Abstract
Purpose and ObjectivesAlthough food insecurity is associated with poor dietary intake and risk of chronic disease, few studies have demonstrated the effectiveness of diabetes prevention interventions delivered through food banks. Food banks serve vulnerable communities. The purpose of this pilot project was to assess the effectiveness of a food bank–delivered intervention aimed at improving food security and reducing risk factors for type 2 diabetes among at-risk clients.Intervention ApproachWe screened adult English- and Spanish-speaking food bank clients for type 2 diabetes risk at 12 community food distribution sites in Alameda County, California. Screening and enrollment for a pilot intervention took place from November 2017 to March 2018. Intervention components were delivered from November 2017 through March 2019. The intervention included monthly diabetes-appropriate food packages, text-based health education, and referrals to health care.Evaluation MethodsFood bank staff members administered surveys to participants at baseline, 6 months (midpoint), and 12 months (postintervention); participants self-reported all responses. Primary outcomes assessed were food security status, dietary intake, health-related behaviors, and body mass index (BMI). Information on demographic characteristics, food pantry access, health care use, and symptoms of depression was also collected.ResultsWe screened 462 food bank clients for eligibility. Of the 299 who were eligible, 244 enrolled; 90.6% were female, 80.1% were Hispanic, and 49.1% had an annual household income less than $20,000. At baseline, 68.8% of participants had low or very low food security. At midpoint, participants had significant improvements in food security status, dietary intake, physical activity, health status, and depression scores. Mean BMI did not change.Implications for Public HealthThis intervention demonstrated that food banks can effectively screen clients at high risk for diabetes and improve household food security and other risk factors for diabetes. Food banks may be an important and strategic partner for health care systems or community-based organizations working to prevent diabetes in food-insecure populations.
Highlights
Food insecurity is a risk factor for type 2 diabetes [1,2], and household food insecurity is more prevalent when a household member has diabetes [3]
Food banks serve vulnerable communities. The purpose of this pilot project was to assess the effectiveness of a food bank–delivered intervention aimed at improving food security and reducing risk factors for type 2 diabetes among at-risk clients
The opinions expressed by authors contributing to this journal do not necessarily reflect the opinions of the U.S Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors’ affiliated institutions
Summary
Food bank staff members screened 462 food pantry clients aged 18 or older at 12 sites beginning in November 2017. Tion sites, not every distribution site for this project had an outreach staff member in attendance to encourage and facilitate SNAP enrollment and maintenance This pilot project demonstrated that food banks serve vulnerable populations at high risk for poor health and chronic disease, and that delivery of disease prevention programs through food banks can be effective, accessible, and relevant for populations that may not be able to access similar services through traditional health care systems or community-based programs. Participants in this pilot project had significant improvements in health-related metrics despite not having access to a formal DPP. Further exploration and evaluation of similar models should be pursued, because these models often reach marginalized populations who are at the highest risk for poor health and who face multiple barriers to accessing and using health care services that target disease prevention and health promotion
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