# A clinical-community partnership to understand health impacts of a food insecurity intervention

> **NIH NIH R01** · UNIV OF MASSACHUSETTS MED SCH WORCESTER · 2024 · $572,796

## Abstract

Project Summary
Food insecurity exacts a devastating toll on U.S. families and reflects a long history of structural injustices.
Experiences of food insecurity are associated with higher rates of chronic disease, greater health care costs
and higher acute health care utilization compared to food secure populations. To address food insecurity and
reduce health disparities, there has been a rapid increase in health care-based delivery of food insecurity
interventions. However, evidence demonstrating impacts of food interventions to improve health outcomes
remains mixed. Most existing food interventions act downstream, solely at the individual level, and focus on
delivering food as treatment rather than prevention. There is an urgent need to identify more holistic, patient-
centered food insecurity interventions, and understand their effectiveness in improving health across diverse
populations. This proposal leverages a strong clinical-community partnership that was formed under a
Massachusetts Medicaid (MassHealth) 1115 waiver demonstration to encourage clinical-community
collaboration to identify and address food insecurity as part of value-based care. Under the MassHealth
demonstration, community based organizations (CBOs) design the food insecurity interventions, which are
implemented in partnership with health care organizations. There is growing interest in not only understanding
impacts of state-incentivized food interventions on health, but how to sustain the program and refine program
implementation to achieve the greatest benefit for the largest number of participants. Given the natural
experiment in food intervention delivery unfolding across Massachusetts, we propose a hybrid implementation
and effectiveness evaluation of a multi-component nutrition program developed as a clinical-community
partnership. Aim 1: Quantify the effects of a multi-component food insecurity intervention on clinical outcomes
among Medicaid enrollees with diabetes, hypertension and depression receiving care at a large federally
qualified health center. Using a quasi-experimental difference-in-difference design we will compare health
outcomes between participants and two separate propensity weighted comparators. Aim 2: Evaluate the
impacts of a multi-component food insecurity intervention on (a) cost and (b) health care utilization among
adult and children Medicaid enrollees receiving care at a federally qualified health center. Using administrative
claims data, we will compare changes in total cost of care and acute health care utilization (ED visits, inpatient
hospitalization days) between participants and propensity weighted comparators. Aim 3: Using the I-PARIHS
implementation framework, identify determinants of implementing a food insecurity intervention for scaling and
sustainment.

## Key facts

- **NIH application ID:** 11060343
- **Project number:** 1R01NR021522-01
- **Recipient organization:** UNIV OF MASSACHUSETTS MED SCH WORCESTER
- **Principal Investigator:** Elena Byhoff
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $572,796
- **Award type:** 1
- **Project period:** 2024-09-04 → 2029-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/11060343

## Citation

> US National Institutes of Health, RePORTER application 11060343, A clinical-community partnership to understand health impacts of a food insecurity intervention (1R01NR021522-01). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/11060343. Licensed CC0.

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