The goal of this clinical trial is to assess the impact of participation in Eat Well for diabetes patients who are at risk of food insecurity. The main questions it aims to answer are: * whether there is a difference in Haemoglobin (Hb) A1c measurements and emergency department (ED) utilization between the Eat Well and control groups up to 18 months post-program completion. * whether there are differences in cardiometabolic health-related outcomes for Eat Well participants. Participants in the program will receive gift/debit cards for fruits and vegetables and educational nutrition materials. Researchers will compare Eat Well participants with those only receiving educational materials to see if there are differences in cardiometabolic health outcomes.
This pragmatic trial aims to assess the impact of Eat Well participation for diabetes patients at risk of food insecurity. Eligible patients will receive gift/debit cards for the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)-approved fruits and vegetables and be assigned to either receive the card for up to 12 months or not. Random assignment will occur using a 2 to 1 treatment to control allocation ratio. Both treatment and control groups will receive curated diabetes educational materials. The study will assess the impact of the intervention on clinical factors such as glycemic control, weight, BMI, lipids, medication adherence, medication number, blood pressure, and utilization up to 18 months pre, during, and post program enrollment using data from clinical visits. The primary analysis of interest will be differences in HbA1c measurements and ED visits between the Eat Well and control groups at 12 months of program participation, with further evaluation of differences at 12 months post-program completion.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
2,177
A program offered by Reinvestment Partners giving clients gift/debit cards that allow the purchase of WIC approved fruits and vegetables.
Duke University Health System
Durham, North Carolina, United States
Change in HbA1C
A measure of average blood sugar levels over the past 3 months.
Time frame: 18 months pre program, during program enrollment, up to 12 months
Change in number of ED Visits
Number of ED visits throughout the study period
Time frame: up to 18 months pre program, during program enrollment, up to 12 months
Outpatient visits
Number of outpatient visits during the study period
Time frame: up to 18 months pre program, during program, and up to 18 months post program
Hospitalizations
Number of patient hospitalizations during the study period
Time frame: up to 18 months pre program, during program, and up to 18 months post program
Change in weight
Time frame: up to 18 months pre program, during program, and up to 18 months post program enrollment
Change in body mass index (BMI)
A measure of body fat based on height and weight.
Time frame: up to 18 months pre program, during program, and up to 18 months post program
Change in cholesterol
Measure of lipids
Time frame: up to 18 months pre program, during program, and up to 18 months post program
Medication adherence (proportion of days covered)
Medication adherence will be measured by linking EHR data with Surescripts e-prescription network data. Surescripts facilitates medication refill information exchange between healthcare organizations and pharmacies. Adherence will be calculated using the proportion of days covered (PDC) approach
Time frame: up to 18 months pre program, during program, and up to 18 months post program
Change in number of diabetes and hypertension medications
Change in diabetes and hypertension medication numbers
Time frame: up to 18 months pre program, during program, and up to 18 months post program
Change in blood pressure
Systolic and Diastolic blood pressure
Time frame: up to 18 months pre program, during program, and up to 18 months post program
Change in HbA1C
A measure of average blood sugar levels over the past 3 months.
Time frame: 18 months post program
Change in number of ED Visits
Number of ED visits throughout the study period
Time frame: 18 months post program
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