Objective: Design a quality improvement intervention for low-income diabetes patients at a free clinic to help them manage their chronic disease.
Target Audience: Low-income patients of a free clinic experiencing diabetes and HbA1C > 7.5%.
Theory, Prior Research, Rationale: Typical food pantry items are shelf-stable donations from the community to address hunger. In order to shift focus to empowering patients with tools and confidence to cook therapeutic foods (vegetables), the intervention design includes fresh produce and nutrition education along with coaching support. Other similar programs show significant improvements in HbA1C with substantial savings in healthcare costs overall for these patients.
Description: The program is a multi-faceted, 12-week nutrition intervention to help reduce HbA1C of diabetic patients. The intervention includes a weekly prescription of fresh vegetables and a hands-on cooking or preparation demonstration provided by a local community farm, bi-weekly nutrition education modules presented by dietetic interns from a local health care system, and bi-weekly client-centered, group health coaching facilitated by volunteers.
Evaluation: The program evaluation is based primarily on the objective clinical measures HbA1C, blood pressure and BMI. HbA1C was collected at baseline and post-intervention. Blood pressure and BMI were recorded at baseline and bi-weekly during the 12-week program. Subjective survey data regarding participant satisfaction and behavior change was collected as well.
Conclusions and Implications: Analysis of objective and subjective participant data provides evidence to support continuation of the program. Advantages of the intervention are recruitment of engaged patients, collaborative community partnerships and generous volunteers at the clinic. Future cohorts will improve by providing program access to more patients and further developing the health coaching protocol. Design of the program could be reproducible in clinics with a similar patient-base in other geographies.
Funding: Health Brigade Clinic.
The following is the supplementary data to this article: