Blue Cross NC, UNC Health Study Food Security, Hypertension
In April 2021, Healthcare Innovation detailed several of Blue Cross and Blue Shield of North Carolina’s initiatives to address food insecurity. Now Blue Cross NC has dedicated $3.2 million for a large clinical study to address food insecurity among its at-risk members who also have hypertension.
The study will measure how to best help people who are food insecure achieve better health through nutrition. UNC-Chapel Hill researchers are leading the study, in conjunction with the UNC Health Alliance, UNC Health’s statewide, clinically integrated physician network and population health services organization. Blue Cross NC, with support from its data scientists and analysts, is collaborating as a co-principal investigator of the study.
In North Carolina, 1.6 million people are estimated to be food-insecure, including one in five children.
“Our immediate goal is to find the best interventions to help Blue Cross NC members who are food insecure and have high blood pressure, a common condition related to many other health issues,” said study co-leader Darren DeWalt, M.D., M.P.H., a practicing primary care doctor with UNC Health and director of the UNC Institute for Healthcare Quality Improvement at the UNC School of Medicine, in a statement. “Our overall goal is to create and sustain research-backed, nutrition-based interventions for anyone dealing with food insecurity.”
Study co-leaders are Alice Ammerman, Dr.PH., the Mildred Kaufman Distinguished Professor of Nutrition at the UNC Gillings School of Global Public Health and director of the UNC Center for Health Promotion and Disease Prevention, and Seth Berkowitz, M.D., M.P.H., assistant professor in the UNC Department of Medicine and member of the UNC Cecil G. Sheps Center for Health Services Research.
The research team will enroll 1,400 eligible Blue Cross NC members with hypertension, who are also experiencing food insecurity. Recruitment for the study is set to begin in the fall of this year through the end of 2023, with results expected in 2024.
Based on screening questions around access to nutritious, sufficient food, each participant in the study will receive an intervention. One group of individuals will receive a $40 grocery store voucher each month to use towards fresh, frozen or shelf-stable produce. A second group will receive a box of healthful, affordable foods delivered to them twice a month, with foods such as seasonal vegetables from North Carolina farms, grains, healthful oils, nuts, etc.
To test how lifestyle support helps individuals develop healthy habits, half of the participants from each group will also receive educational materials, including samples, demonstrations, and video instruction on how to prepare delicious meals, and they will receive direct assistance from UNC Health Alliance community health workers and registered dietitians, who will help participants understand dietary guidelines, prepare healthy meals, find affordable nutritious foods near them and identify resources to aid them in other aspects of life that contribute to food insecurity. Lifestyle support from the UNC Health Alliance staff will be offered for six months for one set of participants, and 12 months for the other set. These trained staff members and other providers will continue to help participants after the study is complete.
“We are very interested to understand and address the core drivers of health outcomes, which are often rooted in social factors like food insecurity,” said Mark Gwynne, D.O., president of UNC Health Alliance, in a statement. “If we understand more deeply, and invest resources more wisely, we can help patients overcome these barriers and hopefully improve their health and well-being.”
Blue Cross NC members who receive care from practices affiliated with UNC Health are eligible for the study. The research team will be enrolling only individuals with a diagnosis of high blood pressure and who have screened positive for food insecurity.
