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Trial registered on ANZCTR
Registration number
ACTRN12621000404820
Ethics application status
Approved
Date submitted
1/02/2021
Date registered
14/04/2021
Date last updated
5/04/2022
Date data sharing statement initially provided
14/04/2021
Type of registration
Retrospectively registered
Titles & IDs
Public title
Food is medicine: pilot testing a ‘Food Farmacy’ program in food-insecure adults with poorly controlled type 2 diabetes in Australia
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Scientific title
Food is medicine: the effect of a pilot ‘Food Farmacy’ program on dietary quality in food-insecure adults with poorly controlled type 2 diabetes in Australia
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Secondary ID [1]
303211
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None
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Universal Trial Number (UTN)
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Trial acronym
None
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Linked study record
N/A
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Health condition
Health condition(s) or problem(s) studied:
Type 2 Diabetes
320360
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Food insecurity
320926
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Condition category
Condition code
Diet and Nutrition
318266
318266
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0
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Other diet and nutrition disorders
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Metabolic and Endocrine
318734
318734
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0
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Diabetes
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Each participant will receive a ‘prescription’ for healthy food boxes which meet Australian Dietary Guidelines and were developed specifically for this study. The participants will have healthy food boxes delivered to them weekly by the study food supplier for a period of 12 weeks. Orders will be placed by study staff at a delivery time convenient for the participant
and each participant will receive the same content. The prescription will also contain simple recipes using foods available in the healthy food boxes. In addition, the prescription will allow the participants to have fortnightly telephone appointments (up to 30-minutes) with trained accredited dietitian capable of offering behaviour change support, who will provide dietary advice, including a specific focus on how to store and cook the healthy foods provided to the participants.
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Intervention code [1]
319526
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Treatment: Other
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Comparator / control treatment
None
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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Changes in dietary quality of the participants, as assessed by the Alternate Healthy Eating Index (AHEI).
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Assessment method [1]
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Timepoint [1]
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3 months post-commencement of intervention
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Secondary outcome [1]
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Feasibility will be assessed as a composite of attrition rates, dietary counselling participation rates, adoption of healthy food boxes. These outcomes will be measured by audit of study database.
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Assessment method [1]
390738
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Timepoint [1]
390738
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3 months post-commencement of intervention
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Secondary outcome [2]
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Acceptability of the content in the healthy food boxes will be measured by routine monitoring data (questions asked by the dietician at fortnightly dietary consultations), self-administered questionnaire and the semi-structured interviews. All questions, self-administered questionnaires and interviews are deigned specifically for this study.
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Assessment method [2]
392737
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Timepoint [2]
392737
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3 months post-commencement of intervention
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Eligibility
Key inclusion criteria
- Adults (greater than or equal to 18 years of age) who have had clinically diagnosed type 2 diabetes for at least 6 months, which is poorly controlled (defined as measured HbA1c greater than or equal to 8% at their most recent clinical assessment).
- Food insecure based on a two-item questionnaire. This two-item questionnaire is based on Questions 1 & 2 of the U.S. Household Food Security Survey and has been validated for use as a screening tool in the health care setting.
- Live within the distribution zone of the study food supplier.
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
- Unable or unwilling to provide informed consent.
- Anyone not planning to stay within their home in Sydney area in the next 4 months.
- On hospice or palliative care.
- Living in a facility that provides meals.
- Does not have refrigerators at home for storing study foods.
- Existing medical conditions that may preclude participants from being able to complete data collection, or result in limited diets, including for example: active cancer, chronic kidney disease (stages 4-5), and coeliac disease.
- Pregnant women, and if sexually active, not using regular contraception.
- People participating in any other lifestyle modification research projects (for example, the Pasifika Preventing Diabetes Programme, a concurrent trial underway in the western Sydney area).
- Another household member already participating in the study
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
N/A
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
N/A
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Single group
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
Baseline subject demographic characteristics will be summarized as mean ±SD or median (inter-quartile range) for continuous variables and frequency (n and %) for categorical variables. Self-reported dietary intake of major food groups (fruits, vegetables, nuts, fish or seafood, meat or meat products, dairy products, alcohol, cereal) and macronutrient intake (protein, carbohydrate, major-groups of dietary fat) at baseline and end of trial will be summarized as servings per day and percentage of total daily energy, respectively.
Exploratory outcomes will include HbA1c, lipid levels, micronutrient status (as measured by blood test), blood pressure (as measured by sphygmomanometer), body weight (as measured by weighing scales) and waist circumference (as measured by tape measure) measured at baseline and 3 months. These are considered exploratory outcomes as the study is not powered to detect treatment effect in these outcomes.
Differences in post- and pre-intervention mean AHEI score (the primary outcome) and the exploratory outcomes (HbA1c and blood pressure etc) will be assessed by paired t-test or Mann-Whitney test as appropriate depending on data distribution.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
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Actual
18/12/2020
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Date of last participant enrolment
Anticipated
30/06/2021
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Actual
30/07/2021
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Date of last data collection
Anticipated
30/11/2021
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Actual
31/10/2021
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Sample size
Target
50
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Accrual to date
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Final
50
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Recruitment in Australia
Recruitment state(s)
NSW
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Recruitment hospital [1]
18465
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Royal Prince Alfred Hospital - Camperdown
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Recruitment postcode(s) [1]
32574
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2050 - Camperdown
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Funding & Sponsors
Funding source category [1]
307615
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Government body
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Name [1]
307615
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NHMRC
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Address [1]
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16 Marcus Clarke St,
Canberra ACT 2601
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Country [1]
307615
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Australia
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Primary sponsor type
Other Collaborative groups
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Name
The George Institute for Global Heath
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Address
Level 5, 1 King St
Newtown
NSW 2042
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Country
Australia
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Secondary sponsor category [1]
308322
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None
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Name [1]
308322
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Address [1]
308322
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Country [1]
308322
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
307666
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Sydney Local Health District Ethics Review Committee (RPAH Zone)
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Ethics committee address [1]
307666
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50 Missenden Rd Camperdown NSW 2050
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Ethics committee country [1]
307666
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Australia
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Date submitted for ethics approval [1]
307666
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24/08/2020
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Approval date [1]
307666
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09/10/2020
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Ethics approval number [1]
307666
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Summary
Brief summary
‘Food is medicine’ programs incorporate provision of healthy foods into the medical system to help improve population diets and complement pharmacologic treatment of non-communicable diseases. Healthy ‘Food Farmacy’ is one such approach, which allows physicians and other health professionals to prescribe healthy food for lower-income or food-insecure patients, in combination with nutrition education and related social support to synergistically improve health behaviour. This is a pilot healthy Food Farmacy trial that will recruit food-insecure patients with poorly-controlled type 2 diabetes (T2D) via physician consultations at hospital sites in Sydney. Participants will be prescribed food boxes comprising of healthy foods such as whole grains, fruits, vegetables, nuts/nut butters, and low-fat unsweetened dairy products; which will be provided to them weekly over 3 months. In addition, participants will be provided simple recipes as well as fortnightly dietary consultations on nutrition education and cooking tips. The primary outcome of interest in this pilot study is to understand the effects of the Food Farmacy intervention on dietary behaviour in patients. In addition, this trial will assess the feasibility and acceptability of the intervention by collecting feedback from key stakeholders. Finally, effects of the Food Farmacy on food security, clinical risk factors and household behaviours will be explored before and after the intervention.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
108062
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A/Prof Jason Wu
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Address
108062
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The George Institute for Global Health
Level 5, 1 King St
Newtown
NSW 2042
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Country
108062
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Australia
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Phone
108062
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+61 2 8052 4648
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Fax
108062
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Email
108062
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[email protected]
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Contact person for public queries
Name
108063
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Jason Wu
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Address
108063
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The George Institute for Global Health
Level 5, 1 King St
Newtown
NSW 2042
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Country
108063
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Australia
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Phone
108063
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+61 2 8052 4648
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Fax
108063
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Email
108063
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[email protected]
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Contact person for scientific queries
Name
108064
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Jason Wu
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Address
108064
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The George Institute for Global Health
Level 5, 1 King St
Newtown
NSW 2042
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Country
108064
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Australia
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Phone
108064
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+61 2 8052 4648
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Fax
108064
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Email
108064
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Doc. No.
Type
Citation
Link
Email
Other Details
Attachment
10301
Ethical approval
[email protected]
Request made to Chief Investigator
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
Testing the Feasibility and Dietary Impact of a "Produce Prescription" Program for Adults with Undermanaged Type 2 Diabetes and Food Insecurity in Australia.
2022
https://dx.doi.org/10.1093/jn/nxac152
N.B. These documents automatically identified may not have been verified by the study sponsor.
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