Fresh Food Farmacy: A Randomized Controlled Trial

We propose a pragmatic, prospective, randomized-controlled trial of Geisinger’s Fresh Food Farmacy (FFF) program. FFF brings a “food-as-medicine” approach to treat food-insecure diabetics featuring a diet prescription filled at an FFF clinic each week—enough healthy food for participants and their households for 2 meals a day over 5 days—along with advice from dietitians on how to prepare the foods and care management aimed at improving diabetes self care. FFF has received considerable, national attention, and the idea of providing food as medicine to address a key social determinant of health is promising and beginning to be adopted ahead of rigorous evidence supporting its effectiveness. We propose the first relatively large scale (N=500) randomized evaluation of a food-as-medicine approach led by a healthcare provider to begin to provide this much-needed evidence. Our outcome measures include clinical outcomes (blood sugar control, blood pressure, weight, and cholesterol) as well as healthcare utilization and patient surveys of self-assessed health, healthy behaviors, self-efficacy, and patient satisfaction. We will also measure spillover effects on household members, and test whether this program is a complement or substitute for other healthy behaviors such as other diabetes and non-diabetes preventive care.