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Author Notes:

Lauren Belak, Email: lbelak14@gmail.com

All authors contributed to this study and manuscript in specific ways. LB contributed to the design of this study and acquisition and interpretation of data and served as the primary contributor to the production of this manuscript. CO contributed to the design of the study, acquisition and interpretation of data, statistical testing, and production and review of the manuscript. MS participated in the acquisition of data and the production of the manuscript. EC contributed to the acquisition, analysis, and interpretation of data, as well as review of the manuscript. LS contributed to the production and review of this manuscript. HE contributed to the acquisition and analysis of data and review of the manuscript. SS contributed to the design of the study and review of this manuscript. All authors have read and approved this manuscript.

We are grateful for all the efforts of Open Hand Atlanta and staff who supported this study. We thank the program participants, without whom this work would not be possible. Funding for this program was granted by the Kaiser Foundation Health Plan of Georgia, Inc. to Open Hand Atlanta.

The authors have no relevant financial or non-financial interests to disclose.

Subjects:

Research Funding:

Funding for this intervention was granted by the Kaiser Foundation Health Plan of Georgia, Inc. to Open Hand Atlanta.

The Kaiser Foundation Health Plan of Georgia, Inc. neither had any roles in the design of this study, nor the collection, analysis, and interpretation of data. Kaiser also did not contribute to writing this manuscript.

Keywords:

  • Congestive heart failure
  • Food insecurity
  • Medically tailored meals
  • Nutrition intervention
  • Program evaluation

The impact of medically tailored meals and nutrition therapy on biometric and dietary outcomes among food-insecure patients with congestive heart failure: a matched cohort study

Tools:

Journal Title:

BMC Nutrition

Volume:

Volume 8, Number 1

Publisher:

, Pages 108-108

Type of Work:

Article | Final Publisher PDF

Abstract:

Background: To evaluate the impact of home-delivered, medically tailored meals and medical nutrition therapy among food-insecure patients following hospitalization for congestive heart failure by comparing clinical outcomes to a retrospectively matched cohort. Methods: Patients at high risk for readmission and food insecurity received up to three months of medically tailored meals and medical nutrition therapy after discharge. Pre-intervention and post-intervention weight, body mass index, blood pressure, and dietary intake were assessed. A combination of difference-in-difference and logistic regression models were used to compare changes between cohorts and evaluate impact attributable to the program. Results: Thirty-nine program participants were compared to a matched cohort of 117 unexposed patients. Participants experienced a marginal reduction in body mass index and an increase in systolic and diastolic blood pressure; however, these results were not statistically significant. To determine relevance to clinical cut-offs, logistic regressions were used, demonstrating that exposure to the intervention resulted in higher odds of a categorical reduction in blood pressure (OR: 1.85), though this did not reach statistical significance (95% CI: 0.67–5.32). Pre vs. post trends indicated that more-healthful foods and drinks increased numerically or remained similar to baseline, while less-healthful foods decreased numerically or remained similar to baseline. Conclusions and implications: These findings highlight the need for more longitudinal research on medically tailored meals and medical nutrition therapy interventions using clinical outcomes while setting realistic suggestions for program implementation. This study additionally illustrates the promise of integrating electronic medical record data and matched cohorts into medical nutrition program evaluation within the health sector.

Copyright information:

© The Author(s) 2022

This is an Open Access work distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/).
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