Toward health promotion and prevention: Evidence from a food and health partnership model of care
研究了一种将初级医疗服务与社区食品援助相结合的伙伴模式，发现依从者体重指数稳定，高共病和高使用频率者体重和糖化血红蛋白显著下降，且就诊模式与食品安全人群一致。
Abstract Health promotion and disease prevention requires health systems address the patients' social needs using new care delivery models. Yet, research in this area has stalled for several reasons. We study a partnership model of care that couples clinical care delivered by primary care providers and social services delivered by community‐based organizations, and its impact on patients' preventive health outcomes and behaviors. We use data from the Mid‐Ohio Farmacy, which is a collaboration across the Mid‐Ohio Food Collective (MOFC), a network of 650+ affiliated food pantries, and a large federally qualified health center (FQHC). The FQHC offers primary and preventative healthcare services across eight free clinics, which are co‐located with the MOFC‐affiliated food pantries. Patients were screened for food insecurity during their clinic visit and, if positive, were referred to the Farmacy. Compliers made at least one visit to the food pantry after referral, while noncompliers did not. Using difference‐in‐differences, we find that compliers had no discernible change in their body mass index (BMI, kg/m 2 ), which we refer to as a BMI stabilization effect. Noncompliers' BMI increased after referral. High comorbid and high pantry use compliers experienced a significant reduction in their BMI and a marginally significant reduction in glycated hemoglobin (HbA1c, %). These patients had unique compliance behaviors, including greater search, frequency, and consistency of food pantry use. Travel costs suggests that high comorbid patients ascribed a greater value to the Farmacy program. In terms of primary care utilization, we find that compliers' clinic visit patterns after referral were consistent with the visit patterns observed in the food secure cohort, suggesting that the Farmacy program may have helped compliers address competing demands that are known to inhibit health behaviors.