Development of a User-Centered Approach for Screening, Referral, and Enrollment Food as Medicine rural and urban adults

Project Summary Our proposal addresses the research question posed on the RFP of “what are effective ways to screen, refer, and enroll patients within the complex healthcare system.” Our proposal utilizes an implementation science approach using the Consolidated Framework for Implementation Research (CFIR), with a user-centered design focus. We are bringing together healthcare and industry partners for screening, referral, and enrollment in food is medicine (FIM) programs to determine which model(s) are most appropriate and effective in the short-term, while also collecting data to inform design considerations for long-term utilization and scalability among individuals experiencing food insecurity and diet-sensitive chronic disease. As part of our current efforts screening and referring individuals into FIM programs within a large urban and rural hospital system, we have learned about the pain points and inconsistencies associated with face-to-face screening, referral, and enrollment. Based on our preliminary work, we are proposing to test a centralized referral system with automatic screening among a geographically (extreme poverty rural and urban) and racially diverse (African American/Black and White) adult Medicaid population with hypertension in Kentucky. We aim to capture the whole user experience with screening, referral, enrollment, and engagement. Our study leverages our existing funded FIM programs (Kentucky Association of Health Plans and Anthem/ Elevance; IRB88696 and IRB86500 and NCT06033664 and NCT05979519 PI: Gustafson, A) to capture the whole user experience to examine the key factors in implementation of screening with the Hunger Vital Sign screener, referral to FIM programs, FIM enrollment, and engagement. Additional outcomes of interest include changes in food security status; changes in blood pressure; and cost efficiencies.