Individuals with type 2 diabetes mellitus (T2DM) experiencing food insecurity often have worse health outcomes than those not experiencing food insecurity. These poor outcomes are often exacerbated among individuals who live in rural areas. Current studies have evaluated the impact of digital health coaching (DHC) and food delivery programs as separate interventions. This study was conducted to assess the impact of a combined health coaching and food delivery intervention on individuals with T2DM who live in rural areas. In this retrospective analysis, individuals were referred by a national insurance payor and screened for food insecurity by a social worker, provider, or payor record. Participants were considered to live in a rural area if they lived outside of a US Census Bureau Urbanized Area (an urban area of 50,000 or more people). Patient reported outcome measures were collected at baseline and 6 months after starting the program. Paired t-tests were used to determine significant differences. At 6 months, 1093 participants were enrolled in the DHC and food delivery program. Of those enrolled, 31% lived in a rural area. Rural participants had significant improvements in HbA1c (7.49 to 6.93, P<0.0295), diabetes distress (2.71 to 2.01, P<0.0001), and food insecurity (2.46 to 1.20, P<0.0024). There were also significant improvements in the PROMIS mental health score (43.04 to 46.30, P=0.0024) and PROMIS physical health score (40.07 to 43.61, P=0.0007). While previous studies have focused on the impact of health coaching or food delivery, few assessed the impact of a combined intervention, and most studies had a small percentage of rural participants. Participants who completed the 6-month intervention had significant improvements among food insecurity and diabetes related quality of life metrics. A combined intervention may lead to improved mental and physical health outcomes among rural populations with T2DM and food insecurity.

Disclosure

J. Moore: None. S. Rutland: Employee; Quest Diagnostics. J. Murphy: Employee; Quest Diagnostics. M. Tarasovich: Employee; Quest Diagnostics.

© 2024 by the American Diabetes Association
2024
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