Nourishing Tomorrow: Role of Medically Tailored Groceries in Addressing Food Insecurity During Pregnancy

NCT ID: NCT06965530

Last Updated: 2025-10-21

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

360 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-10-06

Study Completion Date

2029-05-31

Brief Summary

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Medically tailored groceries (MTG), involving grocery items to be prepared at home, selected by a nutritional professional based on a treatment plan, is a growing approach adopted by healthcare systems to address food insecurity in their patient populations, a leading contribution to health disparities such as poor birth outcomes within pregnant populations. However, transportation and other social needs can often hinder patient uptake of clinic-based approaches. Findings from this study will help to better understand how home delivery of MTGs, with and without supplemental education and support to improve food literacy, behavioral and health outcomes.

Detailed Description

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Medically tailored groceries (MTG) generally involve fresh and shelf-stable grocery items to be prepared at home, selected by a nutritional professional based on a treatment plan and are typically picked up at a clinic, market, or pantry. This clinic-based market or pantry model (CB-MTG) is a growing approach adopted by health care systems in their effort to address food insecurity in their patient population, including University Hospitals of Cleveland (UH) and MetroHealth Medical Center (Metro), two of the three largest health systems in Cleveland, Ohio. Often offered to patients with food-related chronic conditions, CB-MTGs have shown to improve medication adherence, increase fruits and vegetable consumption and decrease HbA1c in people with diabetes. However, less evidence is available on the impact of CB-MTGs with food insecure pregnant individuals, where food insecurity has been strongly associated with prematurity and other negative birth outcomes.

While promising, the CB-MTG approach requires transportation, having the tools and equipment to prepare meals at home and some basic food preparation skills, all potential barriers for low-income pregnant individuals, especially younger parents-to-be or those already with children. The Greater Cleveland Food Bank and partners, seeking to address these barriers, recently developed a home delivered version of MTG (HD-MTG), offered to Medicaid-eligible pregnant individuals across the county, with promising results. The investigators seek to integrate these approaches into patient care for food insecure, pregnant women and test the effectiveness of these two approaches, alongside an additional intervention arm that adds supplemental nutrition and culinary education and support to the home-delivered approach (HD-MTG PLUS). These three approaches will be offered (via randomization) to 360 pregnant individuals (120 per arm) with food insecurity who are patients within UH and Metro's largest urban obstetric practices, each with direct electronic health record (EHR) referral systems to their "food as medicine" clinics/markets. Data are collected at baseline, near/at delivery and 6 months post-delivery. This study seeks to understand the unique contribution of each approach, as well as implementation and intervention uptake barriers, with the goal of building the evidence base of MTG interventions and making recommendations to providers and health systems seeking to address food insecurity and nutrient deficiencies during pregnancy.

Conditions

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Pregnancy Related Prematurity Birth Outcome, Adverse

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

DOUBLE

Caregivers Outcome Assessors

Study Groups

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Clinic-Based Medically Tailored Groceries (CB-MTG)

Standard of Care: Patients enrolled in the health systems clinic-based Food is Medicine Program.

Group Type ACTIVE_COMPARATOR

Clinic-Based Medically Tailored Groceries (CB-MTG)

Intervention Type DIETARY_SUPPLEMENT

Patients have the opportunity to pick up medically tailored groceries every other week at the Food Is Medicine Clinic or Market associated with their provider.

Home Delivered Medically Tailored Groceries (HD-MTG)

Patient received home delivered medically tailored groceries every two weeks during pregnancy and up to 6 months post-delivery.

Group Type EXPERIMENTAL

Home Delivered Medically Tailored Groceries (HD-MTG)

Intervention Type DIETARY_SUPPLEMENT

Patient receive home delivered medically tailored groceries every two weeks during pregnancy and up to 6 months post-delivery.

Home Delivered Medically Tailored Groceries PLUS (HD-MTGPLUS)

Same as Arm 2, receiving home delivered medically tailored groceries every two weeks during pregnancy and up to 6 months post-delivery, but receives additional nutrition and culinary education and support throughout the trial.

Group Type EXPERIMENTAL

Home Delivered Medically Tailored Groceries plus Education (HD-MTG_PLUS)

Intervention Type DIETARY_SUPPLEMENT

Patients receive home delivered medically tailored groceries every two weeks during pregnancy and up to 6 months post-delivery, plus also receives additional nutrition and culinary education and support throughout the trial.

Interventions

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Clinic-Based Medically Tailored Groceries (CB-MTG)

Patients have the opportunity to pick up medically tailored groceries every other week at the Food Is Medicine Clinic or Market associated with their provider.

Intervention Type DIETARY_SUPPLEMENT

Home Delivered Medically Tailored Groceries (HD-MTG)

Patient receive home delivered medically tailored groceries every two weeks during pregnancy and up to 6 months post-delivery.

Intervention Type DIETARY_SUPPLEMENT

Home Delivered Medically Tailored Groceries plus Education (HD-MTG_PLUS)

Patients receive home delivered medically tailored groceries every two weeks during pregnancy and up to 6 months post-delivery, plus also receives additional nutrition and culinary education and support throughout the trial.

Intervention Type DIETARY_SUPPLEMENT

Eligibility Criteria

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Inclusion Criteria

* 18 years of age and older
* Pregnant patients \>10 weeks and \<22 weeks gestation at randomization (must be consented by 20 weeks)
* Eligible for Medicaid
* Singleton pregnancy, confirmed by ultrasound
* An established patient of the UH or Metro pregnancy clinic
* English speaking
* Lives in Cuyahoga County, Ohio

Exclusion Criteria

* Under 18 years old
Minimum Eligible Age

18 Years

Maximum Eligible Age

55 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

Yes

Sponsors

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National Institute of Nursing Research (NINR)

NIH

Sponsor Role collaborator

University Hospitals Cleveland Medical Center

OTHER

Sponsor Role collaborator

MetroHealth Medical Center

OTHER

Sponsor Role collaborator

Greater Cleveland Food Bank

UNKNOWN

Sponsor Role collaborator

Case Western Reserve University

OTHER

Sponsor Role lead

Responsible Party

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Elaine Borawski

Vice Chair for Applied Research, Department of Nutrition

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Elaine A Borawski, PhD

Role: PRINCIPAL_INVESTIGATOR

Case Western Reserve University

Locations

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MetroHealth Medical Center

Cleveland, Ohio, United States

Site Status RECRUITING

University Hospitals Rainbow Ahuja Women and Children's Center

Cleveland, Ohio, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Samantha Bentley, MPH

Role: CONTACT

216-368-1024

Elaine A Borawski, PhD

Role: CONTACT

216-368-1024

Facility Contacts

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Kelly Gibson, MD

Role: primary

216-778-7076

Christopher Nau, MD

Role: primary

216-844-1000

Provided Documents

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Document Type: Informed Consent Form

View Document

Other Identifiers

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R01NR021490

Identifier Type: NIH

Identifier Source: secondary_id

View Link

STUDY20241029

Identifier Type: -

Identifier Source: org_study_id

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