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Am J Public Health. 2018 Sep;108(9):1227-1234. doi: 10.2105/AJPH.2018.304528. Epub 2018 Jul 19.

Comprehensive Diabetes Self-Management Support From Food Banks: A Randomized Controlled Trial.

Author information

1
Hilary K. Seligman and Sophie Rosenmoss are with the Division of General Internal Medicine and Center for Vulnerable Populations, University of California San Francisco. Hilary K. Seligman is also with, and Morgan Smith and Michelle Berger Marshall are with Feeding America. Elaine Waxman is with Urban Institute, Washington, DC.

Abstract

OBJECTIVES:

To determine whether food bank provision of self-management support and diabetes-appropriate food improves glycemic control among clients with diabetes.

METHODS:

We screened 5329 adults for diabetes at food pantries (n = 27) affiliated with food banks in Oakland, California; Detroit, Michigan; and Houston, Texas, between October 2015 and September 2016. We individually randomized 568 participants with hemoglobin A1c (HbA1c) 7.5% or greater to waitlist control or 6-month intervention including food, diabetes education, health care referral, and glucose monitoring. The primary outcome was HbA1c at 6 months.

RESULTS:

Food security (relative risk [RR] = 0.85; 95% confidence interval [CI] = 0.73, 0.98), food stability (RR = 0.77; 95% CI = 0.64, 0.93), and fruit and vegetable intake (risk difference [RD] = 0.34; 95% CI = 0.34, 0.34) significantly improved among intervention participants. There were no differences in self-management (depressive symptoms, diabetes distress, self-care, hypoglycemia, self-efficacy) or HbA1c (RD = 0.24; 95% CI = -0.09, 0.58).

CONCLUSIONS:

Food banks are ideally situated to provide diabetes-appropriate food to food-insecure households. Effective strategies for food banks to support improvements in diabetes clinical outcomes require additional study. Public Health Implications. Moving chronic disease support from clinics into communities expands reach into vulnerable populations. However, it is unclear how community interventions should be integrated with clinical care to improve disease outcomes.

TRIAL REGISTRATION NUMBER:

NCT02569060.

PMID:
30024798
PMCID:
PMC6085038
[Available on 2019-09-01]
DOI:
10.2105/AJPH.2018.304528

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