# Preparing a Food Insecurity Intervention for Implementation

> **NIH NIH R01** · INDIANA UNIVERSITY INDIANAPOLIS · 2024 · $109,959

## Abstract

Abstract of the Parent Award (R01MD017961)
Food insecurity, defined by the United Nations as inconsistent access to a sufficient quantity of affordable,
nutritious food, is a prevalent social determinant of health (SDOH) among safety-net primary care patients.
Among adults with food insecurity, conditions like hypertension (hypertension) and type 2 diabetes (type 2
diabetes) are as much as two times more prevalent. Widely available chronic disease self-management
education and support (SMES) programs place much emphasis on nutrition education but do not significantly
address access to affordable, nutritious food or meals. Notably, simulations have shown that medically-tailored
meals for food-insecure adults could be as cost-effective as some commonly prescribed medications.
Drawing upon our knowledge of systems engineering and user-centered design, our team created and
successfully piloted a novel, dietitian-led sociotechnical intervention called Food Resources & Kitchen Skills
(FoRKS). Safety-net primary care patient-participants (N=20 across two pilots) received essential home
cooking tools, home delivered lower sodium, lower-carbohydrate Mediterranean-style meals and ingredients,
and twice- weekly hands-on home cooking classes. Mean attendance was 87% and mean satisfaction was
4.7/5.0 for delivered foods and 4.9/5.0 for hands-on cooking class. Webex videoconference classes allowed
participants to learn and cook together in a socially supportive “space” from their own home kitchen.
We proposed a randomized controlled trial to evaluate FoRKS versus enhanced usual care (EUC). Safety-net
primary care patients aged 35 years or over with food insecurity and systolic blood pressure ≥120 mm Hg
(~40% will also have type 2 diabetes) will be invited, consented, assessed, and randomized. EUC consists of
SDOH screening, referrals to food pantries, and assistance enrolling in food programs (e.g., SNAP). EUC also
consists of our CDC-approved 5-week SMES program. Those randomized to FoRKS will, in addition to EUC,
receive home-delivered meals and ingredient kits, and twice-weekly Webex cooking classes to week 16. In
week 17, participants will transition from FoRKS-delivered foods to shopping for affordable, nutritious foods.
FoRKS classes will continue in order to maintain learning and social support that may be critical to longer-term
engagement and self-efficacy for obtaining and preparing nutritious food.
The primary hypothesis is that, relative to EUC, FoRKS participants will experience lower mean systolic blood
pressure immediately post-intervention (16 weeks post-baseline). Maintenance to 24-weeks post-baseline will
also be assessed. Food security, nutrition, and HbA1c will also be evaluated as will cost-effectiveness and
behavioral mechanisms such as learning engagement, self-efficacy, and food resource management skills.

## Key facts

- **NIH application ID:** 10977165
- **Project number:** 3R01MD017961-03S1
- **Recipient organization:** INDIANA UNIVERSITY INDIANAPOLIS
- **Principal Investigator:** DANIEL O CLARK
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $109,959
- **Award type:** 3
- **Project period:** 2022-09-22 → 2025-03-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10977165

## Citation

> US National Institutes of Health, RePORTER application 10977165, Preparing a Food Insecurity Intervention for Implementation (3R01MD017961-03S1). Retrieved via AI Analytics 2026-05-27 from https://api.ai-analytics.org/grant/nih/10977165. Licensed CC0.

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