title: A Pilot Food Bank Intervention Featuring Diabetes-Appropriate Food Improved Glycemic Control Among Clients In Three States.
abstract: Food insecurity--defined as not having adequate quantity and quality of food at all times for all household members to have an active, healthy life--is a risk factor for poor diabetes control, yet few diabetes interventions address this important factor. Food pantries, which receive food from food banks and distribute it to clients in need, may be ideal sites for diabetes self-management support because they can provide free diabetes-appropriate food to people in low-income communities. Between February 2012 and March 2014, we enrolled 687 food pantry clients with diabetes in three states in a six-month pilot intervention that provided them with diabetes-appropriate food, blood sugar monitoring, primary care referral, and self-management support. Improvements were seen in pre-post analyses of glycemic control (hemoglobin A1c decreased from 8.11 percent to 7.96 percent), fruit and vegetable intake (which increased from 2.8 to 3.1 servings per day), self-efficacy, and medication adherence. Among participants with elevated HbA1c (at least 7.5 percent) at baseline, HbA1c improved from 9.52 percent to 9.04 percent. Although food pantries are nontraditional settings for diabetes support, this pilot study suggests a promising health promotion model for vulnerable populations. Policies supporting such interventions may be particularly effective because of food pantries' food access and distribution capacity.
authors.affiliation: Hilary K. Seligman (hseligman@medsfgh.ucsf.edu) is an associate professor of medicine and of epidemiology and biostatistics at the University of California, San Francisco (UCSF) and at the UCSF Center for Vulnerable Populations.
authors.forename: Hilary K
authors.initials: HK
authors.lastname: Seligman
authors.affiliation: Courtney Lyles is an assistant professor of medicine at UCSF and at the UCSF Center for Vulnerable Populations.
authors.forename: Courtney
authors.initials: C
authors.lastname: Lyles
authors.affiliation: Michelle B. Marshall is director of community health and nutrition at Feeding America, in Chicago, Illinois.
authors.forename: Michelle B
authors.initials: MB
authors.lastname: Marshall
authors.affiliation: Kimberly Prendergast is a community health and diabetes consultant at Feeding America.
authors.forename: Kimberly
authors.initials: K
authors.lastname: Prendergast
authors.affiliation: Morgan C. Smith is manager of interventions for health at Feeding America.
authors.forename: Morgan C
authors.initials: MC
authors.lastname: Smith
authors.affiliation: Amy Headings is director of research and nutrition at the Mid-Ohio Foodbank, in Grove City.
authors.forename: Amy
authors.initials: A
authors.lastname: Headings
authors.affiliation: Georgiana Bradshaw is a diabetes program coordinator at the Food Bank of Corpus Christi, in Texas.
authors.forename: Georgiana
authors.initials: G
authors.lastname: Bradshaw
authors.affiliation: Sophie Rosenmoss is a research intern in the Division of General Internal Medicine and the Center for Vulnerable Populations, both at UCSF.
authors.forename: Sophie
authors.initials: S
authors.lastname: Rosenmoss
authors.affiliation: Elaine Waxman is a senior fellow at the Urban Institute, in Washington, D.C.
authors.forename: Elaine
authors.initials: E
authors.lastname: Waxman
mesh_terms: D001786:Blood Glucose / Q000378:metabolism*; D003924:Diabetes Mellitus, Type 2 / Q000178:diet therapy*; D000072001:Diet, Healthy; D005523:Food Supply; D006293:Health Promotion; D006801:Humans; D010865:Pilot Projects; D014481:United States
chemical_list: D001786:Blood Glucose
keywords: Disparities; Public Health