J Nutr Educ Behav. 2025 Jun 10:S1499-4046(25)00313-6. doi: 10.1016/j.jneb.2025.05.197. Online ahead of print.
ABSTRACT
OBJECTIVE: Determine whether the frequency of attendance to Recipe4Health was associated with improvements in health-related outcomes.
DESIGN: Secondary analysis of the Recipe4Health quasi-experimental study.
SETTING: Federally Qualified Health Centers in Alameda County, California.
PARTICIPANTS: Patients with nutrition-related chronic conditions and/or food insecurity.
INTERVENTION: Sixteen weekly produce deliveries and behavioral intervention sessions.
MAIN OUTCOME MEASURES: Attendance was categorized by percentage: low (< 50%), moderate (50% to < 75%), and high (≥ 75%), and outcomes included vegetable/fruit intake, physical activity (PA), mental health, and clinical biomarkers.
ANALYSIS: Prepost changes were assessed using repeated measures linear mixed-effects models, adjusting for baseline values.
RESULTS: Of the 199 patients, approximately one-third had low (36%), moderate (30%), and high (34%) attendance. Patients with high attendance had greater improvements in vegetable/fruit intake (0.3 cups/d; P = 0.03), PA (24.4 min/wk; P < 0.01), and depression symptoms (Patient Health Questionnaire score: -1.1; P < 0.01) compared with patients with low attendance. Patients with moderate attendance had greater improvements in PA compared with low attendance (15.1 min/wk; P = 0.03). Patients with high attendance had greater improvements in physically unhealthy days compared with moderate attendance (-2.4 d/mo; P < 0.01). Patients with high attendance had significant improvements in hemoglobin A1c from baseline (-0.7%; P = 0.02).
CONCLUSIONS: Strategies to improve attendance should be prioritized in food as medicine interventions.
PMID:40498429 | DOI:10.1016/j.jneb.2025.05.197
