprehensive Food as Medicine program, was implemented in 4 Federally Qualified Health Centers in California for patients with food insecurity and/or nutrition-related chronic conditions. Patients were referred by a healthcare provider to a "Food Farmacy" (16 weekly produce home deliveries) alone or in combination with a "Behavioral Pharmacy" (16 weekly group visits). A quasi-experimental study with pre/post surveys (4 months) and propensity score matched controls for Electronic Health Record outcomes over 12 months was conducted. Participants were 2,643 R4H patients and 2,643 controls identified from 1/2020 to 12/2022; data were analyzed from 2023 to 2024. RESULTS: There was a significant increase in produce consumption from baseline to 4 months (0.41 servings/day [0.11, 0.72], p=0.007) in the Food Farmacy in combination with Behavioral Pharmacy. Compared to controls, there were improvements in non-HDL cholesterol for the Food Farmacy alone (-17.1 mg/dL [-26.9, -7.2], p<0.001) and in combination with Behavioral Pharmacy (-17 mg/dL [-28.3, -5.8], p=0.003) at 12 months. Compared to controls, HbA1c significantly decreased in the Food Farmacy alone at 12 months (-0.37%, 95% CI [-0.65, -0.08]; p=0.01), but not the Food Farmacy with Behavioral Pharmacy. CONCLUSIONS: R4H resulted in improvements in diet and multiple clinical health outcomes, such as non-HDL cholesterol and HbA1c.
AD - Department of Epidemiology and Population Health, Stanford University, Palo Alto, California; Department of Medicine, Stanford University, Palo Alto, California. Electronic address: lgrosas@stanford.edu.; Alameda County Health, San Leandro, California.; Department of Epidemiology and Population Health, Stanford University, Palo Alto, California.; Community Health Center Network, Oakland, California.; Open Source Wellness, Oakland, California.; Osher Center for Integrative Health, University of California San Francisco, San Francisco, California; Department of Family and Community Medicine, University of California San Francisco, San Francisco, California; School of Medicine, University of California Irvine, Irvine, California.; Department of Epidemiology and Population Health, Stanford University, Palo Alto, California; School of Medicine, University of California Irvine, Irvine, California.; Department of Pediatrics, University of California San Francisco, San Francisco, California.
AN - 39491775
BT - Am J Prev Med
C5 - General Literature
CP - 2
DA - Feb
DO - 10.1016/j.amepre.2024.10.020
DP - NLM
ET - 20241102
IS - 2
JF - Am J Prev Med
LA - eng
N2 - INTRODUCTION: Food as Medicine is increasingly recognized as an important strategy for addressing the related challenges of food insecurity and nutrition-related chronic conditions. Food as Medicine refers to integration of food-based nutrition interventions into healthcare to prevent and treat disease. However, there is limited evidence to understand the effectiveness of Food as Medicine. METHODS: Recipe4Health (R4H), a comprehensive Food as Medicine program, was implemented in 4 Federally Qualified Health Centers in California for patients with food insecurity and/or nutrition-related chronic conditions. Patients were referred by a healthcare provider to a "Food Farmacy" (16 weekly produce home deliveries) alone or in combination with a "Behavioral Pharmacy" (16 weekly group visits). A quasi-experimental study with pre/post surveys (4 months) and propensity score matched controls for Electronic Health Record outcomes over 12 months was conducted. Participants were 2,643 R4H patients and 2,643 controls identified from 1/2020 to 12/2022; data were analyzed from 2023 to 2024. RESULTS: There was a significant increase in produce consumption from baseline to 4 months (0.41 servings/day [0.11, 0.72], p=0.007) in the Food Farmacy in combination with Behavioral Pharmacy. Compared to controls, there were improvements in non-HDL cholesterol for the Food Farmacy alone (-17.1 mg/dL [-26.9, -7.2], p<0.001) and in combination with Behavioral Pharmacy (-17 mg/dL [-28.3, -5.8], p=0.003) at 12 months. Compared to controls, HbA1c significantly decreased in the Food Farmacy alone at 12 months (-0.37%, 95% CI [-0.65, -0.08]; p=0.01), but not the Food Farmacy with Behavioral Pharmacy. CONCLUSIONS: R4H resulted in improvements in diet and multiple clinical health outcomes, such as non-HDL cholesterol and HbA1c.
PY - 2025
SN - 0749-3797 (Print); 0749-3797
SP - 377
EP - 390+
ST - The Effectiveness of Recipe4Health: A Quasi-Experimental Evaluation
T1 - The Effectiveness of Recipe4Health: A Quasi-Experimental Evaluation
T2 - Am J Prev Med
TI - The Effectiveness of Recipe4Health: A Quasi-Experimental Evaluation
U1 - General Literature
U3 - 10.1016/j.amepre.2024.10.020
VL - 68
VO - 0749-3797 (Print); 0749-3797
Y1 - 2025
ER -